Morton's Neuroma

Medically Reviewed by Tyler Wheeler, MD on August 12, 2022
5 min read

Morton’s neuroma, also called intermetatarsal neuroma, is the thickening of tissue in your toe. This tissue is next to a nerve. Pressure against the nerve irritates it and causes pain.

You might be walking along and feel a pain near the ball of your foot, like there’s a little pebble inside your shoe. The pain usually crops up between your third and fourth toes. (That’s counting the big toe as the first.)

Women are more likely than men to get Morton’s neuroma.

Why? You can probably guess: High-heeled shoes are among the main culprits, because they put pressure on the feet. The cure may be as simple as switching to shoes with lower heels.

Morton’s neuroma has no visible sign, such as a lump. So you have to go by what you feel. The first sign may be a tingling between your toes. After that:

  • The tingling may get stronger as time goes on.
  • You may feel shooting pains around the ball or your foot or the base of your toes.
  • Your foot may feel like there’s a pebble in your shoe or a sock is bunched up. Your toes might burn or feel numb.
  • The discomfort may get worse when you’re walking or wearing shoes that squeeze your feet.
  • The pain tends to ease off at night.

Doctors don’t know exactly what causes Morton’s. It may come from the nerve to the toe being mashed, stretched, or injured. But several things can make it likelier to happen. They include:

Shoes: High heels can put pressure on your toes or the balls of your feet. Shoes that are tight or don’t fit right also can do it.

Sports: High-impact activities such as running or tennis can cause stress on the feet. Snow skiing and rock climbing, which involve tight shoes, can put pressure on your toes.

Your feet themselves: Flat feet, overly high arches, misshapen toes (“hammer toes”), or other abnormal conditions can make you more likely to get Morton’s.

If pain lasts longer than a few days, don’t ignore it. Switch to shoes that are easier on your feet. Don’t exercise as hard for a while, or do something (like swimming) that doesn’t pound on your feet.

After that, if your feet still hurt, go to your doctor. Finding the problem fast can make it much easier to deal with.

In order to tell if you have Morton’s neuroma, your doctor may only need to ask you about your symptoms and examine your foot. But you may need further tests to make sure.

To diagnose you, your doctor can use:

  • Symptom history. Your doctor will ask about the pain you’re having, when it started, the kinds of shoes you wear, and your work and other activities.
  • Physical exam. Your doctor will probably first press on your foot to check for a tender spot. If you feel a sort of click between the toes, that can also be a sign of Morton’s neuroma.
  • X-ray. An X-ray might help your doctor rule out other potential problems, such as a fracture.
  • Ultrasound. This test uses sound waves to create images and is a good way to spot Morton’s neuroma and other conditions that involve soft tissue.
  • Range of motion test. Your doctor will move your foot and toe around to see if the cause of your pain could be arthritis or joint inflammation.
  • MRI. Magnetic resonance imaging uses radio waves and a magnetic field to look at your soft tissues. Doctors don’t usually use MRIs for diagnosing Morton’s neuroma, because it’s an expensive test.

When you have Morton’s neuroma, your doctor will probably try simple solutions first, such as:

  • Shoe inserts. Pads that fit inside your shoe can reduce the pressure on your foot. Drugstores sell some kinds over the counter, which means that you don’t need a prescription. But your doctor may prescribe a custom-made one that has been molded to fit your foot exactly.
  • Ice massage. A paper cup full of frozen water works, as well as a cold roller over the site of your pain.
  • Rest. Your doctor may have you stay off your feet until the symptoms go away.
  • OTC pain medications. Non-steroidal anti-inflammatory drugs such as ibuprofen and naproxen can reduce swelling and pain.
  • Weight loss. If you’re overweight and lose some of those extra pounds, that may help, too.
  • Changing your footwear. High heels or tight shoes can ramp up your symptoms. Stick to shoes with plenty of room for your toes.
  • Physical therapy. A physical therapist can show you exercises to help stretch and strengthen your foot.

If you’re still having problems, your doctor might move on to:

  • Steroid injections. These shots may ease the irritation of the nerve.
  • Numbing injections. Your doctor can give you a shot of local anesthetic in your toe to numb the area.
  • “Decompression” surgery. If you need an operation, this procedure cuts some areas inside your foot that are near the affected area. It may reduce the pressure on the nerve.
  • Cold therapy. This involves applying extremely low temperatures to the irritated nerve, which kills some of the nerve cells. People who get the cold treatment are less likely to have Morton’s neuroma come back.
  • Neurectomy. This surgery that takes out the nerve is also an option, but usually only if all other treatments fail.

Depending on how severe your symptoms are and which kind of treatment you have, your recovery time could be very short or last a couple of months.

Some simple precautions will help you keep problems away. They include:

  • Don’t wear high heels or tight shoes for long periods.
  • Buy shoes that are wide enough at the toe that they don’t squeeze.
  • Choose athletic shoes or socks with enough padding in the soles to cushion your feet when you run or play sports.
  • Talk to your doctor about adding an orthotic insert to your shoe. They can help correct imbalances that might contribute to Morton’s neuroma. You can get some over the counter in drugstores.
  • Keep up with any exercises your physical therapist or doctor recommends to help strengthen your foot.

For most people, shots, exercises, or changes in footwear are enough to ease or stop symptoms. But if you’ve tried all these things and still don’t get relief, your doctor might suggest surgery. Of the people who have it for this condition, it helps about 75%-85% of the time.