Morton’s Neuroma Causes, Symptoms & Treatment Options

Overview

Morton’s neuroma, also known as interdigital neuritis, is a painful condition that affects the ball of the foot, most commonly the area between the third and fourth toes. It is marked by sharp, burning, or shooting pain that often worsens when wearing tight or narrow footwear. A neuroma itself is a benign growth of nerve tissue. 

In the foot, it develops when the tissue surrounding a nerve leading to the toes thickens due to repeated pressure or irritation. This thickening can create the uncomfortable sensation of walking on a marble or small pebble, especially while standing or walking.

What causes Morton’s Neuroma?

Often, the exact cause of Morton’s neuroma is not known. In most cases, it develops over time from repeated pressure or irritation to a nerve that runs between the toes. Several factors may contribute, including:

• Tight or narrow footwear: Shoes with a narrow toe box or high heels squeeze the front of the foot, repeatedly pinching the nerve between the toes.
• Repeated toe bending: Activities such as running or jumping force the toes upward over and over, placing stress on the nerve and leading to irritation.

How the Condition Occurs: Morton’s neuroma usually develops gradually. Ongoing pressure and friction cause the nerve tissue to thicken as a protective response, which can lead to pain, burning, or numbness in the forefoot.

Common Everyday Causes: Wearing tight shoes, using high heels, standing for long periods, and activities that place extra load on the front of the foot can trigger or worsen symptoms.

Morton’s Neuroma is most common in these sports:

• Running: High-impact, repetitive forefoot loading irritates the interdigital nerve over time.
• Skiing: Tight ski boots apply constant pressure across the ball of the foot.
• Snowboarding: Prolonged forefoot compression inside rigid boots stresses the nerve.
• Dance: Frequent toe loading, jumps, and tight footwear increase nerve irritation.

Symptoms

Symptoms associated with Morton’s neuroma typically develop gradually and may worsen over time if the pressure on the nerve continues. Common symptoms include:

• Sharp pain in the ball of the foot that worsens when wearing tight shoes: The pain is often burning or stabbing in nature and increases with walking, standing, or narrow footwear.
• Feeling as if you’re standing on a pebble or a marble: Many people describe a constant foreign-body sensation under the foot that becomes more noticeable with movement.
• Numbness and tingling in the affected toes: Irritation of the nerve can cause pins-and-needles sensations or reduced feeling in the toes connected to the affected nerve.

Non-operative treatment

The approach to treating Morton’s neuroma depends on the severity of your symptoms. In most cases, doctors begin with conservative, non-surgical methods aimed at reducing pressure on the affected nerve and managing pain. Common non-operative Morton’s neuroma treatments include:

• Using shoes with a wider toe box: Reduces compression on the forefoot and allows the toes to spread naturally, relieving nerve irritation.
• Inserting soft insoles with an offloading pad that relieves pressure on the toes: Cushioned insoles help distribute weight evenly across the foot, minimizing stress on the neuroma.
• Corticosteroid injections administered by your orthopedic specialist to relieve pain and inflammation: These injections can reduce swelling and provide pain relief, allowing for improved comfort during daily activities.

Try these exercises to help address your condition:

Below is a PDF of the Exercise Program

Morton’s Neuroma

Surgical Treatment

If conservative measures fail to provide relief, surgical excision of the neuroma may be advised. Surgery generally offers excellent results, effectively removing the inflamed nerve tissue and resolving pain. Recovery is typically straightforward, and most patients experience significant improvement in mobility and comfort.