Morton’s Neuroma

Understand the causes of pain and tingling in your toes.

What is Morton's neuroma?

A Morton’s neuroma occurs when tissue grows and presses on a nerve in your toes. It usually is between the middle and fourth toe. It is also called interdigital neuroma, intermetatarsal neuroma, and forefoot neuroma.

Morton’s neuroma can cause pain in the ball of your foot. You may also have pain, burning, and tingling in the toes. Though painful, it is a benign condition (not cancerous).

Morton's neuroma is much more common in women. Generally, it is caused by wearing high heels often, but it can also be caused by playing sports or wearing poorly fitting or tight shoes that squeeze your toes together.

The best way to treat is to switch to shoes with low heels, use shoe padding, and get orthotic inserts.

Most common symptoms

Dr. Rx

Be sure to show your doctor your usual footwear. Have an idea of how to describe your pain (for example, “it burns”), as well as what seems to make the pain better or worse. —Dr. Debbie Dang, MD

It feels like a burning pain in the ball of the foot, in the toes, or both. Sometimes, toes are numb or tingly. It may also feel like there’s a small rock stuck in your shoe.

Symptoms may become worse when you wear high heels or tight shoes or when jogging or walking. You may start limping or walking differently to avoid the pain. Some people may hear a click when they move their toes.

It is important to see a doctor who can distinguish Morton’s neuroma from a stress fracture, synovitis, and nerve entrapment.

Main symptoms

  • Burning, tingling, numbness in the toes or the ball of the foot, especially when pressing on it.
  • Feeling like you are standing on a pebble.
  • Symptoms get worse when you wear heels or shoes that squeeze your toes together. Also when jogging or playing sports.

Other symptoms

  • Limping to avoid pain
  • Clicking in your foot with moving your toes

What causes Morton’s neuroma to flare up?

Morton’s neuroma is caused by repeated pressure on the nerves of the foot. This may eventually cause a mass of tissue to form—the “pebble” that you feel. The thickened tissue pushes on the nerve, causing pain, burning, numbness, and tingling.

Factors that increase your risk include:

  • Wearing high heels or shoes that are too tight.
  • Playing sports that put pressure on the ball of your foot, such as running and rock climbing. (Sports that require tight shoes or boots, like skiing, are also a risk.)
  • Foot conditions (such as a bunion, high arch, or flat foot).
  • Having had Morton's neuroma in the past.

Pro Tip

While this condition is often related to tight shoes—women tend to wear shoes with a tighter toe box—it can occur in anyone in whom the common digital nerve sees undue pressure. The pressure could be from tight shoes, acute trauma (such as a fall from height), and chronic trauma (consistently running with poorly supportive shoes). —Dr. Dang

What can be done for Morton’s neuroma?

Pro Tip

Surgical treatment of a Morton’s neuroma is reported to be effective in about 75% of patients. While this is good news, it does mean that a number of patients continue to have symptoms after surgery and may even require repeat surgery. —Dr. Dang

If foot pain lasts more than a few days, see your doctor. You may be referred to an orthopedic surgeon if your symptoms are severe or don’t improve. The doctor may want to do x-rays, ultrasound, or an MRI to rule out a bone fracture.

The growth should go away when there is no longer pressure on the ball of your foot. To reduce pressure:

  • Stop wearing high heels.
  • Make sure shoes fit correctly and are not too tight.
  • Try orthotic inserts in your shoes. There are orthotics made specifically to treat Morton’s neuroma.
  • Take a break from any sport or activity that may be making it worse.

If the pain doesn’t go away after 4 to 6 weeks, talk to your doctor about other options.

  • For pain, take acetaminophen (Tylenol), ibuprofen (Advil, Motrin), or naproxen (Aleve), according to your doctor’s instructions.
  • Your doctor may recommend a cortisone injection in the foot.

When the other treatments are not working, your doctor may suggest surgery.

Prevention

  • Limit use of high heels or avoid them completely if painful.
  • Do not wear tight or poor-fitting shoes. Wear roomy shoes with a wider toe box instead.
  • Try not to put pressure on the ball of your foot.
  • Use metatarsal shoe pads (inserts), which you can buy at the drugstore, to relieve pressure on the ball of your foot.
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