Morton’s neuroma FAQs

Morton’s neuroma, also known as metatarsalgia, interdigital neuritis and interdigital neuroma, is a common foot problem that affects around one in three people at some point in their lifetime. Although it can be very painful, it is important to note that it is not cancerous and in the vast majority of cases, can be successfully treated. 

Here, we’ll take a closer look at Morton’s neuroma, from its symptoms and causes to diagnosis and treatment options. 

What is Morton’s neuroma?

Morton’s neuroma occurs when the digital nerve, which runs between the toes in your foot, becomes inflamed and the surrounding tissue thickens. 

It most commonly occurs between the third and fourth toes, however, it can also occur between the second and third toes. In rare cases, it can occur between the first and second toes or fourth and fifth toes.

What are the symptoms of Morton’s neuroma?

The most common symptom of Morton’s neuroma is a burning, shooting and/or stabbing foot pain that radiates into your toes. 

Pain is usually worse during weight-bearing activities, such as walking, or when wearing tight and/or high-heeled shoes, which squeeze the front part of your foot (forefoot). You may also feel as if there is a pebble stuck beneath your foot. 

Other symptoms of Morton’s neuroma include tingling, a pins and needles sensation, and/or numbness in the ball of your foot and toes. 

How long symptoms last varies considerably from a few minutes to a constant presence even when resting.

What causes Morton’s neuroma?

Morton’s neuroma is around four times more common in women than in men and is usually caused by low-level, repetitive trauma to the nerves between your toes. 

Trauma may occur due to wearing tight, pointed-toe and/or high-heeled shoes, or performing high-impact activities (eg running, dancing or working on hard surfaces). In both cases, greater pressure is placed on your feet. 

Your risk of Morton’s neuroma is also higher if you have other foot problems, such as bunions, flat feet, high arches or claw toes.

What can I do to treat my Morton’s neuroma?

You may be able to manage your Morton’s neuroma by making a few, simple lifestyle changes. Firstly, it is important to consider your footwear. 

Your shoes should provide a comfortable fit with plenty of room for your toes to move. It should also have appropriate shock absorption, specifically cushioning under your forefoot. Look for wider-fit shoes, especially as you get older, as feet tend to spread with age.

Secondly, if you notice certain activities worsen your symptoms, try to reduce how often or how long you perform these activities for, or alternatively, adjust how you perform them to reduce the pressure placed on your feet. 

If you’re still struggling with foot pain, see your GP or an MSK podiatrist. Your GP will examine your foot to determine whether or not you have Morton’s neuroma. If appropriate, they will refer you to a podiatrist. 

How is Morton’s neuroma diagnosed?

A podiatrist or GP will ask you about your symptoms, examine your foot and in some cases, perform an ultrasound scan of your foot. This will determine if Morton’s neuroma is the cause of your foot pain or whether another forefoot problem is responsible. 

Other conditions that can mimic the symptoms of Morton’s neuroma include bursitis (inflammation of the fluid-filled cushions called bursae that sit within your joints) and capsulitis (inflammation of the joint capsule, that is, the connective tissue that forms a sleeve around your joint). 

How can a podiatrist treat Morton’s neuroma?

A podiatrist will advise you on footwear and footwear habits to help relieve your symptoms. This may include suggesting you wear orthotic insoles to offload the pressure on the area of your foot affected by Morton’s neuroma. 

They may also suggest pain medication and steroid injections to manage your symptoms. If you’re overweight, safely and sustainably losing excess weight can also help reduce your foot pain. 

If these treatment measures aren’t successful, your podiatrist may suggest radiofrequency ablation. This involves inserting a special probe into the affected nerve and applying pulses of radiofrequency energy to heat up and consequently destroy this part of the nerve. 

In severe cases of Morton’s neuroma, your podiatrist may suggest surgery to remove the neuroma. 

What does surgery for Morton’s neuroma involve?

Morton’s neuroma excision surgery is performed by an orthopaedic surgeon specialising in foot and ankle surgery. It is a day case, so you can usually return home on the same day as your operation. It can be performed under general, spinal or regional anaesthesia. 

During your operation, a small cut will be made on the top of your foot so that the neuroma can be carefully removed and the surrounding tissue released. The wound is then closed with stitches. 

Removing the neuroma will help resolve your foot pain, however, there will be some numbness in the space between your toes where part of the nerve was removed. 

You can usually return to work four to six weeks after surgery if your job doesn’t require lots of physical activity; in the latter case, you will need longer to recover.