Morton’s Neuroma – Relieving Nerve Pain in the Ball of Your Foot
Overview
Morton’s neuroma is a painful nerve condition that affects the ball of your foot, usually between the third and fourth toes. It occurs when the tissue surrounding one of the digital nerves becomes thickened and irritated, often from chronic compression or repetitive pressure.
The result is a burning, sharp, or tingling pain that can feel like you’re “walking on a pebble” inside your shoe. Without treatment, the discomfort may worsen over time, making it difficult to wear certain footwear or remain active.
At Dr. Burke Orthopedics, we provide compassionate, evidence-based care for Morton’s neuroma — combining advanced diagnostics and customized treatment plans to relieve nerve pressure, restore comfort, and prevent recurrence. We proudly serve patients across Pearland, Houston, Friendswood, and Southeast Texas.
Understanding Morton’s Neuroma
Morton’s neuroma develops when a nerve in the forefoot becomes compressed or irritated, typically between the third and fourth metatarsal bones. Repetitive stress, tight shoes, or certain foot deformities can lead to thickening of the nerve sheath, causing inflammation and pain.
Although it is not a true tumor, the term “neuroma” refers to the benign enlargement of the nerve caused by irritation. Over time, this condition may interfere with balance, walking, and athletic performance.
Morton’s neuroma is more common in women due to footwear style (narrow or high-heeled shoes), but it can affect anyone who spends significant time on their feet.
Common Causes and Risk Factors
- Footwear compression: Tight, narrow, or high-heeled shoes that squeeze the toes.
- Repetitive stress: Sports or occupations involving running, jumping, or prolonged standing.
- Structural imbalances: Flatfoot, high arches, or hammertoes that change weight distribution.
- Injury: Direct trauma to the foot or repetitive irritation of the forefoot nerve.
- Inflammation: Chronic swelling or arthritis that increases pressure on nerve tissue.
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Risk Factors:
- Middle-aged adults, especially women.
- Runners and athletes who frequently push off the forefoot
- Occupations requiring tight or protective footwear (construction, healthcare).
- History of bunions, hammertoes, or other foot deformities
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Symptoms
Symptoms typically develop gradually and may worsen when wearing tight shoes or performing high-impact activities.
Common signs include:
- Sharp, burning pain in the ball of the foot.
- Numbness or tingling in the toes.
- Sensation of “walking on a pebble” or “folded sock” under the toes
- Pain that increases with tight footwear or prolonged standing.
- Temporary relief when removing shoes or massaging the foot.
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Symptoms may come and go at first but often progress without intervention.
Diagnosis
At Dr. Burke Orthopedics, Dr. Robert L. Burke uses a detailed and patient-centered approach to confirm the diagnosis and rule out other causes of forefoot pain.
Diagnostic process includes:
- Medical history: Identifying triggers such as footwear type or activity level.
- Physical examination: Checking swelling, alignment, circulation, and nerve function.
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Physical examination:
- Palpation of the forefoot to locate tenderness or reproduce pain.
- Compression testing to elicit the “click” or “Mulder’s sign” characteristic of neuromas
- Gait analysis to assess mechanical stress points.
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Imaging:
- Ultrasound: Detects nerve thickening and inflammation.
- MRI: Used in complex cases to visualize surrounding tissue and confirm diagnosis
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Accurate diagnosis ensures that the treatment plan targets the exact source of pain rather than masking symptoms.
Treatment Options at Dr. Burke Orthopedics
The goal of treatment is to relieve nerve compression, reduce inflammation, and prevent further irritation. Most cases can be managed successfully without surgery.
Non-Surgical Treatments
Footwear modification:
- Choose wide-toe shoes with soft cushioning to relieve nerve pressure.
- Avoid high heels or tight-fitting footwear.
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- Custom orthotics:
- Redistribute weight evenly across the foot and reduce metatarsal compression.
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- Padding or metatarsal bars:
- Cushion the forefoot to alleviate direct nerve pressure.
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- Anti-inflammatory medications:
- Reduce swelling and pain around the nerve.
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- Manual therapy and mobilization to improve foot flexibility.
- Nerve-glide exercises to restore mobility and decrease irritation.
- Strengthening and gait retraining to prevent recurrence.
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- Platelet-rich plasma injections can promote tissue healing and reduce chronic inflammation.
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- Corticosteroid or local anesthetic injections:
- Provide targeted relief in cases of acute nerve irritation.
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Most patients experience relief within 6–8 weeks of consistent conservative care.
Surgical Treatments
If symptoms persist or worsen despite non-surgical care, Dr. Burke may recommend a minimally invasive surgical procedure to remove or decompress the affected nerve.
Surgical options include:
- Neurectomy:
- Removal of the inflamed segment of the nerve to eliminate pain.
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- Nerve decompression:
- Releasing surrounding tissue or ligament pressure without nerve removal.
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- Used in complex or recurrent cases to restore proper alignment and prevent re-compression
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These outpatient procedures are performed with precision to minimize recovery time and maximize long-term outcomes.
Recovery and Rehabilitation
- Non-surgical: 6–8 weeks with progressive improvement.
- Surgical: 8–12 weeks with guided rehabilitation.
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Rehabilitation goals:
- Restore normal foot alignment and nerve function.
- Strengthen intrinsic foot muscles.
- Improve balance and gait stability.
- Prevent recurrence through custom footwear and orthotic support.
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Following recovery, most patients return to normal activities with little to no residual discomfort.
Long-Term Outlook and Prevention
With early intervention, most patients fully recover from Morton’s neuroma without long-term nerve damage. Preventive care helps maintain pain-free mobility.
Prevention tips:
- Choose footwear with wide toe boxes and supportive arches.
- Avoid tight or high-heeled shoes for extended periods.
- Stretch and strengthen the feet and calves regularly.
- Replace worn shoes or orthotics promptly.
- Seek evaluation for foot pain early to prevent chronic nerve irritation.
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Consistent attention to footwear and biomechanics helps prevent recurrence and supports lasting comfort
When to Seek Medical Care
You should see Dr. Burke Orthopedics if you experience:
- Persistent forefoot pain or tingling.
- Pain that worsens with tight shoes or standing.
- Numbness between the toes.
- A sensation of a lump or pebble underfoot.
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Early orthopedic evaluation prevents nerve damage and ensures faster relief.
Take the Next Step Toward Relief
Don’t let nerve pain limit your movement or quality of life.
At Dr. Burke Orthopedics, we offer advanced diagnostics and customized treatment for Morton’s neuroma, designed to relieve pain, restore balance, and get you back on your feet.
Call (713) 436-3488 or Request an Appointment Online to schedule a consultation with Dr. Robert L. Burke,
board-certified orthopedic surgeon specializing in foot and ankle conditions.
Serving Pearland, Houston, Friendswood, and Southeast Texas.
