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Morton’s Neuroma (Foot Neuroma)

Morton’s neuroma is a thickening of the tissue around a small nerve in the ball of the foot, most often between the third and fourth toes. It can feel like walking on a pebble, with burning or shooting pain into the toes. Roomier, lower-heeled shoes and pads help many people; injections or surgery are options when they don’t.

Morton’s neuroma itself is not an emergency — but ball-of-foot pain can have other causes that are. Get urgent advice right away if:

  • The pain is severe, you can’t walk, or the foot has changed shape, you heard a snap, grinding or popping noise when you hurt it, or the pain makes you feel faint, dizzy or sick. These can be signs of a broken bone; don’t try to treat a possible broken foot yourself (NHS).
  • Your foot is hot, swollen and painful, or you feel hot, cold or shivery — possible signs of an infection (NHS). Painful, hot, swollen skin can be cellulitis, which needs prompt antibiotics; with a very high temperature, a fast heartbeat or breathing, confusion, or feeling dizzy or faint, the NHS advises emergency care (NHS) — in the U.S., call 911 or go to the ER.
  • You have diabetes and a sore, blister or cut on your foot that isn’t starting to heal after a few days, or skin that turns red, warm or painful — call your provider right away (NIDDK). With diabetes, see your provider about any foot pain (NHS), and you can have foot problems without feeling pain (NIDDK). See our diabetes guide.

Don’t wait for a chiropractic, acupuncture, massage or coaching appointment for any of these.

What is Morton’s neuroma?

If it feels like you are “walking on a marble” and the ball of your foot hurts for a long time, you may have Morton’s neuroma. Despite the name, it is not a true tumor: it is a thickening of the tissue around one or more of the small nerves that run to the toes (AAOS OrthoInfo). The NHS describes it as thickened tissue around a nerve in the foot that has been irritated or damaged (NHS).

Other names. Your doctor may call it an interdigital neuroma, Morton metatarsalgia, interdigital neuritis or a plantar neuroma (AAOS OrthoInfo). Foot and ankle surgeons also use intermetatarsal neuroma, because it sits in the ball of the foot between the metatarsal bones. Morton’s is the most common neuroma in the foot, though neuromas can occur elsewhere in the foot too (ACFAS FootHealthFacts). So a “foot neuroma” or “neuroma between the toes” usually means the same condition.

Where and who. It most often develops between the third and fourth toes (the “third web space”), and less often between the second and third. It is around 8 times more common in women than in men and typically affects people aged 30 to 60 (AAOS OrthoInfo).

Symptoms

Symptoms usually start gradually, at first only now and then, but can grow more lasting and intense as the nerve changes become permanent (ACFAS FootHealthFacts). Untreated, neuromas tend to get worse (APMA).

Causes and risk factors

The exact cause isn’t known. Current research suggests the nerve is squeezed (entrapped) where it passes under a ligament between the metatarsal heads, which may trigger swelling and abnormal tissue around it (AAOS OrthoInfo). Things linked to it include:

How it’s diagnosed

Diagnosis starts with your history — where it hurts, what makes it worse and what helps, such as changing shoes — and an exam. The doctor checks for pressure points and toe deformities, presses between the toes to find the painful spot, checks the toe joints for signs of arthritis, and may squeeze the foot to feel for a “Mulder’s click.” Numbing the web space with a local anesthetic can both ease the pain and confirm the diagnosis if the symptoms go away (AAOS OrthoInfo).

In a 2024 review, a click you notice yourself strongly pointed toward the diagnosis, and no tenderness when the web space is squeezed made it unlikely; the “pebble” feeling and burning pain were much less reliable (Pitcher et al., 2024).

Imaging. X-rays may be used to rule out a stress fracture or arthritis. Ultrasound is the preferred test for the neuroma itself and can guide injections; an MRI is usually not needed (AAOS OrthoInfo). A review of 14 studies found ultrasound and MRI about equally good at detecting a neuroma, each catching roughly 9 in 10 that surgery later confirmed (Bignotti et al., 2015).

Other causes of ball-of-foot pain include sprains, bursitis and bunions (NHS). Stress fractures are most common in the metatarsal bones, especially the second and third (AAOS OrthoInfo). For heel pain, see our heel pain guide; for arthritis in the toe joints, our arthritis guide.

Who treats it, and what to expect

A primary care doctor can examine your foot and refer you to a podiatrist or foot and ankle surgeon (NHS); AAOS suggests an orthopaedic surgeon for continuing pain or tingling (AAOS OrthoInfo). Early diagnosis greatly lessens the need for more invasive treatment (ACFAS FootHealthFacts). Many people get long-term relief from shoe changes, orthotics, anti-inflammatory medicines and/or steroid injections, though shoe and orthotic changes alone help in only up to about half (AAOS OrthoInfo). About 30% may not respond to nonsurgical care (Cooper, JAMA, 2023); for them, see Surgery: options and trade-offs.

See a provider soon (not an emergency) if the pain is severe or stops your normal activities, is getting worse or keeps coming back, hasn’t improved after 2 weeks of self-care, or comes with tingling, weakness or numbness in your foot — or if it started after a recent foot injury or foot or ankle surgery (NHS).

Side by side

Six approaches compared

For every condition we look at the same six approaches: what each involves, what it typically costs, and what a patient can realistically expect.

ApproachWhat it involves Estimated costWhat to expect
Conventional medicine (AMA) Wider, lower-heeled shoes, metatarsal pads and orthotics, ice and anti-inflammatory pain relievers, steroid injections (often ultrasound-guided); alcohol, radiofrequency or freezing treatments for some; surgery if months of care fail. Cortisone shot about $100–$500 self-pay; custom orthotics about $300–$800 (store inserts about $15–$60). Medicare Part B covers medically necessary foot treatment (20% after the deductible). Surgery: cost estimate being researched. Shoe and pad changes help some people; steroid shots often help for a few months. Surgery succeeds in most people but can leave permanent toe numbness.
Chiropractic Hands-on mobilization and manipulation of the toe and foot joints, aiming to loosen stiff tissue around the nerve — never on a possible fracture or infected foot. Without insurance, a first appointment commonly about $90–$200 and a follow-up visit about $55–$100. A few small trials and case series report pain relief; promising but low-quality evidence. Mild, short-lived soreness is common.
Acupuncture Fine needles at acupuncture points for pain; there is no standard protocol for Morton’s neuroma. About $125–$230 for a first private visit and $90–$185 for follow-ups; community clinics about $50–$90. We found little research on acupuncture for this condition. Extra caution with diabetes, blood thinners or skin infection.
Herbal medicine No herb is shown to shrink or treat a neuroma. Capsaicin, from chili peppers, has been tested only as an injection given by a clinician. Cost estimate being researched. We found little research on herbal remedies for Morton’s neuroma. Check any herb for drug interactions.
Massage therapy Gentle rubbing of the forefoot for short-term relief; soft-tissue and fascial techniques studied only in a case report and a tiny pilot study. One national chain’s franchises list about $125–$160 for a 60-minute massage for non-members; memberships about $70–$90 a month. May ease pain for a while; no good trials. Gentle pressure only with numb feet or diabetes.
MBHA Wellness Coach Shoe fit and shopping habits, cutting back on high heels, pacing high-impact activity, healthy weight, workday strategies and tracking what triggers pain. Cost estimate being researched. Supports — never replaces — medical care. Shoe habits are the first-line treatment and help keep symptoms from returning.

Approach 1 of 6

Conventional medicine (AMA)

Treatment depends on how long you have had the neuroma and how far it has developed (ACFAS FootHealthFacts). It usually starts simple and steps up only if needed.

1. Shoes and activity changes

Avoid high heels and tight, narrow shoes, and choose wider shoes (a wide toe box) with lower heels and a soft sole. This lets the bones spread out and may take pressure off the nerve (AAOS OrthoInfo). The NHS also suggests resting and raising the foot and avoiding or reducing impact activities such as running and jumping (NHS). See Shoes, pads and everyday habits.

2. Pads and orthotics

Metatarsal pads or bars and custom shoe inserts spread pressure across the forefoot and separate the metatarsal bones, easing pressure on the neuroma (AAOS OrthoInfo); a podiatrist may also use padding and taping (APMA). Off-the-shelf devices can sometimes work as well as custom ones, but ask your doctor first: the wrong device can change how you walk (AAOS OrthoInfo).

3. Ice and pain relievers (by class)

An ice pack on the area can reduce swelling (ACFAS FootHealthFacts). NSAIDs (anti-inflammatories such as ibuprofen or naproxen) can ease inflammation (AAOS OrthoInfo), and the NHS also lists paracetamol (acetaminophen) (NHS). Ibuprofen may not suit you if you have a heart, liver or kidney condition, a stomach ulcer now or in the past, or asthma, and it may not mix with blood thinners such as warfarin or with blood pressure medicines; ask a pharmacist or doctor first (NHS). We don’t list doses.

4. Steroid (cortisone) injections

One or more corticosteroid injections can reduce swelling around the nerve; they may be given under ultrasound guidance (AAOS OrthoInfo). AAOS reports short-term relief in about 50% to 70% of people, with long-term relief less common (AAOS OrthoInfo). The trials are mixed:

  • In a UK trial of 131 people, steroid plus anesthetic beat anesthetic alone for at least three months (Thomson et al., 2013). In a Spanish trial of 41 people it did not, and about half of all participants later asked for surgery (Lizano-Díez et al., 2017).
  • A 2024 Cochrane review (six trials, 373 people) rated the evidence that steroid adds benefit over anesthetic alone as low-certainty, showing little to no difference in pain. It found moderate-certainty evidence that ultrasound-guided injections probably reduce pain and improve function more than unguided ones. Side effects of steroid included mild thinning or lightening of the skin and thinning of the fat pad under the foot, each in a few percent of people (Matthews et al., Cochrane, 2024).

5. Nerve-targeting procedures

When simpler care isn’t enough, some specialists offer minimally invasive treatments that disrupt the nerve’s pain signals: alcohol (ethanol) injections, radiofrequency ablation (heat) and cryoablation (cold), whose long-term results are still being studied (AAOS OrthoInfo).

  • Alcohol injections appear safe, but a review of 11 studies found the evidence too weak to draw conclusions (Santos et al., 2018).
  • Radiofrequency ablation: a review of eight studies (237 people), including case series without a comparison group, found about 48% had complete pain relief and about 16% no benefit, with few complications (Llombart-Blanco et al., 2025).
  • Cryoablation: in one clinic’s review of 54 patients, about 60% reported complete relief at six months and about 11% no relief or more pain; complications included two chilblain-like skin injuries and one stress-type (insufficiency) bone fracture (Moulin et al., 2024).

6. Add-on options with limited research

Shockwave therapy and platelet-rich plasma (PRP) injections may be considered as add-ons, but research on them is limited (AAOS OrthoInfo). In one sham-controlled shockwave trial, pain fell over four weeks in the treated group but the neuroma did not shrink (Seok et al., 2016).

7. Surgery

If symptoms don’t improve within 3 to 6 months, or come back, surgery may be recommended (AAOS OrthoInfo). See Surgery: options and trade-offs.

What it costs

  • Cortisone shot: usually about $100–$500 without insurance in a medical office; the whole appointment can reach $300–$1,000 or more when the exam, imaging guidance and facility fee are billed separately; some insured patients pay about $20–$50 (The Pricer).
  • Orthotics: custom orthotics about $300–$800 self-pay; store-bought inserts about $15–$60 a pair (The Pricer, The Pricer).
  • Medicare: Part B covers podiatrist exams and treatment that are medically necessary for foot injuries or diseases; you pay 20% of the approved amount after the deductible. Routine foot care usually isn’t covered (Medicare.gov).
  • Office visits, ultrasound, nerve-ablation procedures and surgery: MBHA cost estimate being researched.

Find a medical doctor in our directory

Approach 2 of 6

Chiropractic

Some chiropractors and other manual therapists use mobilization (gentle, repeated movement) and manipulation (a quick thrust) of the toe and foot joints, which may ease pain by loosening the stiff tissue around the nerve (Matthews et al., 2019, full text).

What the research says

  • 2019 review: steroid injections and manipulation or mobilization were the two treatments with the strongest evidence for pain reduction, but no high-quality evidence supported any one treatment as best (Matthews et al., 2019). Its manipulation trial was small (40 people, six sessions versus sham ultrasound) and followed people for only six weeks, so the authors urged caution. No side effects were reported in the manipulation studies (Matthews et al., 2019, full text).
  • Case series: in a review of 38 patients’ records, most were pain-free by their sixth manipulation session, but there was no comparison group (Cashley & Cochrane, 2015).
  • 2026 trial: in an exploratory trial of 61 adults, six weekly sessions of foot manipulation produced larger, longer-lasting improvements in pain and function over 12 months than a steroid injection (Cashley et al., 2026). It is a single, fairly small study, and its results need confirming.

Safety

  • The NHS says chiropractic may not be safe if you take blood thinners or have a higher risk of bleeding or stroke, have very weak or seriously damaged bones or joints, or have a nerve condition such as peripheral neuropathy (NHS) — common with diabetes.
  • Stress fractures are common in the metatarsals, and returning to activity too soon can turn one into a complete break (AAOS OrthoInfo). MBHA suggests having a possible fracture, or a red, hot or swollen foot, checked by a doctor before any manipulation.
  • Mild, temporary soreness or stiffness is common after manipulation and usually goes away within 24 hours (NCCIH).

What it costs

Without insurance, a first appointment commonly runs about $90–$200 and a follow-up visit about $55–$100 (The Pricer).

Find a chiropractor in our directory

Approach 3 of 6

Acupuncture

Acupuncture is used for many kinds of pain, but we found little research on acupuncture or dry needling for Morton’s neuroma, and no clinical trials.

What the research says

  • Across pain conditions, part of acupuncture’s benefit appears to come from nonspecific (placebo) effects: in many studies, benefits are larger when acupuncture is compared with no treatment than with sham acupuncture (NCCIH).

Safety

  • Complications are relatively rare but have come from non-sterile needles and poor technique; the FDA requires acupuncture needles to be sterile and single-use (NCCIH).
  • The NHS says acupuncture may not be safe if you take blood thinners, have a higher risk of bleeding, or have a skin condition or skin infection (NHS).
  • With diabetes, you may have foot problems without feeling pain (NIDDK). MBHA suggests telling your acupuncturist, avoiding needles in numb, broken or infected skin, and checking your feet afterward.

What it costs

About $125–$230 for a first private visit and $90–$185 for follow-ups; community clinics about $50–$90 a visit (The Pricer).

Find an acupuncturist in our directory

Approach 4 of 6

Herbal medicine

No herb has been shown to shrink a neuroma or relieve the pressure on the nerve. We found little research on herbal remedies for Morton’s neuroma.

Capsaicin: a pepper compound, tested as a medical injection

Capsaicin is the hot ingredient in chili peppers. In a placebo-controlled trial of 58 people, a single capsaicin injection into the painful web space, given by clinicians after numbing the area, reduced foot pain more than placebo at weeks one and four (Campbell et al., 2016). The authors’ affiliations include a drug company, and a 2020 review noted that capsaicin injections have limitations (Thomson et al., 2020). It is not a home remedy, and we found little research on capsaicin creams for this condition.

Herbs and your other medicines

The NHS advises against herbal medicines if you are pregnant or breastfeeding or have kidney or liver problems, and warns they may not mix with statins, antidepressants, diabetes medicines such as metformin, blood pressure medicines, blood thinners such as warfarin, and hormonal contraception. Check with a pharmacist first (NHS). Ginkgo taken with warfarin, for example, is linked to a higher risk of major bleeding (NCCIH). Tell your doctor about every herb or supplement you use. We don’t list doses here.

Approach 5 of 6

Massage therapy

Many people find relief by stopping, taking off the shoe and rubbing the foot, and resting and massaging the area can temporarily ease neuroma pain (APMA, ACFAS FootHealthFacts). Massage won’t remove the pressure on the nerve, so pair it with better shoes and padding.

What the research says

  • Case report: one active 25-year-old woman had six weekly massage sessions plus a home exercise, and her pain during exercise fell from 5 to 0 out of 10. The author called for proper trials (Davis, 2012).
  • Pilot study: “fascial manipulation,” a hands-on technique aimed at the deep connective tissue, was followed by less pain at three weeks and three months — but only 9 of the 28 people recruited completed it (Biz et al., 2021).
  • Reflexology is claimed to cause relaxation and healing elsewhere in the body, but this has not been proven (NCCIH). Enjoy it as relaxation, not treatment.

Safety

  • The risk of harm from massage appears low, but rare serious problems — a blood clot, nerve injury or broken bone — have been reported, sometimes with vigorous deep-tissue work (NCCIH).
  • With diabetes or numb feet you may not feel an injury (NIDDK); MBHA suggests gentle pressure only and no massage over broken skin. Skip massage on a hot, swollen foot and get it checked instead.

What it costs

Prices vary by location. At one national chain, franchise price lists show about $125–$160 for a 60-minute massage for non-members and about $65–$90 for members, whose memberships run about $70–$90 a month (The Pricer). Tips are extra.

Find a massage therapist in our directory

Approach 6 of 6

MBHA Wellness Coach

Shoe choices and daily habits are the first-line treatment for Morton’s neuroma, and they help keep it from coming back. An MBHA Wellness Coach can help you make those changes stick, alongside — never instead of — your medical care.

Another approach

Shoes, pads and everyday habits

Because tight and high-heeled shoes squeeze the nerve, the right shoes are the foundation of treatment (AAOS OrthoInfo).

  • Room for the toes. Choose a square or wide toe box with a heel lower than 2 inches; pointed high heels put even more pressure on the forefoot. If you wear heels, a platform under the toe box lowers the stress (AAOS OrthoInfo).
  • Adjustable, cushioned shoes. Look for laces or buckles that let you adjust the width, thick shock-absorbing soles, and insoles designed to keep excessive pressure off the foot (APMA).
  • Shop smart. Feet can swell up to 8% during the day, so buy shoes toward the end of the day; have your feet measured standing; leave about half an inch beyond your longest toe; and buy by fit, not size. If a shoe is too narrow, try a brand with a wider toe box rather than a bigger size (AAOS OrthoInfo).
  • Metatarsal pads. Soft pads or insoles take pressure off the painful area; a pharmacist can help you choose them (NHS). Padding supports the metatarsal arch, lessening pressure on the nerve as you walk (ACFAS FootHealthFacts). Ask your podiatrist where to place them.

Another approach

Surgery: options and trade-offs

Surgery is usually considered when symptoms haven’t improved after 3 to 6 months of other care, or keep coming back (AAOS OrthoInfo). It is often an outpatient procedure (APMA). The surgeon reaches the nerve through a cut on the top (dorsal) or the bottom (plantar) of the foot and then does one of two things (AAOS OrthoInfo):

  • Decompression (neurolysis): releasing the tissue that squeezes the nerve. It can preserve feeling but gives slightly less predictable results, and it has become more popular because it spares the nerve (AAOS OrthoInfo).
  • Neurectomy: removing the diseased part of the nerve. It can bring high pain relief, but risks include permanent numbness and a new painful “stump neuroma” at the cut end of the nerve (AAOS OrthoInfo).

How well it works

Recovery

Recovery is usually short: walking in a stiff-soled post-op shoe, no high-impact activity or soaking the foot until the wound heals (usually at least 2 to 3 weeks), and normal shoes by about 4 weeks. Follow your own surgeon’s instructions (AAOS OrthoInfo).

Ask your surgeon whether they recommend decompression or removing the nerve and why, whether your toes will be numb afterward, and which incision they plan. Surgery cost: MBHA estimate being researched; Medicare Part B covers medically necessary foot treatment at 20% after the deductible (Medicare.gov).

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Sources

This page is for education only and is not medical advice. Costs are typical U.S. ranges and estimates; yours will depend on your provider, location and insurance. Talk with your doctor before starting, stopping or combining any treatment. In an emergency, call 911. See our disclaimer.

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