Morton’s neuroma is a painful foot condition that affects the nerves between the toes, most commonly between the third and fourth toes. This thickening of nerve tissue, often caused by compression or irritation, leads to sharp, burning pain in the ball of the foot. While Morton’s neuroma isn’t life-threatening, it can significantly impact mobility and daily activities if left untreated.
At The Foot Institute, our expert foot and ankle pain podiatrists frequently diagnose and treat Morton’s neuroma in patients experiencing persistent forefoot pain. Understanding the symptoms, causes, and treatment options can help individuals seek timely care and prevent worsening discomfort.
What Causes Morton’s Neuroma?
Morton’s neuroma develops when a nerve in the forefoot becomes compressed, irritated, or damaged, leading to inflammation and thickening. Several factors contribute to this condition:
- Footwear choices. Tight, narrow, or high-heeled shoes squeeze the toes, increasing pressure on the nerves.
- Foot deformities. Conditions like bunions, hammertoes, or flat feet alter foot mechanics, straining the nerves.
- Repetitive stress. High-impact activities (running, jumping) or occupations requiring prolonged standing may aggravate nerve tissue.
- Trauma. Injuries to the forefoot, such as stubbing or dropping something heavy on the toes, can trigger neuroma formation.
- Biomechanical issues. Abnormal gait or excessive pronation (rolling inward of the feet) places extra stress on the metatarsals.
While anyone can develop Morton’s neuroma, it’s more common in women (likely due to footwear habits) and individuals aged 40–60.
Symptoms of Morton’s Neuroma
Patients with Morton’s neuroma often describe distinct sensations in the forefoot. Common symptoms include:
- Burning or sharp pain. Typically localized between the third and fourth toes, worsening with activity or tight shoes.
- Tingling or numbness. A "pins and needles" sensation radiating toward the toes.
- Feeling of a lump. Some describe the sensation of standing on a pebble or folded sock.
- Symptom relief with rest. Removing shoes and massaging the foot may temporarily ease discomfort.
Symptoms often develop gradually and intensify over time. Without intervention, the pain may become chronic, limiting mobility.
Diagnosing Morton’s Neuroma
Podiatrists at The Foot Institute use a combination of methods to diagnose Morton’s neuroma:
- Physical examination. The foot is palpated to identify tender spots or a "click" (Mulder’s sign) when squeezing the forefoot.
- Imaging tests. X-rays rule out fractures or arthritis, while ultrasound or MRI can visualize nerve thickening.
- Gait analysis. Assessing walking patterns helps identify contributing biomechanical issues.
Early diagnosis improves treatment outcomes, so patients experiencing persistent forefoot pain should schedule an evaluation.
Conservative Treatment Options
Most cases of Morton’s neuroma respond well to non-surgical treatments. Podiatrists may recommend:
- Footwear modifications. Switching to a more appropriate and relieving footwear choice like wide-toe-box, low-heeled shoes can reduce nerve compression.
- Orthotic devices. Custom or over-the-counter arch supports redistribute pressure away from the affected nerve.
- Padding or taping. Metatarsal pads or athletic tape can separate and cushion the toes.
- Anti-inflammatory medications. NSAIDs (e.g., ibuprofen) help reduce swelling and pain.
- Corticosteroid injections. Targeted injections decrease inflammation around the nerve for months of relief.
- Physical therapy. Stretching and strengthening exercises improve foot mechanics.
- Activity modifications. Temporarily avoiding high-impact activities prevents further irritation.
Patients typically try conservative therapies for 3–6 months before considering surgery.
Surgical Treatment for Morton’s Neuroma
If conservative measures fail, surgery may be recommended. Two common approaches include:
- Neurectomy. The damaged nerve segment is removed, eliminating pain but potentially causing permanent numbness in the affected toes.
- Decompression surgery. Ligaments pressing on the nerve are released to relieve pressure.
Recovery varies but generally involves 2–4 weeks in a postoperative shoe, with full recovery taking several months.
Preventing Morton’s Neuroma Recurrence
To reduce the risk of recurrence after treatment:
- Wear supportive footwear. Avoid narrow or high-heeled shoes long-term.
- Use orthotics as prescribed. Custom inserts maintain proper foot alignment.
- Stretch and strengthen. Calf and toe stretches improve flexibility.
- Monitor symptoms. Address discomfort early to prevent worsening.
When to See a Podiatrist
Consult a foot doctor in Texas at The Foot Institute if you experience:
- Persistent forefoot pain unrelieved by rest or shoe changes
- Numbness or tingling interfering with daily activities
- Difficulty walking due to discomfort
Early intervention improves outcomes for Morton’s neuroma.