The short answer
A Morton's neuroma is a thickening of a nerve between the toes, usually the third and fourth, causing burning or shooting forefoot pain, numbness in the toes, and the sensation of a pebble bunched up in the shoe. It often improves with wider footwear, metatarsal padding or orthotics, activity changes, and precise ultrasound-guided injections.
Medically reviewed by Marc Gruner, DO, MBA, RMSK
Sports medicine physician, Mayo Clinic fellowship. Last reviewed June 2026
Overview
A Morton's neuroma develops when the tissue around one of the nerves between the toes thickens, most often between the third and fourth toes. Compression from narrow or high-heeled shoes irritates the nerve, producing burning or shooting pain in the ball of the foot, numbness in the neighboring toes, and the classic feeling of a pebble or bunched sock underfoot.
Dr. Gruner starts by taking pressure off the nerve with roomier footwear, metatarsal pads or orthotics, and activity modification. Ultrasound both confirms the diagnosis and guides precise injections — cortisone, or in some cases a nerve ablation — into the exact spot, reserving surgery for cases that don't respond.
Common symptoms
- Burning or shooting pain in the ball of the foot
- Numbness or tingling in the toes
- Feeling of a pebble or lump in the shoe
- Pain relieved by removing the shoe and rubbing the foot
What to expect at your visit
- 1.
A focused conversation
Dr. Gruner reviews your history, prior imaging, and goals — what you want to get back to doing.
- 2.
Point-of-care ultrasound
When useful, a diagnostic musculoskeletal ultrasound evaluates the injury in real time, with no radiation.
- 3.
A clear, individualized plan
You leave understanding the diagnosis, the non-surgical options, and the expected timeline — in plain language.
Frequently asked questions
- How is a Morton's neuroma treated without surgery?
- Most improve with wider, lower-heeled footwear, metatarsal padding or orthotics to spread the bones, activity modification, and ultrasound-guided injections placed precisely at the nerve. Surgery is considered only when these measures fail to relieve the pain.