The Centers for Advanced Orthopaedics
Maryland Orthopedic Specialists
A Division of The Centers for Advanced Orthopaedics
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Foot & Ankle

Morton's Neuroma

Morton's neuroma is one of the most common causes of forefoot pain in adults, yet it is frequently misdiagnosed or under-treated. Despite its name, it is not a true neuroma — it is perineural fibrosis of the interdigital nerve, resulting from chronic compression and irritation as the nerve passes between the metatarsal heads. The result is a nerve that becomes thickened, scarred, and exquisitely painful with standing and walking. At Maryland Orthopedic Specialists, we provide a full spectrum of care: from simple shoe modifications that relieve symptoms immediately, to ultrasound-guided injections, to definitive surgical neurectomy for patients who have exhausted conservative options.

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What is morton's neuroma?

The interdigital nerves travel between the metatarsal heads to provide sensation to adjacent toes. The third web space (between the 3rd and 4th toes) is most commonly affected, accounting for approximately 70% of cases, likely because the medial and lateral plantar nerve branches both contribute to this web space, making the nerve slightly larger and more prone to compression.

The interdigital nerves travel between the metatarsal heads to provide sensation to adjacent toes. The third web space (between the 3rd and 4th toes) is most commonly affected, accounting for approximately 70% of cases, likely because the medial and lateral plantar nerve branches both contribute to this web space, making the nerve slightly larger and more prone to compression. The second web space is the next most common.

Repetitive compression — from narrow toe boxes, high heels, forefoot loading during sport, or intrinsic metatarsal anatomy — causes perineural and intraneural fibrosis. The nerve enlarges to between 5–10 mm in diameter in most symptomatic cases. The condition affects women far more frequently than men (approximately 8:1 ratio), attributable to footwear patterns.

Bilateral neuromas are uncommon; when present in multiple web spaces simultaneously, secondary causes (systemic neuropathy, inflammatory arthritis) should be excluded.

Treatment options

Morton's neuroma responds well to conservative treatment in most patients.

Non-Operative Management

Switching to shoes with a wider toe box is the single most important step and relieves symptoms in many patients on its own. A metatarsal pad placed just behind the affected area takes pressure off the nerve. A corticosteroid injection provides significant pain relief and is effective for most patients who don't respond to footwear changes alone.

Surgical Procedure

Ankle Arthroscopy

Minimally invasive joint scope to treat intra-articular ankle pathology — osteochondral lesions, anterior bony impingement, and synovitis — through small portals with same-day discharge at our ambulatory surgery center.

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Frequently Asked Questions

What is Mulder's click?
Mulder's click is a clinical test in which the examiner squeezes the forefoot laterally while pressing the specific web space — the enlarged neuroma subluxes, producing a palpable and sometimes audible click. It is the most specific physical finding for Morton's neuroma.
Will I lose feeling in my toes after surgery?
Yes — excision of the interdigital nerve produces permanent numbness between the affected toes. Most patients find this an acceptable trade-off given the severe pain they experienced beforehand. The risk of complications beyond numbness is low.
Are injections a permanent cure?
Corticosteroid injections are often not permanent, with benefits lasting weeks to months. Alcohol sclerosing injections aim for a more lasting effect by progressively fibroing the nerve, and success rates are comparable to surgery in some series. Neither option guarantees permanent resolution for all patients.
Can I have a neuroma in two web spaces?
Yes, but multiple simultaneous neuromas should prompt evaluation for an underlying contributing diagnosis such as inflammatory arthritis or peripheral neuropathy. Bilateral neuromas in the same web space are rare and warrant careful re-evaluation of the diagnosis.
How long is recovery after Morton's neuroma excision surgery?
Most patients are walking in a surgical shoe or wide supportive footwear within a few days of Morton's neuroma excision. Swelling in the forefoot can persist for four to eight weeks, and the small area of permanent numbness in the affected web space typically becomes less noticeable over time as the brain adapts. Return to regular shoes and low-impact activity is usually possible by four to six weeks, with full activity including sport by two to three months. Your MOS foot and ankle surgeon will discuss realistic expectations for symptom relief and guide your return to footwear and activity.

Meet the specialists

Gary Feldman, DPM, FACFAS

Gary Feldman, DPM, FACFAS

Podiatry (Foot & Ankle Surgery)

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Related conditions

MetatarsalgiaPlantar Fasciitis
Medically reviewed by Gary Feldman, DPM, FACFAS, DPM, FACFAS
Last reviewed May 1, 2026

References

  1. Thomson CE, Beggs I, Martin DJ, et al. Methylprednisolone injections for the treatment of Morton neuroma: a patient-blinded randomized trial. Journal of Bone and Joint Surgery (American). 2013;95(9):790–798. doi:10.2106/JBJS.J.01748
  2. Espinosa N, Seybold JD, Jankauskas L, Erschbamer M. Alcohol sclerosing therapy is not an effective treatment for interdigital neuroma. Foot & Ankle International. 2011;32(6):576–580. doi:10.3113/FAI.2011.0576
  3. Akermark C, Crone H, Skoog A, Weidenhielm L. A prospective randomized controlled trial of plantar versus dorsal incisions for operative treatment of primary Morton's neuroma. Foot & Ankle International. 2013;34(9):1198–1204. doi:10.1177/1071100713484950
  4. Mahadevan D, Venkatesan M, Bhatt R, Bhatia M. Diagnostic accuracy of clinical tests for Morton's neuroma compared with ultrasonography. Journal of Foot and Ankle Surgery. 2015;54(4):549–553. doi:10.1053/j.jfas.2014.09.010
  5. OrthoInfo — AAOS. Morton's Neuroma. Available at: https://orthoinfo.aaos.org/en/diseases--conditions/mortons-neuroma