Morton’s Neuroma in the Foot: Symptoms, Causes, and Treatments

At Istituto Image, we approach personal well-being with a method that integrates scientific innovation and a deep understanding of the body’s biological mechanisms.
For this reason, we offer cutting-edge solutions for painful and disabling conditions such as Morton’s Neuroma.
Our goal is not only to relieve symptoms but to act on the root cause of inflammation through advanced regenerative therapies, such as the Lipogems technology, to provide effective and lasting relief and improve quality of life.

What is Morton’s Neuroma?

Morton’s Neuroma, despite its name, is not a tumor or neoplasm, but a benign degenerative condition affecting one of the interdigital nerves of the foot. It is a perineural fibrosis, meaning a thickening of the connective tissue surrounding the nerve, caused by chronic irritation or mechanical compression.
This condition most commonly develops in the space between the third and fourth toes, an area anatomically more prone to stress and microtrauma. The increase in fibrous tissue volume compresses the nerve, triggering painful and bothersome symptoms that can become disabling in daily activities. The sensation is often described as having a “pebble in the shoe,” a persistent discomfort that prevents normal walking.

Common Symptoms of Morton’s Neuroma in the Foot Nerves

The symptoms of Morton’s Neuroma are very characteristic and tend to worsen with tight footwear or physical activity, then ease with rest and by removing the shoes. Recognizing them is the first step toward a correct diagnosis.
The most common signs include:

• Sharp, burning pain: Mainly localized in the forefoot, at the base of the toes.
• Foreign body sensation: The feeling of having a pebble, a bead, or a fold in the sock under the foot.
• Electric shocks or tingling: Pain and numbness radiating towards the affected toes.
• Toe cramps: The sensation of toes “overlapping” or sudden cramps.
• Immediate relief when removing shoes: A typical and almost instinctive gesture is taking off footwear and massaging the area to find relief.

Main Causes of Morton’s Neuroma

Morton’s Neuroma is a condition caused by mechanical overload. Inflammation and the subsequent nerve thickening are the body’s response to compression or repeated stress over time. Understanding the causes is essential to set an effective prevention and treatment strategy.
The pain under the foot at the base of the toes is the main warning sign, which can appear as sudden sharp stabs to the toes, sometimes radiating into more generalized discomfort that also affects the big toe area due to altered walking mechanics.

The main risk factors include:

Diagnosis: How to Recognize Morton’s Neuroma

An accurate diagnosis is essential to distinguish Morton’s Neuroma from other foot conditions with similar symptoms (such as stress fractures, bursitis, or arthritis). The diagnostic pathway is based on two key steps:

• Clinical Examination: The specialist collects the patient’s history, analyzing the type of pain and habits (work, sports, footwear). During the visit, they perform targeted palpation of the intermetatarsal area. A specific test, the “Mulder’s sign,” consists of lateral compression of the forefoot: if this maneuver elicits a painful “click,” the diagnosis of Morton’s Neuroma is highly likely.
• Imaging Diagnostics: Ultrasound is the first-choice test, as it accurately shows the fibrous thickening of the nerve and allows measurement of its size. In doubtful cases, or to exclude other pathologies, MRI may be requested, providing a more detailed view of the soft tissues and bone structures of the foot.

Medical Treatments for Walking with Morton’s Neuroma

The aim of treatment is to reduce nerve compression, alleviate inflammation, and resolve pain. The approach is gradual, starting with the most conservative solutions and moving toward more innovative options.

• Conservative Therapies: The first step includes the use of custom orthotics to offload the metatarsal area, the choice of comfortable, wide-toe footwear, and cycles of physiotherapy (physical therapies such as tecar therapy or laser and stretching).
• Corticosteroid Injections: If pain persists, cortisone injections can reduce inflammation, providing relief that is often temporary.
• Regenerative Medicine with Lipogems®: At Istituto Image, we offer a regenerative approach as an alternative to traditional therapies. Treatment with Lipogems® consists of infiltrating micro-fragmented adipose tissue harvested from the patient. This tissue is rich in mesenchymal cells with strong anti-inflammatory and regenerative properties. The infiltration creates a natural cushion that protects the nerve from compression, reduces inflammation in a lasting way, and stimulates tissue repair processes.
• Surgery: If other therapies fail, surgical intervention is performed, consisting of removing the neuroma (neurectomy). Although definitive, the surgery results in loss of sensitivity in the affected area.

Prevention and At-Home Care Strategies

Prevention is the best cure for Morton’s Neuroma. Adopting a few simple habits can drastically reduce the risk of developing this bothersome condition or worsening its symptoms:

• Choose the Right Shoes: Opt for comfortable footwear with a wide toe box that does not compress the toes and a heel no higher than 3–4 cm. Alternate different shoes throughout the week.
• Use Orthotics: If foot support is incorrect, a custom orthotic can make the difference by distributing weight evenly.
• Manage Acute Phases: In case of pain, apply ice to the affected area for 15–20 minutes and keep the foot at rest.
• Stretching Exercises: Regularly stretching the calf and sole muscles can help reduce tension on the forefoot.

👉 Contact our specialists and book a consultation to define the most effective treatment pathway for you!

FAQ

Why does Morton’s Neuroma form?

Morton’s Neuroma forms due to chronic compression and irritation of an interdigital nerve in the foot. The main causes are tight or high-heeled shoes, alterations in foot shape (e.g., hallux valgus), or repeated microtraumas from certain sports or work activities.

How can Morton’s Neuroma inflammation be reduced?

It can start with conservative remedies such as rest, ice application, and comfortable footwear. Medically, corticosteroid injections can reduce inflammation. An advanced and natural alternative is regenerative therapy with Lipogems®, which has a powerful anti-inflammatory and regenerative effect.

Can Morton’s Neuroma heal on its own?

It is very unlikely for Morton’s Neuroma, being a fibrotic degeneration of nerve tissue, to heal spontaneously. However, symptoms may regress and be controlled by adopting proper conservative measures (adequate shoes, orthotics) and avoiding triggers.

How do I know if I have Morton’s Neuroma?

Typical symptoms are burning pain in the forefoot, the sensation of having a “pebble in the shoe,” and tingling in the toes, which worsen with tight shoes. For a certain diagnosis, a specialist consultation is essential, including clinical examination (with Mulder’s Test) and ultrasound.

What is the treatment for Morton’s Neuroma?

The treatment follows a gradual approach: it starts with conservative methods (orthotics, proper footwear, physiotherapy). If these are insufficient, infiltrative therapies (cortisone or regenerative medicine such as Lipogems®) are considered. Surgical removal of the neuroma is reserved for cases that do not respond to other therapies.