In Morton’s neuroma, a small nerve between the metatarsal bones becomes irritated and the surrounding tissue thickens. It most often occurs between the third and fourth toes. Despite its name, this is not a true nerve tumour.
Increasing sensory disturbance, an open skin lesion or severe new pain should be examined.
Causes and risk factors
Repeated pressure on the forefoot may contribute. Tight shoes and high heels often aggravate symptoms. Activity and foot shape may also play a role; a clear cause cannot always be identified.
Typical symptoms
Burning or shooting pain in the ball of the foot is typical, sometimes with tingling in adjacent toes. Some people describe feeling a small stone in their shoe. Symptoms can increase with walking and ease after removing the shoe.
Diagnosis
We examine the affected space, tenderness and sensation in the toes. Ultrasound or MRI may help when the findings are unclear. However, an imaging finding alone does not explain every case of forefoot pain; the joints and bones are assessed too.
Non-surgical treatment
Wide shoes and a suitable insole or metatarsal pad may relieve pressure on the nerve. Adjusting activity is often helpful. A targeted injection may be considered in selected cases; its benefits, temporary effect and risks are discussed.
Surgical options
For persistent pain despite conservative measures, specialist surgery to release pressure or remove the affected nerve segment may be considered. Permanent reduced sensation and recurrent nerve pain are possible consequences and are included in the discussion before surgery.
Aftercare and rehabilitation
After surgery, the wound, swelling and ability to bear weight are checked. Shoes should not press on the surgical area. Return to longer walks and sport is gradual and follows the individual aftercare plan.
Common questions
Is this a malignant tumour?
No. Here, the term describes irritation-related thickening around a small nerve in the foot.
Will numbness remain after surgery?
If a nerve segment is removed, reduced sensation in the corresponding toe area is expected. This is discussed before the procedure.
Arrange a consultation
We discuss which treatment is suitable for your findings and which procedures are available within our outpatient service during a personal consultation. Outpatient operations take place at an external surgical centre.
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Further reading
Selected external resources about this condition. Some linked publications are in German.
Medical background
Sources & further information
These professional and patient resources provide further information about this condition. The text on this page is independently written.
AAOS: Morton’s neuromaNHS: Morton’s neuroma