Overview
Morton neuroma is a painful condition in the forefoot where the tissue around an interdigital nerve (most often between the 3rd and 4th toes) becomes irritated and thickened. Despite the name, it is not always a true tumor; it is usually nerve irritation from compression. As the nerve gets squeezed, it can send abnormal pain signals, causing burning, shooting, or electric shock-like sensations. Symptoms often flare with walking, tight shoes, or activities that overload the forefoot.
Symptoms
Patients commonly notice burning or sharp pain in the ball of the foot or between the toes, sometimes with tingling or numbness. The pain may feel like a pebble in the shoe or an electric shock that can radiate into the adjacent toes. Symptoms are often worse with tight or narrow footwear, prolonged standing, running, or pushing off during walking. Some people develop reduced tolerance for activities and may start to change their gait to avoid forefoot pressure.
Causes
Morton neuroma typically develops when the interdigital nerve is repeatedly compressed by the metatarsal heads or by tight footwear. Chronic friction and pressure can lead to nerve irritation, inflammation, and thickening of the surrounding tissue. Over time, this can make the nerve more sensitive so that even mild pressure triggers pain.
Risk Factors
Risk increases with frequent use of narrow toe-box shoes or high heels that force forefoot loading. People who have repetitive impact or prolonged standing, or who run and walk on hard surfaces, are more likely to overload the forefoot. Foot mechanics that increase pressure in the forefoot, such as certain arch and gait patterns, can contribute. Being overweight can further raise forefoot stress.
Prevention
You can reduce flare-ups by wearing shoes with a wide toe box and adequate forefoot cushioning, and avoiding high heels when possible. Using supportive footwear and limiting activities that strongly provoke symptoms can help reduce repetitive nerve compression. When long days of standing or walking are unavoidable, consider breaks, alternating activity, and early use of cushioning or orthotic support. Maintaining a healthy body weight can also lower forefoot load over time.
How the Diagnosis Is Evaluated
Clinicians usually start with a detailed history focused on shoe-related pain, where the symptoms occur, and what movements or activities trigger them. A physical exam often includes palpating the forefoot to reproduce pain and assessing for numbness between the toes. Imaging is not always required, but ultrasound or MRI may be used when the diagnosis is unclear, symptoms are persistent despite treatment, or to rule out other causes of forefoot pain. In some cases, diagnostic injections may help confirm the pain source.
Nonsurgical Treatment Options
Non-surgical care focuses on removing pressure from the irritated nerve and calming inflammation. Footwear changes are usually the first step, including switching to a wide toe box and using supportive shoes to decrease forefoot compression. Orthotic inserts or metatarsal pads can help redistribute load away from the painful interspace and reduce nerve irritation. Activity modification, such as temporarily reducing running or high-impact walking, can help symptoms settle. Anti-inflammatory medication such as NSAIDs or topical pain relievers may help manage discomfort, when safe for you. If symptoms persist, a corticosteroid injection around the affected nerve can reduce inflammation and pain and may improve function.
When to Seek Medical Attention
Seek medical attention if pain between the toes persists beyond a few weeks despite shoe changes and activity modification, or if numbness and tingling are progressing. Get prompt evaluation if you cannot bear weight, if pain is rapidly worsening, or if there is significant swelling, redness, or warmth that could indicate an alternative problem. You should also seek care if you experience new weakness, severe loss of sensation, or other neurologic symptoms that are not typical for your usual flares.
Frequently Asked Questions
It commonly feels like burning, shooting, or electric shock pain in the ball of the foot between the toes, sometimes with tingling or numbness.
Not usually; diagnosis is often made from your history and exam, and imaging like ultrasound or MRI is used when needed to clarify the cause or rule out other conditions.
If conservative measures and a corticosteroid injection do not provide meaningful relief, a clinician can reassess the diagnosis and consider alternative non-surgical strategies.
Next Steps
If your symptoms match Morton neuroma, start by switching to wider, more supportive footwear and using a metatarsal pad to reduce pressure while you limit provoking activities. If pain, numbness, or tingling persists or worsens, schedule an evaluation with a clinician so the diagnosis can be confirmed and an appropriate non-surgical plan can be tailored to you.