Morton's Neuroma
Morton's neuroma is a thickening of the tissue around a nerve leading to the toes, most often between the third and fourth metatarsals. Despite the name, it is not a tumor. It is benign fibrous tissue that builds up around the digital nerve in response to chronic compression. The result is burning or sharp pain in the ball of the foot. Women are affected more often than men, particularly those who regularly wear tight, narrow, or high-heeled shoes.
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Symptoms
- Burning, stinging, or sharp pain in the ball of the foot, between the third and fourth toes
- Numbness or tingling in the affected toes
- A feeling of walking on a marble or a bunched-up sock that never smooths out
- Pain that worsens with activity or wearing narrow shoes
- Relief when removing shoes and massaging the foot
When to See a Doctor
See a foot and ankle specialist if ball-of-foot pain persists despite switching to wider footwear. Morton's neuroma is diagnosed clinically by a Mulder's click (a palpable snap when the forefoot is compressed) and confirmed with ultrasound or MRI. Conservative treatment works for most patients when started early; chronic untreated neuromas become harder to treat without surgery.
Treatment Options
Shoe modification and metatarsal padding
Wider toe box shoes and a metatarsal pad placed just behind the ball of the foot reduce nerve compression. This is first-line treatment and resolves symptoms in many patients.
Corticosteroid injection
Ultrasound-guided injection of cortisone around the neuroma reduces inflammation and pain. About 50-60% of patients get lasting relief from 1-3 injections.
Alcohol sclerosing injections
A series of dilute alcohol injections progressively destroy the nerve tissue, reducing pain without open surgery. Effective for patients who have not responded to cortisone.
Surgical excision
Removal of the neuroma through a small incision on the top of the foot. Reserved for patients who fail conservative treatment. Highly effective but leaves permanent numbness between the affected toes.
Recovery Timeline
Conservative treatment with padding and injections: 3-6 months. Sclerosing injections: 6-8 sessions over 3 months. Surgical excision: return to regular footwear in 3-6 weeks, full recovery in 3 months. About 80% of patients improve without surgery.
Frequently Asked Questions
What causes Morton's neuroma?
Chronic compression of the interdigital nerve from tight footwear, high heels, or high-impact activities causes the nerve to thicken as a protective response. The third web space is affected most often because that nerve is slightly larger where two branches converge. Flat feet, bunions, and hammertoes increase susceptibility by shifting load across the forefoot.
Can Morton's neuroma go away on its own?
Mild cases sometimes improve significantly with footwear changes alone. Switching from narrow heels to a wide-toe-box shoe removes the primary cause of compression. Established neuromas rarely fully resolve without treatment, though. The longer the nerve is compressed, the more fibrous tissue accumulates and the less effective conservative treatment becomes. Early evaluation is worth it.
Will surgery cure Morton's neuroma?
Surgical excision has a success rate of 75-85%, but it permanently removes the nerve, leaving numbness between the affected toes. Most patients consider this an acceptable tradeoff for pain relief. About 15-20% have recurrence or stump neuromas after excision, so surgery is reserved for patients who have genuinely exhausted conservative options.
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This information is for educational purposes only and is not a substitute for professional medical advice. Always consult a qualified healthcare provider for diagnosis and treatment.