Morton's Neuroma | Keep On Your Feet
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Morton's Neuroma

Morton's Neuroma is a swelling or thickening of the nerve sheath which surrounds the nerve that runs in between the metatarsal heads. Symptoms may include tingling, burning, electric shocks or numbness to the affected toes.

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A graphic of the forefoot showing where a Morton's Neuroma forms.

About Morton's Neuroma

Each toe shares a nerve with the toe next to it, and the nerve effectively 'splits' in two parts when it passes the knuckle joints. 

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For those with a Morton's Neuroma, the nerve may become thickened at this point where it has been rubbed between the knuckle joints. 

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Technically, the swelling will only be a Morton's Neuroma if it is between the third and fourth toes. Otherwise, each swelling has a different name according to the location:

  • 1st toe (outer side): Joplin's Neuroma

  • 1st-2nd toe: Heuter's Neuroma

  • 2nd-3rd toe: Hauser's Neuroma

  • 3rd-4th toe: Morton's Neuroma

  • 4th-5th toe: Iselin's Neuroma

Symptoms of Morton's Neuroma

Symptoms of Morton's Neuroma are consistent with those for any nerve entrapment:

  • Numbness

  • Burning

  • Tingling

  • Shooting pains or electric shocks

Although, because the neuroma affects the nerve on the bottom of the foot, it can also create feelings like:

  • A rucked-up sock under the foot/toes

  • A pebble in your shoe

When a neuroma gets particularly large, it can also create a 'Churchill sign', which is where it causes the toes either side to splay; however, this is more likely to be the result of plantar plate injuries than Interdigital Neuromas.

A collage showing a photo of Winston Churchill (with a cigar) making the 'peace' sign (two fingers up, palm facing forward) and a lady's foot where the toes have separated slightly forming something known as 'Churchill's sign'.
A graphic showing the anatomy of the bottom of a foot.

What else could it be?

Despite the relatively small amount of space at the front of the foot, there is quite a lot going on, especially due to the amount of force that goes through this region. Other differential diagnoses for Morton's Neuroma include:

How is a Morton's Neuroma diagnosed?

Morton's Neuroma is notoriously difficult to diagnose and the most useful diagnosis often comes from the history patients give and the physical examination.​

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Imaging that can be used for Morton's Neuroma:

  • Ultrasound scans (particularly dynamic)

  • MRI Scans (may often miss neuromas if 'slices' taken are too widely spaced.

  • X-rays can be used to rule out other issues, like fractures, however, unless the X-ray is a standing X-ray, it provides very little useful information that may assist with the diagnosis of a neuroma.

A sagittal plane MRI scan of a foot.
A barefoot person standing stretching their big toe skywards as an exercise that might be given for some types of foot pain.

How are Morton's Neuromas treated?

Morton's Neuromas are typically caused by biomechanical factors, and so the way to treat them is often to alter biomechanics. This being said, analgesics can also be helpful. 

Some of the treatments that are recommended include:

Ready to start being pain free?

How long does it take to cure Morton's Neuromas?

Once a patient has a Morton's Neuroma, it very rarely goes away. This being said, the symptoms can be managed very effectively, to the point you forget you ever had any issues. 

Generally speaking, symptoms can be improved by 30-50% within a week of starting insole therapy. 

If combined with changes in footwear, an improvement of 70-80% can often be enjoyed. 

Very few patients, after 6-8 weeks of treatment, will 

be considering surgery. 

Lady running with her dog
Ready to say goodbye to your pain?

At Keep On Your Feet, we openly acknowledge that we cannot guarantee a cure for things: but we will work as hard as we can with you to help you reach your goals. 

If your symptoms fit the above, you will need to book a 'Foot Pain' consultation. This will be £95 and lasts approximately 60 minutes usually. If you need insoles, we'll give you some basic ones to try out (or some fancier ones and reduce their price!). 

This is a picture of Jeremy Ousey, director and podiatrist of Keep On Your Feet.

About the Author

Jeremy Ousey, Podiatrist

Jeremy Ousey is the owner at Swansea's podiatry clinic: Keep On Your Feet. All the information found on this page was written by him (there's no AI or Chat-GPT here!), and has been carefully chosen to provide you with the information that you need to know about the condition. Jeremy has a Bachelor of Science in Podiatry, with honours, a Post-Graduate Certificate in Podiatric Sports Medicine, a Post-Graduate Diploma in Medical Ultrasound, and two Master's of Science degrees in the Theory of Podiatric Surgery, and Sports & Exercise Medicine. If you would like to know more about Jeremy, please click here.

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