Morton’s neuroma is the thickening and irritation of one of the nerves running between the metatarsal heads, nearly always between the third and fourth toes. What characterises it is not a dull ache but an electrical sensation: shooting pain, burning or tingling travelling towards the toes, often with the impression of a fold of sock or a small stone inside the shoe.
It worsens with narrow-toed footwear and with heels, because both compress that area and increase pressure on the nerve; it eases on taking the shoe off and massaging the forefoot. What we look for at the appointment is to reduce that compression: give the nerve room, redistribute pressure across the metatarsal heads, and take the offending footwear out of the equation.
What is done
- Precise location of the point that reproduces the symptoms.
- Telling mechanical pain apart from pain of nerve origin.
- Assessment of forefoot pressure and of the width of your footwear.
- Offloading of the area to separate the metatarsal heads.
- Insoles when that offloading needs to be maintained while walking.
Do you feel shooting pain or tingling between your toes in closed shoes?
Book an appointmentFrequently asked questions
- Why does it feel like a stone or a fold in my sock?
- Because what is irritated is a nerve, and a nerve does not report where it is: it reports the area it supplies. When it is compressed between two metatarsal heads, the sensation reaching the brain is of something pressing in the sole or something odd between the toes, even though there is nothing in the shoe. That is why many people take the shoe off and look, and find nothing. That detail is exactly what distinguishes this from mechanical pain: an overload hurts where it is, whereas a nerve produces tingling, burning or a shooting sensation towards the toes. Describe it in those words at the appointment, because it changes the approach.
- What should my footwear be like?
- What matters most is the width of the toe box, not the size: the shoe has to let the metatarsal heads spread as you load them, and a narrow toe squeezes them together exactly where the nerve runs. Measure your foot standing with the weight spread, which is when it truly widens, and rule out pointed shapes even if the length fits. High heels add to it too, because they shift load towards the forefoot: the lower, the less pressure in that area. And a sole that is not very thin helps stop the ground reaching you so directly. Bring the shoes you are worst in to the appointment: it quickly shows what is pressing.
