Morton’s neuroma is a common cause of forefoot nerve pain that often feels sharp, burning, or like standing on a pebble. Many people with foot pain notice symptoms flare with tight shoes or long periods on their feet. Physiotherapy may help reduce nerve irritation, improve foot mechanics, and restore walking comfort.

The condition most often affects the nerve between the third and fourth toes. If you want a deeper medical overview of the condition, the NCBI Bookshelf summary provides a clear, non-commercial outline.

What is Morton’s neuroma?

Despite its name, Morton’s neuroma is not a tumour. It involves thickening and irritation of the tissue around a digital nerve. Over time, repeated compression and overload may contribute to inflammation and fibrotic change around the nerve.

This nerve irritation can make everyday activities such as walking, standing, or wearing enclosed shoes uncomfortable. Some people also notice symptoms overlap with other causes of pain in the ball of the foot (metatarsalgia).

Morton’s neuroma symptoms

Common symptoms include:

• Burning or sharp pain in the ball of the foot
• Pain between the toes, most often the third and fourth
• Tingling, pins and needles, or numbness
• A sensation of a lump or pebble under the foot

Symptoms often worsen with tight footwear and improve when shoes are removed.

People also ask: can Morton’s neuroma go away on its own?

Sometimes symptoms settle when you reduce compression on the forefoot and improve load control. However, ongoing nerve irritation often returns if the same footwear and walking loads continue. A plan that targets footwear, foot control, and graded activity usually gives a more reliable path forward.

What causes Morton’s neuroma?

Morton’s neuroma usually develops due to repeated mechanical overload of the forefoot. Contributing factors may include:

• Tight or narrow toe-box footwear, including high heels
• Increased forefoot loading during walking or running
• flat feet or excessive pronation
• Previous foot injuries altering foot mechanics
• Poor control of intrinsic foot muscles

Footwear that slopes weight onto the forefoot and compresses the toes can increase nerve irritation over time. Many people do best with a wider toe box and a lower heel-to-toe drop while symptoms settle.

Morton’s neuroma physiotherapy treatment

Physiotherapy focuses on reducing nerve irritation, improving foot mechanics, and gradually restoring function.

Phase 1: Pain relief and unloading

Early treatment aims to settle pain and inflammation. A physiotherapist may recommend:

• Activity and load modification
• Ice therapy
• Taping or padding to offload the nerve
• Footwear adjustments
• Short-term use of orthotics

Metatarsal domes or padding are often helpful for reducing pressure across the nerve. In some cases, your clinician may discuss options such as injections, depending on symptoms and duration.

When to consider a cortisone injection for Morton’s neuroma

In some cases, a cortisone injection may be considered to help reduce inflammation around the irritated nerve. This option is usually discussed when pain persists despite appropriate footwear changes, activity modification, and physiotherapy treatment.

A cortisone injection does not correct the underlying mechanical cause of Morton’s neuroma. For this reason, it is often used alongside strategies such as footwear modification, padding, or orthotic support rather than as a stand-alone solution.

Many people experience short- to medium-term symptom relief after an injection. However, responses vary, and symptoms may return if ongoing forefoot overload is not addressed. Repeated injections are generally used with caution due to potential effects on surrounding tissues.

Your physiotherapist or doctor can help determine whether a cortisone injection is appropriate based on symptom duration, severity, and response to conservative care.

Phase 2: Restore movement and flexibility

As pain settles, treatment may progress to restoring normal toe and foot movement. This may include joint mobilisation, soft tissue techniques, targeted stretching, and foot alignment strategies.

Phase 3: Improve muscle control and strength

Weak or poorly controlled foot muscles can increase forefoot load. Exercises aim to improve arch control, toe strength, and load distribution during walking.

Phase 4: Return to normal activity

Rehabilitation goals depend on your activity needs. Some people aim to walk comfortably, while others want to return to running or work demands. Progression is guided by symptoms and load tolerance.

Phase 5: Prevent recurrence

Long-term management focuses on reducing repeated overload. A physiotherapist may recommend footwear changes, ongoing exercises, or temporary orthotic support.

When is surgery considered?

Surgery may be discussed if symptoms persist despite several months of conservative care. Many people improve without surgery. Your physiotherapist or doctor can help guide decision-making based on symptom severity and response to treatment.

What to do next

If forefoot pain is affecting your walking or footwear choices, an assessment may help identify contributing factors and guide appropriate treatment options.

References

1. Choi JY, Lee KT, Kim TW, et al. Corticosteroid Injection for Morton’s Interdigital Neuroma: A Systematic Review. 2021.
2. Jaai M, et al. Retrospective Study of Morton’s Neuroma: Clinical outcomes of conservative interventional treatment. 2024.
3. Munir U, et al. Morton Neuroma. StatPearls. NCBI Bookshelf. Updated 2023 (updated regularly).