Morton's Neuroma
Reviewed by Andrew Schox, BSc(Hons) PGradDipPod MPod, October 2026
Morton's neuroma is a painful problem with a nerve in the ball of your foot, usually between the third and fourth toes. Despite the name, it isn't a true tumour. The nerve becomes thickened and irritated, with scar-like tissue around it. About 4 per cent of people are affected, most often women in their late 40s or early 50s. The main symptom is burning, stabbing or shooting pain, sometimes with tingling or a feeling of walking on a pebble. Non-surgical care comes first, and many people find their pain improves or settles with the right plan.
What is it?
Morton's neuroma is a painful problem with a nerve in the ball of your foot. The nerve runs between the long bones of your foot (the metatarsals) and out to your toes. It most often happens in the space between the third and fourth toes, and less often between the second and third.
Despite its name, it isn't a true tumour and it isn't cancer. The nerve becomes thickened, with scar-like tissue growing around it. Some people use the name Morton's metatarsalgia (pain in the ball of the foot) instead, but Morton's neuroma is still the name most people recognise.
Who does it affect?
About 4 per cent of people are affected. After carpal tunnel syndrome (a pinched nerve in the wrist), it is the most common pinched-nerve problem.
It is most often seen in women in their late 40s or early 50s. Many people with it are active, and running and dancing are often linked with it.
Signs and symptoms
The pain usually starts in the ball of your foot, often between the third and fourth toes, and can spread into the toes. People describe it as burning, stabbing or shooting. You may also have tingling or numbness between the toes, or feel as if you are walking on a pebble or a lump.
Symptoms are usually worse when your foot is squeezed into a shoe, and when you stand or walk. Taking off your shoes and massaging the area often eases the pain. The pain typically settles when you rest and returns when you put weight on the foot.
In severe cases, it can make it harder to get around and do the things you enjoy, and it can affect your quality of life.
What causes it?
The exact cause isn't known. It is most likely a nerve problem brought on by repeated strain. The nerve may be squeezed, rubbed or stretched. A reduced blood supply to the nerve, or irritation from an inflamed fluid-filled sac (a bursa) nearby, may also play a part. Over time the damage can make the nerve thicker, which causes more irritation and more symptoms.
Several things are linked with it:
- narrow, pointed or high-heeled shoes
- heavy loading of the front of the foot
- bunions or hammer toes (toes that bend at the middle joint)
- tight calf muscles
- long periods of standing, walking or running, especially after a sudden increase in activity
- being overweight
- a past foot injury, or arthritis that causes inflammation
- weak muscles in the foot or leg
These are links, not proof. It isn't clear that tight shoes cause the nerve to thicken, so no single thing can be blamed for your neuroma.
How is it diagnosed?
Your podiatrist will mainly use your story and an examination. They will ask where the pain is, what brings it on (shoes, standing, walking) and whether it eases when you rest or take your shoes off. They will press on your foot and squeeze across the ball of it. Sometimes this produces a click, known as Mulder's click.
No single test is enough on its own to confirm it. An ultrasound or MRI scan can show a thickened nerve, but a thickened nerve can be there without causing any pain. Your podiatrist will weigh up your scan results alongside your symptoms.
Several other foot problems can feel like Morton's neuroma, and some can happen alongside it. These include damage to the tissue under the toe joint (a plantar plate injury), an inflamed bursa, inflamed or unstable toe joints, and a stress fracture (a small crack in a bone). If your pain is in an unusual spot, or you have more than one painful area on the same foot, your podiatrist may look for other causes.
Treatment
Non-surgical care comes first. It isn't yet known which of the non-surgical treatments works best, so your podiatrist will usually start with simple steps and build from there.
Looking after it at home
Choose shoes that are long, with a wide, deep toe box (the front part where your toes sit), a low or flat heel and a thick sole that doesn't bend too easily. A shoe with a curved, rocker-style sole may help. Avoid high-heeled, narrow or pointed shoes.
Cut back the activities that bring on your pain. If you are carrying extra weight, losing some may ease the load on your foot. When the pain flares, taking your shoes off and gently massaging the area can help.
Treatment from your podiatrist
Your podiatrist can check your shoes and advise on a better fit. They can also show you stretches for the muscles in your foot and calf. Orthoses (shoe inserts) are another common option. Many people find their pain improves or settles with a plan that combines these steps.
Other options
If simple steps haven't helped, a steroid injection is the usual next step. An injection of steroid and local anaesthetic given with ultrasound guidance probably reduces pain and improves how well your foot works. Without ultrasound guidance it may make little difference, so it is worth asking how your injection would be given. Steroid injection did better than footwear changes or padding alone at getting people a good result.
Steroid injections can cause side effects. These include thinning of the skin (3.9 per cent), paler skin (3.9 per cent) and thinning of the fat pad under the foot (2.6 per cent). The numbers on side effects are uncertain.
Hands-on joint treatment (manipulation or mobilisation) has also shown some pain relief, though it was only followed up for a short time. Other options include shockwave therapy, alcohol injections, radiofrequency ablation (using heat to calm the nerve) and cryotherapy (using cold). It isn't yet clear how well these work. Pain during and after an alcohol injection is the most common side effect.
Surgery
Surgery is considered only after non-surgical care has failed. The surgeon removes the part of the nerve that is causing the pain. It is described as helping about 80 per cent of people.
The sides of the two toes that the nerve supplied will be permanently numb. Up to 5 per cent of people have ongoing pain at the cut end of the nerve (a stump neuroma), and they need further surgery. Other risks include nerve irritation, scarring that can occasionally be painful or inflamed, and some numbness and tingling in the toes and ball of the foot. Talk through these with your surgeon beforehand.
The risk of infection after surgery is higher in people with diabetes or rheumatoid disease, and in people who smoke. Surgeons may refuse to operate on smokers unless they stop before surgery and while the wound heals. After surgery, tell your surgical team if you have excessive pain, swelling, redness or discharge.
Recovery
It isn't yet clear how long recovery usually takes without surgery. Many people find their pain improves with a plan that includes better shoes, stretches and shoe inserts, and some find it settles completely. For others it is a longer process, so it helps to keep going with your plan and check in with your practitioner along the way.
If you have surgery, the main trade-off is the permanent numbness at the sides of the two toes, against a good chance of less pain.
Preventing it
The advice for stopping it coming back is the same as the advice for treating it. Wear roomy shoes with a deep toe box, a low heel and a thick sole, even after your symptoms settle. Avoid high-heeled, narrow and pointed shoes. How well these steps prevent it returning isn't clear yet, but they are sensible for your foot either way.
When to see a podiatrist
Book an appointment if
You have burning, tingling or pebble-like pain in the ball of your foot and want it checked. Or you have made changes to your shoes and activity and see no noticeable change after six to twelve weeks, or your pain flares markedly after exercises. Book an appointment with your podiatrist or GP.
Seek prompt assessment if
your foot pain is severe, is stopping your normal activities, is getting worse or keeps coming back, or hasn't improved after about two weeks of looking after it yourself. The same applies if you have tingling, numbness or weakness in your foot: see your GP soon. If you have diabetes, see your GP soon about any foot problem, because it can be more serious. If you think you have broken your foot or toe, don't treat it yourself, because a fracture can look like a sprain: see your GP or another doctor today. If your GP can't see you today, go to an urgent care clinic or an after-hours GP. Go to the nearest emergency department if a bone has come through the skin or your foot is at an odd angle after an injury. After surgery, tell your surgical team if you have excessive pain, swelling, redness or discharge.
Frequently asked questions
Do shoe inserts help Morton's neuroma?
Shoe inserts (orthoses) are one of the usual first steps, used alongside roomier shoes and stretches. Many people find their pain improves with this kind of combined plan. How much inserts help on their own isn't clear yet. Your podiatrist can advise whether they suit your foot.
Can I keep running or exercising?
Cutting back the activities that bring on your pain is part of looking after it. When you return to running or walking, build up gradually rather than suddenly. Your podiatrist can help you plan this around your pain and your usual activities.
When can I drive after surgery?
Before you drive again, check that you can do an emergency stop safely, and that your insurance cover is valid. Ask your surgical team when it is likely to be right for you, as it will depend on which foot was operated on and how your recovery is going.