Conditions / Forefoot & Toes
Morton's Neuroma
Burning, shooting or numb pain in the ball of the foot is a common presentation of neuroma. Accurate diagnosis is essential — we identify the cause and build a plan to reduce pain and prevent recurrence.
A Morton's neuroma is a benign thickening of the tissue surrounding a nerve in the foot, most commonly developing between the third and fourth toes. It is caused by chronic irritation or compression of the nerve, which over time leads to tissue thickening and nerve damage.
Despite the name, it is not a tumour — it is a nerve entrapment and irritation condition. Left untreated, symptoms typically worsen as the nerve becomes increasingly sensitised. Early, accurate diagnosis leads to significantly better outcomes.
Foot Posture & Mechanics
Poor foot posture and lower limb mechanics can increase load and compression through the forefoot, irritating the intermetatarsal nerve.
Footwear
Narrow, tight or high-heeled shoes compress the metatarsal heads and are a major contributing factor in neuroma development.
Muscle Imbalance
Tight or weak intrinsic foot muscles alter how load is distributed across the forefoot, increasing nerve irritation with each step.
Training Overload
A sudden increase in running, jumping or high-impact activity raises cumulative forefoot load and can trigger or aggravate symptoms.
Adjacent Pain Sources
Pain referred from other structures — such as metatarsal stress fractures or bursitis — can mimic neuroma and must be ruled out at assessment.
Burning sensation in the ball of the foot
Shooting or electric pain into the toes
Numbness or tingling between the third and fourth toes
Pain on weight-bearing, particularly in narrow footwear
A sensation of walking on a pebble or bunched sock
Relief when removing shoes and massaging the foot
Most neuromas are diagnosed clinically through a thorough examination. Key tests include direct compression between the metatarsal heads to reproduce symptoms, and the Mulder's click test — a forefoot squeeze that produces a palpable click and pain in positive cases.
Where the diagnosis is unclear or symptoms are not improving, we can arrange ultrasound or MRI imaging to confirm the neuroma and rule out differential diagnoses such as metatarsal stress fractures, intermetatarsal bursitis, or referred nerve pain from higher up the limb.
Treatment is tailored to the severity of your neuroma, footwear habits, and activity level. Most cases respond well to conservative management — surgery is rarely required when the right treatment plan is followed consistently.
If you have persistent burning, shooting or numb pain in the ball of the foot — particularly in narrow footwear or during activity — an assessment is recommended. Neuromas tend to worsen over time without treatment as the nerve becomes increasingly sensitised.
Early intervention gives the best outcomes. Long-standing neuromas are more difficult to treat conservatively and are more likely to require injection or surgical referral.
Is it always between the third and fourth toes?
Most commonly, yes — around 80% of neuromas occur between the third and fourth metatarsal heads. They can occasionally develop between the second and third, but other spaces are rare.
Do I need surgery?
The majority of neuromas respond well to conservative treatment — orthotics, footwear changes, and injection therapy resolve most cases. Surgery is considered only when conservative treatment has been exhausted over an extended period.
Will a corticosteroid injection cure it?
An injection can provide significant and sometimes lasting relief by reducing nerve inflammation, but it works best alongside footwear and orthotic changes that address the underlying compression. Without these, symptoms often return.
Do I need a scan?
Not always. Most neuromas are diagnosed clinically. Ultrasound or MRI is arranged where the diagnosis is uncertain, symptoms are unusual, or where we need to rule out other forefoot pathology before proceeding with treatment.
Can I keep running with a neuroma?
Often yes, with appropriate load management, footwear changes, and forefoot offloading. We will guide you on a safe plan that keeps you active while allowing the nerve to settle.
Ready to book your neuroma assessment?
We'll diagnose the cause and build a plan to reduce your pain and get you back on your feet.
