Conditions
Morton's Neuroma
Reviewed by Anureet Selach, Podiatrist · Australian Podiatry Association · Registered with AHPRA
Last updated
Feeling like you’re walking on a pebble that isn’t there. Burning or tingling between the toes. Numbness in the forefoot that comes on in tight shoes and eases the moment you take them off and rub your foot.
That combination is Morton’s neuroma.
What it is
A benign thickening of the tissue around one of the digital nerves that runs between the long bones of the forefoot. Most commonly it’s the nerve between the third and fourth toes.
As compression and irritation build, the nerve becomes inflamed and starts producing nerve-type symptoms rather than ordinary soreness.
What it feels like
- Burning, tingling or numbness in the forefoot or the toes
- The sensation of a lump or stone under the ball of the foot
- Shooting or electric pain when walking or running
- Worse in tight or narrow shoes, and in heels
- Relief on taking the shoe off and massaging the foot
That last one is diagnostically useful. Ordinary forefoot pain doesn’t characteristically switch off when the shoe comes off.
What drives it
Compression and repetitive irritation across the forefoot:
- Tight or narrow shoes
- Long-term high heel wear
- High-impact sport, or running on hard surfaces
- Long periods standing in unsupportive footwear
- Foot mechanics that load the forefoot unevenly
Assessment
Your podiatrist will take the history — which is often enough on its own — and examine the foot, including squeezing across the forefoot to reproduce the symptoms and check for a click.
Imaging isn’t always needed. Ultrasound is used where the diagnosis is unclear, where something else may be involved, or where an injection or surgical opinion is being considered.
Treatment
The aim is to take the compression off the nerve and stop the irritation repeating.
- Footwear. Wider toe box, lower heel, adequate depth. Usually the single biggest change available.
- Offloading. Metatarsal padding or a dome placed to spread the metatarsal heads and lift pressure off the nerve.
- Orthotics to redistribute forefoot pressure where the assessment shows mechanics are contributing.
- Activity modification while symptoms settle.
- Hands-on treatment for the surrounding soft tissue.
Where conservative care doesn’t resolve it, corticosteroid injection, other injection therapies and surgical options exist. Those are outside podiatry scope — your podiatrist will refer you to the right person rather than leaving you without a next step.
Frequently asked questions
Why does it feel like a stone in my shoe?
Because the thickened tissue around the nerve sits right under the ball of the foot, between the metatarsal heads, and you load it with every step. The classic description is walking on a pebble that isn't there. Taking the shoe off and rubbing the foot usually helps, which is another characteristic sign.
Is it actually a tumour?
No. Despite the name, a Morton's neuroma is benign — a thickening of the tissue surrounding a digital nerve, caused by irritation and compression. It isn't cancerous and it doesn't become cancerous.
Will changing my shoes fix it?
For a lot of people it makes the biggest single difference. The condition is driven by compression across the forefoot, so a wider toe box and a lower heel directly reduce what's causing it. It isn't usually the only change needed, but it's the one with the fastest effect.
Do I need a scan?
Not always. It's often diagnosable from the history and examination alone. Ultrasound is useful where the diagnosis isn't clear, where there might be something else going on, or where an injection or surgery is being considered.
What if conservative treatment doesn't work?
There are further options — corticosteroid injection, other injection therapies, and surgery for the ones that don't settle. Those sit outside podiatry scope, and your podiatrist will refer you rather than leaving you at a dead end.
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