Morton’s Neuroma Treatment
Morton's neuroma is a thickening of the nerve between the toes that causes burning, stabbing pain. Most patients improve without surgery.
Morton’s neuroma is a thickening of one of the nerves to the toes, most often between the third and fourth toes. It is not a true tumour but a thickening caused by repeated compression and irritation of the nerve. It is more common in women and in people who wear narrow shoes.
Causes
- Narrow, high-heeled shoes
- Repeated loading of the front of the foot (running, dancing, standing for long hours)
- Foot shape differences such as bunions, flat feet or high arches
- Pressure on the nerve from the metatarsal bones
Symptoms
- Burning, stabbing or electric pain in the ball of the foot
- A feeling of a pebble in the shoe
- Numbness and tingling in the two affected toes
- Relief when taking off the shoe and rubbing the foot
Diagnosis
Pain when the spaces between the toes are squeezed, and sometimes a palpable click, help the diagnosis. Ultrasound or MRI can show the thickened nerve and rule out conditions with similar pain, such as stress fractures and joint inflammation.
Non-surgical treatment
Most patients improve without surgery:
- Wide, low-heeled, well-cushioned shoes
- Insoles with a metatarsal pad that spread the bones and reduce pressure
- Activity changes
- Pain relief
- Injection in suitable patients
Surgical treatment
Surgery is performed if symptoms continue despite non-surgical care. There are two approaches:
- Neuroma excision: The thickened part of the nerve is removed. Pain usually resolves, but permanent numbness remains between the two toes.
- Decompression: The ligament pressing on the nerve is released. The nerve can be preserved in suitable patients.
Recovery
A special shoe is worn for a few weeks, followed by wide, comfortable shoes. Returning to daily activities is usually possible within a few weeks.
Conditions that cause similar pain
Forefoot pain is not only caused by Morton’s neuroma. Stress fractures of the metatarsals, inflammation of the toe joints (synovitis), ligament tears under the second toe and nerve compression from the lower back can cause similar symptoms. An accurate diagnosis avoids unnecessary treatment.
Shoes and insoles
Shoes with a wide toe box, a low heel and a soft sole reduce pressure on the nerve. A metatarsal pad placed in the insole spreads the bones slightly and gives the nerve more room. Positioning the pad correctly makes it more effective.
Frequently asked questions
Can Morton's neuroma turn into cancer?
No. Despite its name, it is not a true tumour and does not become cancer.
Will there be numbness after surgery?
When the nerve is removed, permanent numbness remains between the two toes; most patients do not find it a significant problem.
Is an injection a permanent solution?
It gives lasting relief in some patients, while in others symptoms return. It works better when combined with changes in footwear.
Can it affect both feet?
Yes, rarely it can occur in both feet or between two different toes in the same foot.
When can I do sport after surgery?
Once the wound has healed and swelling has settled, walking and light sport can usually be resumed within a few weeks. Sports that load the forefoot, such as running, are introduced gradually.
The information on this page is general and does not replace an examination. An examination is needed to decide which treatment suits you.