Will a Morton's neuroma go away on its own?

Mild cases often settle once the pressure on the nerve is removed by switching to roomier, lower shoes and using a metatarsal pad. If the irritation has been going on for a long time, the nerve may stay thickened, and symptoms can persist or recur without ongoing footwear care or further treatment.

Is Morton's neuroma a tumour?

No. Although 'neuroma' suggests a growth, it is a benign thickening of the tissue surrounding a nerve caused by chronic irritation. It does not spread and cannot become cancerous.

How successful is surgery for Morton's neuroma?

Removing the neuroma relieves pain in the large majority of people, with recovery over a few weeks. The main trade-off is permanent numbness in the adjacent toes, which most people find acceptable, and a small risk of a painful stump neuroma. Releasing the ligament without removing the nerve avoids numbness but has slightly lower success rates.

MusculoskeletalICD-10: G57.6Fairly common, particularly in middle-aged women

Morton's Neuroma

Also known as: Interdigital neuroma, Intermetatarsal neuroma, Morton's metatarsalgia

Morton's neuroma is a painful thickening of the tissue around one of the nerves leading to your toes, most often between the third and fourth toes. Despite the name, it is not a true tumour but an irritated, swollen nerve that is being squeezed between the long bones of the foot. The classic description is feeling as though you are standing on a pebble or a bunched-up sock, with burning pain in the ball of the foot that shoots into the toes and sometimes numbness or tingling. It is far more common in women, largely because of narrow or high-heeled shoes, and in runners and people who spend long hours on their feet. Most cases improve with footwear changes and padding; injections or surgery are reserved for persistent pain.

At a Glance

Common symptoms: Burning, sharp or aching pain in the ball of the foot that may radiate into the toes, A sensation of standing on a pebble or a fold in your sock, Tingling or numbness in the affected toes
Main treatments: Switching to wide, low-heeled shoes with a soft sole and roomy toe box, Metatarsal pads or custom orthotics placed just behind the ball of the foot to spread the bones and relieve pressure on the nerve, Reducing high-impact activity temporarily and switching to swimming or cycling
Category: Musculoskeletal · Fairly common, particularly in middle-aged women
See a doctor if: Forefoot pain or toe tingling lasting more than a few days despite changing shoes

Symptoms

Burning, sharp or aching pain in the ball of the foot that may radiate into the toes

A sensation of standing on a pebble or a fold in your sock

Tingling or numbness in the affected toes

Pain that worsens with walking, running or wearing tight shoes and eases when you remove the shoe and rub the foot

A clicking feeling when walking (Mulder's click)

Usually no visible lump on the outside of the foot

Causes

Compression and irritation of the nerve between the metatarsal heads
Narrow, tight or pointed shoes that squeeze the toes together
High heels, which shift body weight onto the forefoot
High-impact activities such as running, court sports or dancing
Foot deformities such as bunions, hammer toes, flat feet or high arches that alter forefoot mechanics
Injury to the forefoot

Risk Factors

Being female, with onset typically between 30 and 60
Regularly wearing high heels or narrow shoes
Running and high-impact sports
Bunions, hammer toes, flat feet or high arches
Jobs involving long periods standing or walking on hard surfaces

Diagnosis

Physical examination that reproduces the pain by pressing on the space between the toes or squeezing the forefoot
Checking for a click (Mulder's sign) when the metatarsals are compressed
Ultrasound, which can show the thickened nerve and exclude other causes
MRI in unclear cases or before surgery
X-rays to rule out stress fractures or arthritis

Treatment

Switching to wide, low-heeled shoes with a soft sole and roomy toe box
Metatarsal pads or custom orthotics placed just behind the ball of the foot to spread the bones and relieve pressure on the nerve
Reducing high-impact activity temporarily and switching to swimming or cycling
Anti-inflammatory medication and icing the foot after activity
Corticosteroid injection around the nerve for persistent pain
Surgery to release the surrounding ligament or remove the neuroma if conservative treatment fails, which usually relieves pain but can leave permanent numbness between the toes
Supportive: foot and calf stretches and massage to ease tightness that increases forefoot loading

Prevention

Wear shoes with a wide toe box and a heel of 2.5 centimetres or less
Avoid narrow, pointed or tight shoes, especially for long periods
Use cushioned insoles or metatarsal pads if you stand a lot or play high-impact sports
Maintain a healthy body weight to reduce forefoot pressure
Rest the feet after intense activity and address any foot pain early

When to See a Doctor

Forefoot pain or toe tingling lasting more than a few days despite changing shoes
Pain that limits walking, exercise or work
Numbness in the toes that is persistent
Pain after a foot injury, as a fracture may need to be excluded
Swelling, redness or warmth in the forefoot

Frequently Asked Questions

Related Conditions

Bunion

Musculoskeletal

Hammer Toe

Musculoskeletal

Plantar Fasciitis

Musculoskeletal

Peripheral Neuropathy

Neurological

Flat Feet

Musculoskeletal

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