Morton's Neuroma
A Morton’s neuroma, or interdigital neuroma, is a thickening of the tissue around a nerve in the foot, often between the third and fourth toes. It can cause pain, tingling, or numbness, especially when walking or wearing tight shoes. Treatment can help relieve symptoms and improve mobility.
Overview | Symptoms & Causes | Diagnosis | Treatment Options
What is a Morton's Neuroma?
The foot contains a network of nerves that run between the bones and muscles, helping you sense the ground and control movement. One important area is the space between the long bones of the forefoot (metatarsals), where nerves pass toward the toes.
A Morton’s neuroma occurs when one of these nerves, usually between the third and fourth toes, becomes thickened or irritated. This can cause pain, tingling, or numbness in the toes and the ball of the foot. The condition is not a true tumor, but rather a nerve irritation that can make walking or standing uncomfortable.
Understanding Morton's Neuromas
Morton’s neuroma can cause a range of sensations in the forefoot, often making walking or standing uncomfortable.
Common features include:
- Pain in the ball of the foot: Often described as sharp, burning, or aching, and sometimes radiating into the toes.
- Tingling or numbness: Affected toes may feel “pins and needles” or lose sensation.
- Feeling of a lump or pebble under the foot: Some people report the sensation of walking on a small stone.
- Worsening with activity or tight shoes: Symptoms may increase when wearing narrow or high-heeled shoes or during prolonged walking or standing.
- Relief when resting or removing shoes: Taking weight off the foot often eases discomfort.
Although a Morton’s neuroma is not dangerous, it can affect daily activities and quality of life, so medical assessment is recommended if symptoms persist or worsen.
Causes and Risk Factors
A Morton’s neuroma develops when the tissue around one of the nerves leading to the toes thickens, often due to repeated irritation or pressure. The exact cause isn’t always clear, but several factors can increase the risk:
| Footwear | Tight, narrow, or high-heeled shoes can compress the toes and forefoot, putting pressure on the nerves. |
| Foot shape & biomechanics | Conditions such as flat feet, high arches, bunions, or hammertoes can alter weight distribution and increase nerve irritation. |
| Repetitive stress | Activities that involve prolonged pressure on the forefoot, such as running, jumping, or certain sports, can contribute to nerve thickening. |
| Gender & age | Morton’s neuroma is more common in women and often develops in middle age. |
| Previous injury | Trauma to the foot or repeated stress injuries may increase susceptibility. |
While these factors can increase the likelihood of developing a neuroma, not everyone with these risks will get one, and sometimes it occurs without any clear cause.
Diagnosing a Morton's Neuroma
Diagnosing Morton’s neuroma usually starts with a detailed clinical assessment. Your healthcare provider will take a full history of your symptoms, including when the pain occurs, what makes it worse, and any previous foot problems or injuries.During a physical examination, the clinician may check for:
- Tenderness or a palpable nodule between the toes.
- Pain or tingling when squeezing the forefoot.
- Altered sensation in the toes supplied by the affected nerve.
Imaging may be used to confirm the diagnosis or rule out other conditions:
| Ultrasound | This is a quick, non-invasive scan that can clearly show a thickened nerve between the metatarsal bones. It also allows the clinician to see any other abnormalities in the soft tissue, such as cysts or bursitis, that could be contributing to symptoms. Ultrasound can even be used dynamically, meaning the foot can be moved during the scan to see if the nerve is being compressed or pinched. |
| MRI | Used in some cases to provide a detailed view of soft tissue and help exclude other causes of forefoot pain. |
Treatment Options
The goal of treatment is to relieve pressure on the affected nerve, reduce pain, and improve foot function.
Conservative Treatments
| Footwear adjustments | Wearing wider shoes with a low heel, cushioned insoles, or pads to offload pressure from the forefoot. |
| Orthotics | Custom shoe inserts to correct foot mechanics and reduce nerve compression. |
| Physiotherapy | Exercises to strengthen the foot and improve flexibility, helping to reduce symptoms. |
Procedural Options
| Steroid Injections | Steroid injections into the affected area can reduce inflammation around the nerve and provide pain relief. |
| Surgery | Considered only when conservative treatments fail. Procedures may involve removing the neuroma or releasing pressure on the nerve. |
How can Lanthorn help?
Ultrasound Foot & Ankle - £300
This non-invasive scan allows us to visualize the affected nerve, confirm the presence of a neuroma, measure its size, and determine its exact location. It also helps to check surrounding tissues for any contributing issues.
Ultrasound-guided Steroid Injections - £450
Using real-time imaging, we can deliver anti-inflammatory medication directly to the affected nerve. This precise approach maximizes pain relief while minimizing the impact on surrounding tissue.
MRI Scan - £350
Provides a high-resolution image of the soft tissues in the foot, which can be useful if the diagnosis is unclear or if additional pathology is suspected. MRI can help differentiate a neuroma from other causes of forefoot pain.
