Morton’s Neuroma

Morton’s neuroma is a thickening of tissue around a nerve in the ball of your foot that causes pain, tingling or numbness. It most often occurs between the bones that lead to your third and fourth toes, but it can also occur between the second and third toes.

What causes Morton’s neuroma?

Morton’s neuroma (aka interdigital neuritis) develops when an interdigital (between the toes) nerve becomes irritated, and thickened due to compression over time. It’s most common in women ages 30 to 60. It is not cancerous.

Because it is caused by nerve compression, any footwear or activity that squeezes your toes together or puts extra pressure on the ball of your foot can trigger symptoms or make them worse. 

Common causes and risk factors

These factors may make Morton’s neuroma more likely:

• Wearing tight or narrow shoes
• High heels that put pressure on the front of the foot (forefoot)
• Standing or walking on hard surfaces for long periods of time
• High-impact activities like jogging or running, especially on hard surfaces
• Sports that put pressure on the front of your foot, like racquet sports, skiing or rock climbing
• Foot issues like tight calf muscles, flat feet, high arches, hammertoe or bursitis
• Foot injuries that irritate the nerve between the toes 

Morton’s neuroma symptoms can include: 

• Burning or sharp pain in the ball of the foot that may spread to the toes or up the foot 
• Feeling like you’re stepping on a pebble or a fold in your sock when nothing is there 
• Tingling, numbness or a pins-and-needles sensation in your toes or between your toes 
• Pain that gets worse when you stand, walk, hike or run or wear tight shoes 
• Relief when you take your shoes off or massage your foot 

See a health care provider for: 

• Foot pain that does not get better with rest 
• Foot pain that does not improve after about two weeks of home treatment and changing your footwear 
• Burning or tingling in your toes 
• Pain, tingling, weakness or numbness in your foot after a foot or ankle injury 
• Pain that limits how much you can walk or do other activities 
• Symptoms that return when you wear certain shoes

Early treatment can help relieve nerve irritation and prevent symptoms from getting worse. Morton’s neuroma usually does not go away on its own. 

To diagnose Morton’s neuroma, your provider may: 

• Ask about your symptoms and footwear 
• Examine your foot and apply pressure to identify pain points and swelling, calluses or deformities that may be putting pressure on the nerve 
• Check for a clicking sensation (Mulder’s sign), where squeezing the front of the foot causes a painful click between the toes 
• Order imaging such as ultrasound or MRI, if needed 
• Rule out other conditions, like joint inflammation, plantar plate injuries, transfer metatarsalgia or Freiberg’s disease 

Many cases get better without surgery, especially when treatment starts early. 

Non-surgical treatment 

These steps may help: 

• Switching to wider, supportive shoes with a stiff sole and a rounded or rocker bottom 
• Custom or over-the-counter (OTC) shoe inserts with a metatarsal pad, to reduce pressure  
• Anti-inflammatory medications 
• Resting and elevating your foot 
• Gently massaging your foot 
• Exercises like picking up small objects with your toes, to build strength and flexibility in your feet 
• Reducing high-impact activities when symptoms flare 
• Applying ice after activity to reduce swelling 

Injections 

Corticosteroid injections can reduce inflammation, but too many injections can break down the fat pad that cushions your step or cause thinning and whitening of the skin

Surgical treatment for Morton’s neuroma 

Most people don’t need surgery for Morton’s neuroma but if the other options don’t help your provider may recommend it. Surgical options include:

• Decompression of the interdigital nerve by cutting or removing structures in the area that may be pressing on the nerve. Decompression is effective when the nerve is not substantially enlarged.
• Nerve resection (neurectomy) removes the affected part of the interdigital nerve. Neurectomy is used to treat substantially enlarged nerves and smaller neuromas when decompression fails.

Your surgeon may access the nerve from the top or bottom of your foot. You may be able to walk in a stiff soled post-op shoe or boot soon after surgery, but you will need to avoid high impact activities until your incision heals. 

You’re likely to improve with non-surgical care, especially if you start treatment early. Recovery time varies depending on the treatment you need. 

You should be able to return to your daily activities after treatment. But you may need to avoid wearing tight shoes or doing high-impact activities to help prevent Morton’s neuroma from returning. Surgery usually helps, but you may have permanent numbness in the space between your toes afterward.

These steps may help you prevent the condition: 

• Choose shoes with a wide toe box 
• Limit or avoid wearing high heels 
• Use cushioning or orthotics to lower pressure on the balls of your feet 
• Avoid repetitive high-impact stress  
• Maintain a healthy body weight 

Morton’s neuroma is a common cause of pain in the ball of the foot. With early diagnosis and the right treatment, most people get pain relief and can return to normal activity.

If you have Morton’s neuroma symptoms, turn to Banner Health for:

• Foot and ankle specialists with advanced training
• Non-surgical and surgical treatment options
• Personalized care plans based on your activity level and goals
• Access to orthotics and rehabilitation services

Schedule an evaluation with a Banner Health specialist. 

What does Morton’s neuroma feel like? 

It often feels like a burning pain in the ball of the foot or like you’re standing on a small pebble.

Will Morton’s neuroma go away on its own?

Mild symptoms may get better with footwear changes but for ongoing irritation you’ll need treatment.

What is the best treatment for Morton’s neuroma?

Treatment may include shoe changes, orthotics, injections or surgery depending on the severity of your condition.

Can I still walk or exercise with Morton’s neuroma?

Yes but modifying your activity and wearing supportive footwear can help reduce your symptoms.

Related conditions

• Plantar fasciitis
• Bunions