Overview

Morton's neuroma is a thickening on the nerves between your toes. It is caused by compression or repeated irritation of the nerve. Sometimes this happens because joints and soft tissues change shape and compress the nerve. Over time, the body responds to this irritation by thickening the nerve to protect itself until it forms a lump, called a neuroma. This causes more pressure between the toes and can be very painful. 

The NHS has more information about Morton's nueroma. 

Signs and symptoms

Usually, a neuroma causes burning or sharp pain in the toes that worsens with the pressure of tight shoes. It may feel like you are walking on pebbles or you have something stuck in your shoe. It can also cause numbness in the toes.  Often the area between the toes is painful to touch, and when your foot is compressed there is a sharp pain. Sometimes when compressed between the bones, the nerve causes a noticeable click, called a Mulder’s click.

Diagnosis

Morton's neuroma is usually diagnosed clinically. The podiatrist will ask you questions about your medical history and lifestyle. 

In some cases the podiatrist refers you for tests, such as ultrasound scans, to confirm the diagnosis. They often do this if they are thinking of offering you a corticosteroid injection or surgery.

Treatment

Changing your footwear to well-fitting shoes with a wide toe box, a rocker forefoot, and a fastening can be enough to relieve the symptoms. 

Read our information about choosing shoes. 

Sometimes a cushioned insole or a specially designed insole (orthoses) with a bump under the metatarsals (bones) is used to relieve pressure on the neuroma.

Read our information about foot insoles. 

If a neuroma does not get better after footwear changes and insoles, we may consider a steroid, or local anaesthetic injection to relieve symptoms. 

Sometimes, for very large or stubborn neuroma, surgery is needed to remove it. If this is needed, we refer you to orthopaedics or podiatric surgery.

If you do not have treatment

Morton's neuroma can be painful and limit your activity and quality of life. Usually, it is best to have it treated so that you can resume normal activity as soon as possible. 

Things you can do to help

Calf stretches

Calf stretches can be very useful to reduce the pressure on the front of your foot where the neuroma occurs. This can help to reduce the pain.

Lifestyle changes

If you are overweight, losing weight will help as it will reduce the amount of weight going through the foot as you walk. If you think you need more help with weight loss, please talk to your podiatrist or GP about this.

Exercise and physical activity

While the foot is painful, you should temporarily reduce weight-bearing activities such as running and strenuous walking. However. it is important that you remain physically active. Activities such as swimming, cycling, and rowing can be useful to stay active until your foot pain improves. It is important that as the pain improves, you gradually increase running or walking to prevent the pain reoccurring. 

Information and support

Versus Arthritis is a UK charity providing information and support for people living with arthritis. You can read their information about foot and ankle pain. 

The Royal College of Podiatry have information for patients about different types of foot conditions: https://rcpod.org.uk/