What is Morton's Neuroma? A Podiatrist Explains the Causes and Treatment
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A podiatrist explains what Morton's neuroma is, what causes that burning pain in the ball of your foot, and how it is treated.
By Sophie McLellan, Co-Owner & Podiatrist, Little Big Feet Podiatry, Brisbane
Key Facts
- What it isA thickened, irritated nerve in the ball of the foot, most often between the third and fourth toes.
- Most at riskPeople in tight or narrow shoes and high heels, and those with unstable foot biomechanics.
- Common symptomsBurning or tingling in the ball of the foot, sometimes like standing on a pebble, with pain spreading into the toes.
- Primary treatmentRoomier, wider footwear, orthotic offloading, and a podiatry review, with cortisone or surgery reserved for chronic cases.
What is Morton's neuroma?
Morton’s Neuroma is an interdigital neuroma commonly located between the 3rd and 4th toes. It is caused by an entrapped nerve running between the long metatarsal bones which becomes inflamed and thickened over time due to constant irritation by the surrounding structures. People commonly complain of a burning or tingling sensation.
What causes Morton's neuroma?
Morton's Neuroma is typically caused by ill-fitting footwear (typically too tight at the forefoot) and or poor biomechanics and instability. Neuromas may be diagnosed by Podiatrists in the clinical setting; however, ultrasound may be used to confirm the diagnosis. Often Podiatrists will reproduce the pain and elicit a ‘click’ when squeezing the forefoot by applying simultaneous pressure both medially and laterally.
How is Morton's neuroma treated?
Treatment of this presentation will depend on the severity of the symptoms. Podiatrists can implement footwear and orthotic modifications to offload the offending neuroma, which may be sufficient to reduce, or in some instances completely resolve the symptoms when utilising the recommended footwear/orthotics. More chronic neuromas may require cortisone injections and, in some instances, surgical removal of the entrapped nerve.
The Comfort Co Breakdown
Morton's neuroma, in plainer English
Morton's neuroma is a nerve between your toes, usually the third and fourth, getting squeezed and irritated until it thickens and starts to burn. The classic description is a hot, tingling pain in the ball of the foot, or the feeling that you are standing on a pebble in your sock.
Why is the ball of my foot burning?
Tight forefoot shoes. Narrow, pointed or shallow shoes and high heels crowd the toes and press right on the nerve.
How your foot moves. Unstable biomechanics can load the forefoot unevenly, keeping the nerve under constant pressure.
Repeated irritation. The more the nerve is compressed day after day, the more it thickens and the more it hurts.
What happens if I ignore it?
Left irritated, the nerve tends to thicken further and the pain can become harder to settle, which is when injections or surgery start to enter the picture. Giving the forefoot room early is far easier than treating a stubborn neuroma later.
Written by The Comfort Co team.
Symptoms, timeline and self-care
Morton's neuroma has a recognisable feel, and small footwear changes often make a real difference early on.
The tell: burning and a "pebble" feeling
The most common symptoms are burning, tingling or numbness in the ball of the foot, pain that spreads into the toes, and the sensation of standing on a small stone or a bunched-up sock. It often eases when you take your shoes off and rub the area.1
What tends to make it worse
Tight, narrow or high-heeled shoes and long periods on hard ground usually flare it, because they keep the forefoot compressed and the nerve under pressure.2
What you can do at home
Switch to shoes with a wide, deep toe box and a low heel, cut back on the activity that flares it, and give the area a rest and a gentle massage after time on your feet. A supportive insole can also help spread the load across the forefoot. If the pain persists, have it assessed rather than pushing through it.2
The Comfort Co Solutions
Chances are the thing that flared your Morton's neuroma is shoes that crowd the forefoot, so the goal is simple: give the toes room and take the pressure off the nerve. Footwear does most of that work.
1. Give the forefoot room
A wide, deep toe box lets the nerve sit without being squeezed. Browse the wide fit collection for roomy everyday styles, and if you want a cushioned starting point we really rate the Vitasole Walker.
2. Offload the nerve with insoles
A supportive insole can spread pressure across the forefoot and steady how your foot loads, which takes the constant irritation off the nerve. Have a look through the insoles range. If you already have a diagnosed neuroma, see a podiatrist first, since any orthotic will likely need to be custom made.
3. Get the fit right in store
Shoes that fit properly are half the battle, and the most accurate way to get sized is in person. Pop into a Comfort Co showroom in Upper Hutt or Hamilton and the team can check your length, width and fit so you leave in a pair that suits your feet.
Comfort Co Pro Tip
Give the pointed heels and narrow flats a rest while the nerve settles. Even an hour a day crammed into a tight toe box keeps the pressure on, so save the snug styles for once you are pain-free.
Keep Reading
Quick questions
What does Morton's neuroma feel like?
It usually feels like burning, tingling or numbness in the ball of the foot, often spreading into the third and fourth toes. Many people describe the sensation of standing on a pebble or a bunched-up sock.
What causes Morton's neuroma?
It is most often caused by shoes that are too tight or narrow at the forefoot, including high heels, and by foot biomechanics that keep the nerve under pressure. Over time the nerve becomes irritated and thickened.
What shoes are best for Morton's neuroma?
Shoes with a wide, deep toe box and a low heel take pressure off the nerve. A supportive insole to spread the load across the forefoot helps too. Narrow, pointed or high-heeled shoes tend to make it worse.
Does Morton's neuroma go away on its own?
Mild cases can settle once you move into roomier shoes and offload the nerve early. More stubborn or thickened neuromas usually need a podiatrist, and sometimes cortisone injections or surgery.
When should you see a podiatrist for Morton's neuroma?
See a podiatrist if the burning, tingling or numbness persists despite roomier shoes, if you feel a lump underfoot, or if the pain keeps returning. Early offloading gives the best chance of avoiding injections or surgery.
Sources
- Cleveland Clinic. Morton's Neuroma. my.clevelandclinic.org
- OrthoInfo, American Academy of Orthopaedic Surgeons. Morton's Neuroma. orthoinfo.aaos.org