Morton’s Neuroma
Updated: Sep 5
Morton’s neuroma is a painful condition affecting the ball of the foot. It can result in altered sensations in the ball of the foot, often extending into the toes, with feelings of burning, tingling or even numbness being reported. Morton’s neuroma are more common in women than men and much more frequent in those wearing narrow high heels.
What is a Morton’s neuroma?
A Morton’s neuroma is caused by thickening of the tissue surrounding a nerve in the ball of the foot. This typically results from ongoing compression of the nerve and is most commonly found between the third and fourth digits. The thickening of this tissue leads to further pressure on the nerve when standing or wearing enclosed footwear, which can lead to neurological symptoms such as burning, tingling and numbness. Aside from a clinical diagnosis, an ultrasound can be used to examine the swelling of the nerve and confirm the diagnosis of a neuroma.
What causes a Morton’s neuroma?
Morton’s neuromas are caused by increased pressure being applied to the nerve in the forefoot. This can result from:
Tight footwear that lead to increased compression of the forefoot. This includes narrow high heels that place more pressure on the ball of the foot.
Gait pathomechanics such as really high arches, flat feet and loading of the outside part of the forefoot with walking can all contribute to the development of a Morton’s neuroma.
Trauma to the forefoot such as landing heavily can be enough to irritate the nerve and lead to neuroma development.
Methods of treating a Morton’s neuroma
If you suspect you may have a Morton’s neuroma, there are a number of ways you can try and relieve this at home. These include:
Avoiding narrow footwear: Narrow shoes put more pressure on the forefoot which increases the compression of the nerve. By wearing shoes with a wider toe box, this pressure is reduced and the nerve can begin to settle.
Avoiding high heels: High heels increase the amount of force we apply to the front of the foot. Moving from stilettos to a smaller wedge will make your feet feel much better.
Wearing shoes with a cushioned forefoot: The less cushion in the forefoot, the more load will be applied directly to the bones under the front of your foot. A small amount of cushioning can be beneficial to distribute this force.
Contact My Family Podiatry: At My Family Podiatry, we will conduct a thorough assessment to identify the cause of the neuroma. From there we will put together a plan to reduce the pressure on the nerve and get you moving more comfortably.
Below is more detail on what a neuroma actually feels like, which shoes tend to help, and the exercises that can take some pressure off the nerve.
What does a Morton's neuroma feel like?
Neuroma pain has a recognisable pattern, and it is usually the pattern rather than any single symptom that points to the diagnosis. Burning pain under the ball of the foot, often shooting forward into the toes. Numbness in the toes, or pins and needles that come and go. The feeling of walking on a pebble, or of a sock bunched up under the forefoot. Pain that is worse in narrow or enclosed shoes and eases when you take them off and rub the foot. A clicking sensation between the toes when the forefoot is squeezed from the sides.
That detail about shoes matters more than people realise. Forefoot pain that settles when you go barefoot and flares in fitted shoes points towards nerve compression rather than a bone or joint problem. Pain that stays the same regardless of what is on your feet usually has a different cause.
Symptoms tend to build over months rather than appearing overnight, because the more the nerve is compressed the more sensitive it becomes.
What shoes should you wear with a Morton's neuroma?
Footwear is usually where the biggest change comes from, because it is the thing compressing the nerve for most of the day. Four features matter.
A wide forefoot. This is the one that counts. The shoe needs to let the long bones of your forefoot sit apart rather than being pressed together around the nerve. Width across the ball of the foot matters far more than length, and plenty of people are in shoes that fit at the toes but pinch across the widest part.
A low heel. Every bit of heel height tips more of your body weight onto the ball of the foot. Moving from a stiletto to a low wedge or a flat changes forefoot pressure noticeably.
A firmer sole, or a rocker. A sole that bends easily through the ball of the foot makes the forefoot work harder at push off. A stiffer sole, or a rocker sole that helps the foot roll through the step, reduces how much the forefoot has to bend.
Some cushioning under the forefoot. Very thin soled and minimalist shoes leave the bones of the forefoot taking impact directly. A moderate amount of cushioning spreads that load.
What to avoid while symptoms are present: narrow and pointed shoes, high heels, and thin flexible soles on hard surfaces.
A practical test before you buy. Take the insole out of the shoe and stand on it. If the widest part of your foot spills over the edge, that shoe will compress the nerve no matter how comfortable it feels in the shop.
Bring the shoes you actually wear most to your appointment. The wear pattern tells us more than the shoes you think you should be wearing.
Exercises for a Morton's neuroma
Exercises will not shrink the thickened tissue around the nerve. What they can do is keep the forefoot mobile so the bones are not held tightly together, and change how load passes through the foot so the nerve is compressed less with each step. They work alongside footwear changes rather than instead of them.
Toe spreading. Sitting or standing, spread your toes apart, hold for five seconds, then relax. Ten repetitions. This works the muscles that separate the long bones instead of letting them sit collapsed together.
Calf stretch. A tight calf pushes more load forward onto the forefoot. Stand facing a wall with the back leg straight and the heel down, and lean in until you feel the stretch through the calf. Hold 30 seconds, three times each side.
Arch strengthening. Sitting with your foot flat on the floor, draw the ball of your foot towards your heel without curling your toes, so a small dome forms under the arch. Hold five seconds, ten repetitions. Better arch control changes how load spreads across the forefoot.
Toe extensor work. Lift your toes towards your shin while keeping the ball of the foot down. Hold, then lower slowly. Ten repetitions. This helps counter the clawing pattern that drives pressure down into the forefoot.
Ball or towel rolling. Roll a soft ball slowly under the arch and the ball of the foot. Keep the pressure comfortable rather than sharp, and avoid pressing directly into the painful spot between the toes.
Start gently. If any of these sharpen the burning or the numbness, stop and mention it at your appointment, because it usually means the loading needs adjusting before the exercises will help.
Is it a neuroma, or something else?
Several conditions cause pain in the same part of the foot and get mistaken for each other. Capsulitis, plantar plate injuries, bursitis between the metatarsals, stress fractures and general forefoot overload can all produce pain under the ball of the foot, and they are managed differently.
A few things point away from a neuroma. If the pain sits under the second toe rather than between the third and fourth, if there is swelling on the top of the foot, or if the pain is there regardless of what shoes you wear, it may be something else. Our guide to pain in the ball of the foot when walking goes through the other causes in more detail.
Diagnostic ultrasound is useful here. It lets us look at the nerve directly, check its size, and see whether one of the look alike conditions is what is actually going on.
When footwear and offloading are not enough
Most neuromas settle once the compression comes off. Where symptoms persist despite appropriate footwear changes, metatarsal padding and orthotics, there are further options including corticosteroid injection and surgical opinion. We do not perform either of those in clinic. We refer you to the right person and coordinate your care from our end.
Common questions about Morton's neuroma
Is a Morton's neuroma a tumour?
No. Despite the name, it is a benign thickening of the tissue around a compressed nerve, not a growth that spreads.
Will a Morton's neuroma go away on its own?
The thickened tissue itself rarely disappears. Symptoms often settle once the compression causing it is removed through footwear changes and offloading. Addressing it earlier generally makes that easier.
Is it spelt Morton's neuroma or mortons neuroma?
Both spellings refer to the same condition. You may also see it called an intermetatarsal neuroma, an interdigital neuroma or Morton's metatarsalgia.
Can I keep running or playing sport?
Often yes, with adjustments to volume and footwear while the nerve settles. Complete rest is rarely necessary and is not usually what we recommend.
What is the difference between a neuroma and metatarsalgia?
Metatarsalgia is a general term for pain under the ball of the foot. A neuroma is one specific cause of it, involving an irritated nerve, and it usually comes with burning, tingling or numbness running into the toes.
Do you treat Morton's neuroma near North Brisbane?
Yes. Our Albany Creek clinic sees patients from Strathpine, Eatons Hill, Warner, Aspley, Bridgeman Downs, Bracken Ridge, Carseldine and across North Brisbane.
Book a forefoot assessment
Burning or numbness in the ball of the foot rarely settles while the nerve keeps being compressed with every step. If it has been bothering you for more than a couple of weeks, book an assessment so you know what you are dealing with and what to change. Call My Family Podiatry on 07 3088 6116 or book online.
