Morton's Neuroma: Burning Pain and Numb Toes? This Helps!

You're walking along, and suddenly there it is: a sharp, burning jolt in your forefoot, as if an electric shock is shooting through your toes. You take off your shoe, rub your foot for a moment, and it settles down. Sound familiar? Then you may well have Morton's neuroma: an irritated, thickened nerve between the metatarsal bones. The name sounds worrying, but a neuroma is benign and in most cases very treatable without surgery — as long as you manage to take the pressure off the nerve. In this article you'll learn exactly what Morton's neuroma is, what causes it and what you can do about it yourself.

What is Morton's neuroma?

Small nerve branches run between your metatarsal bones, providing sensation to your toes. With Morton's neuroma, one of these branches — almost always the one between the third and fourth metatarsal, sometimes between the second and third — gets pinched between the bones and the ligament that runs across them. The constant friction and pressure cause the tissue around the nerve to thicken, which makes it even easier to pinch: a vicious circle of irritation.

The result is typical nerve pain: burning, electric, shooting, often with tingling or numbness in the adjacent toes. Unlike ordinary pressure pain, the complaint isn't under a bone but between two bones. Morton's neuroma is most common in women between 40 and 60 — narrow shoes and heels play a leading role — but runners and people with a dropped transverse arch are also affected more often.

Causes of Morton's neuroma

Anything that reduces the space between the metatarsals or increases pressure on the forefoot can irritate the nerve:

• Narrow shoes: a tight toe box squeezes the metatarsals together and pinches the nerve — the main cause.
• Heels: shift your weight onto the forefoot and increase pressure exactly where the nerve runs.
• A dropped transverse arch: when the metatarsals sink, the space between them changes and friction on the nerve increases.
• Repeated peak loads: running, jumping and sports with lots of push-off moments irritate the nerve again and again.
• Foot shape: flat feet, a high instep or hammer toes change the position of the bones and the room for the nerve.

Symptoms: how to recognise it

Morton's neuroma has a very recognisable pattern of complaints:

• Burning or electric pain in the forefoot, usually radiating into the third and fourth toes.
• Tingling or numbness in the adjacent toes.
• The feeling that something is in your shoe (a lump, a bunched-up sock) when nothing is there.
• Worse in (narrow) shoes, better barefoot — many people prefer to slip their shoe off for a moment, and it genuinely helps.
• Shooting pains when pushing off or standing on your toes.

The difference with metatarsalgia: that causes nagging pressure pain under the metatarsal heads, without radiation or numb toes. Read more in our article on metatarsalgia. The two can also occur together, as they share the same underlying cause: too much pressure on the forefoot.

Bracefox® Arch Support Insoles – ErgoSole

Supports the transverse arch and gives the nerve room again.

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What can you do yourself?

Treatment of Morton's neuroma revolves around one principle: space and rest for the pinched nerve. In most cases, complaints clearly ease within weeks to a few months:

• Choose shoes with a wide toe box: your toes should be able to lie freely side by side. This alone often removes the biggest share of the complaints.
• Skip the heels: the flatter the shoe, the less weight rests on the forefoot.
• Wear insoles with transverse arch support: by slightly lifting and spreading the metatarsals, there's literally more room for the nerve — the very mechanism by which insoles work for a neuroma.
• Temporarily reduce peak loads: less jumping and sprinting, more cycling and swimming, until the nerve has calmed down.
• Cool during a flare-up: a cold pack under the forefoot for 10 minutes dampens the nerve irritation.

3 exercises and self-help tips

These exercises relieve the area around the nerve and keep the forefoot supple. Do them daily, calmly and within your pain limits.

Exercise 1: toe spreading (creating space)

1. Sit with your foot flat on the floor and spread your toes as far apart as possible, without lifting them.
2. Hold for 5 seconds and relax. Repeat 10 times, twice a day.
3. Struggling to spread them? Weave your fingers between your toes for a minute (like at a pedicure) — a soothing passive variation.

Exercise 2: rolling the sole (relaxation)

1. Roll your sole calmly over a massage ball or tennis ball for 1 to 2 minutes.
2. Work around the painful zone, not hard on top of it — the nerve itself doesn't want extra pressure.
3. Ideal at the end of the day.

Exercise 3: calf stretch against the wall (easing the roll-through)

1. Hands against the wall, affected leg well back, heel on the floor.
2. Bend your front knee until you feel the stretch in your calf and hold for 30 seconds — 3 repetitions, twice a day.
3. Supple calves reduce the pressure on the forefoot as each step rolls through.

When to see a doctor?

Make an appointment with your doctor if:

• the complaints don't clearly ease after six to eight weeks of roomier shoes, insoles and exercises;
• the pain is so severe that it limits your daily walking or work;
• the numbness in your toes persists or spreads;
• you have diabetes and notice sensory changes in your foot — that always needs to be checked.

A doctor can usually make the diagnosis with a simple compression test and refer you to a podiatrist if needed. For stubborn complaints there are further options, from an injection to — as a last resort — a minor procedure. The vast majority of people, however, become symptom-free with conservative treatment.

Our recommendations for Morton's neuroma

Room for the nerve starts under your foot. The Bracefox® Arch Support Insoles – ErgoSole support the transverse arch, gently lifting and spreading the metatarsals — exactly the relief a pinched nerve needs to calm down. Wear them consistently in your everyday shoes (with a wide toe box!) for the best effect.

Also looking for daily comfort with forefoot cushioning, for long days on your feet? The Bracefox® Daily Insoles – AeroSoll are a pleasant addition: light, soft on the ball of the foot and suitable for almost any shoe.

Bracefox® Daily Insoles – AeroSoll

Soft cushioning for the forefoot, comfortable every day.

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Frequently asked questions about Morton's neuroma