That pebble in your shoe might be a damaged nerve, not a rock.

Health · Published 3 October 2026 Swipe more like this →

In short: If you feel a sharp, burning sensation between your toes or the persistent sensation of a lump under your foot, you may be experiencing Morton's neuroma. This common condition involves an irritated nerve in the forefoot, often aggravated by footwear choices, but it is frequently manageable with simple, non-invasive adjustments.

Morton's neuroma is a thickening of the tissue around a nerve leading to the toes, typically occurring between the third and fourth metatarsals. Despite the name, it is not a true tumor; rather, it is often classified as a perineural fibroma—a formation of fibrous tissue around nerve structures. The condition is frequently linked to mechanical stress, such as wearing tight, high-heeled, or pointy shoes, or participating in high-impact activities like running. Underlying foot issues, including flat feet, high arches, or bunions, can also contribute to the nerve entrapment.

Patients often describe the pain as shooting or stabbing, sometimes accompanied by numbness or tingling. While the condition is commonly attributed to compression between metatarsal heads, some researchers suggest the transverse metatarsal ligament is the more likely culprit for the entrapment. Diagnosis often involves physical examination, such as Mulder's sign, where pressure on the forefoot replicates symptoms. Imaging tools like ultrasound are highly effective, as they can visualize nerve thickening greater than 3mm and allow for dynamic assessment by applying pressure with the probe.

First-line treatment typically focuses on conservative measures: switching to wide, low-heeled shoes with thick soles, using metatarsal pads to splay the bones, and resting. When these fail, specialists may offer corticosteroid or alcohol injections. For severe cases, surgical excision or radiofrequency neurolysis are options. A 2012–2022 study found that while surgical excision provided greater pain reduction, it carried a higher complication rate of 13% compared to 3.7% for radiofrequency ablation. However, radiofrequency ablation showed less durable results, with 26% of patients eventually requiring surgical follow-up.

General information, not professional advice. Spotted an error? Flag the card or see corrections and complaints.

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