Overview
what it is and why it mattersMorton's neuroma is a thickening of one of the small nerves between the bones of your forefoot — despite the name, it's not actually a true tumor; it's chronic scarring and swelling around the nerve. Most often it shows up between the third and fourth toes. The cause is repetitive compression of the nerve from narrow toe boxes and high heels. The classic symptom is burning forefoot pain or tingling between the toes — many patients describe it as feeling like they're stepping on a marble or a folded-over sock.
Symptoms
what you may notice- Burning pain between the toes — most often between the third and fourth toes, worsened by tight or narrow shoes
- Marble-in-the-shoe sensation — feeling like you're stepping on a pebble or a bunched-up sock under the ball of your foot
- Numbness or tingling — radiating into the affected toes as the swollen nerve is compressed
- Relief with shoe removal — symptoms often ease quickly when you take the shoe off and massage the forefoot
Diagnosis
exam first, imaging secondYour surgeon will use a specific test (Mulder's click) — squeezing the forefoot from side to side while pressing on the affected web space — which produces a feelable click and reproduces the pain. Ultrasound confirms the thickened nerve and is also used to guide injections. MRI is an alternative. Standing X-rays rule out other forefoot problems that can mimic the symptoms.
Treatment Path
how care progresses at OSIWide toe-box footwear
Wider, softer shoes that don't squeeze the forefoot — the single most important first step. For many patients, just changing footwear is enough.
Metatarsal pad
A small pad placed just BEHIND the painful spot lifts and spreads the bones apart slightly, taking pressure off the irritated nerve.
Corticosteroid injection
An corticosteroid injection placed precisely between the bones, guided by ultrasound — relieves symptoms in 50 to 70 percent of patients.
Sclerosing ethanol injection
A series of dilute alcohol injections can chemically destroy the nerve over several sessions — an alternative to surgery for refractory cases.
Surgical Options at OSI
if non-operative care isn't enoughSurgical removal of the thickened nerve is offered after non-operative care (footwear changes, padding, and at least one injection cycle) hasn't given lasting relief. The trade-off: the nerve is gone, which means permanent numbness in a small patch between the affected toes — most patients consider that a worthwhile trade for being out of pain.
Further Reading
authoritative sourcesExternal patient-education references and related OSI pages for additional background: