What is Morton’s neuroma?
Despite the name, it is not a tumour. It is a thickening of the fibrous tissue around one of the digital nerves that run between the metatarsal bones to the toes. Repeated compression, especially between the third and fourth metatarsal heads, irritates the nerve and leads to swelling and scarring. It is also called interdigital neuroma or Morton’s metatarsalgia.
Symptoms
- Burning, sharp or shooting pain in the ball of the foot.
- Tingling or numbness in the toes, usually the third and fourth.
- A feeling of a pebble, marble or folded sock under the foot.
- Pain worse when walking, running or wearing tight or high-heeled shoes.
- Relief when removing shoes and rubbing the foot.
- Sometimes a clicking sensation when squeezing the forefoot.
- Usually one foot, occasionally both.
Causes and risk factors
- Narrow, pointed or tight shoes that squeeze the toes.
- High heels that push weight onto the ball of the foot.
- High-impact sports such as running, tennis and court sports.
- Foot shape: bunions, hammer toes, flat feet or high arches.
- More common in women aged 40–60.
- Prolonged standing or walking.
How it is diagnosed
A doctor, podiatrist or physical therapist examines the foot, pressing between the metatarsal heads and squeezing the forefoot to reproduce the pain and sometimes a click (Mulder’s sign). Ultrasound or MRI can confirm the diagnosis and rule out other causes such as stress fractures, metatarsal joint inflammation (capsulitis), bursitis or arthritis. Pain under the middle of the foot is covered in our guide to foot arch pain.
Self-care and footwear
- Wear wide shoes with plenty of room for the toes.
- Choose low heels and cushioned soles.
- Use a metatarsal pad placed just behind the painful area to spread the bones.
- Try off-the-shelf insoles with metatarsal support.
- Reduce high-impact activities temporarily; swap for cycling or swimming.
- Ice the area after activity and massage the foot.
- Lose weight if overweight, to reduce load on the forefoot.
Medical treatment
If symptoms persist, a podiatrist may provide custom orthotics. A corticosteroid injection, often guided by ultrasound, can reduce pain for weeks to months, although symptoms may return. Some clinics offer alcohol sclerosing injections, radiofrequency ablation or cryotherapy, with varying evidence. Surgery is considered when other treatments fail: either releasing the ligament that compresses the nerve or removing the thickened nerve. Removing the nerve leaves permanent numbness between the toes, and recovery takes several weeks.
Exercises that may help
- Toe spreading: spread the toes wide, hold 5 seconds, 10 times.
- Towel curls to strengthen the small foot muscles.
- Calf stretches: tight calves increase forefoot pressure.
- Rolling the arch on a ball, avoiding the painful area.
- Exercises support foot health but do not replace footwear changes.
Outlook
Most people improve with conservative treatment, particularly if footwear changes are made early. Symptoms that have been present for a long time are more likely to need injections or surgery. Even after successful treatment, wearing tight or high-heeled shoes regularly can bring symptoms back.
Three common situations
- Burning pain in the ball of the foot in narrow work shoes: switching to wider shoes and adding a metatarsal pad often helps within weeks.
- Runner with toe numbness on long runs: check shoe width, lacing and training load.
- Pain persists after months of footwear changes: ask about ultrasound and injection options.
Conditions that can feel similar
- Metatarsalgia: general pain and inflammation under the ball of the foot, often from overload.
- Stress fracture of a metatarsal bone, with localised bony tenderness and swelling after increased activity.
- Capsulitis of the joint at the base of the second toe, with pain and sometimes a drifting toe.
- Intermetatarsal bursitis, which often occurs alongside a neuroma.
- Nerve problems from the back or diabetes, which usually cause more widespread numbness.
- Pain on the top of the foot has different causes; see top of foot pain.
Running and sport with Morton’s neuroma
Many runners and court-sport players can keep training with some adjustments. Choose shoes with a wide forefoot and adequate cushioning, loosen the laces across the forefoot or skip the eyelets over the painful area, and add a metatarsal pad. Reduce hill and speed work, which load the forefoot more, and build mileage gradually. If numbness or burning appears during activity, stop and let it settle rather than pushing through.
Key points to remember
- Morton’s neuroma is a thickened nerve between the toes.
- It causes burning pain and a pebble-like sensation in the ball of the foot.
- Wide, low-heeled shoes and metatarsal pads help most people.
- Injections and surgery are options for persistent symptoms.
Questions about Morton’s neuroma
These answers are general information and do not replace an examination or individual medical advice.
Can Morton’s neuroma go away on its own?
Symptoms often improve with footwear changes, but the thickening may persist. Early changes give the best chance of relief.
What shoes are best for Morton’s neuroma?
Shoes with a wide toe box, low heel and cushioned sole.
Is walking bad for Morton’s neuroma?
Walking in supportive, wide shoes is usually fine. Long walks in tight shoes can worsen symptoms.
Does massage help Morton’s neuroma?
Massaging the foot can relieve symptoms temporarily, but it does not treat the cause.
How long does recovery from Morton’s neuroma surgery take?
Many people return to normal shoes within four to six weeks, with full recovery taking several months.
Sources
This guide is for general information and does not replace medical advice. How a problem is diagnosed and treated depends on your examination and medical history. If you think you have an emergency, contact your local emergency services.