What Is Morton's Neuroma?
Morton's neuroma occurs when the tissue around one of the nerves in the foot, most often the nerve between the third and fourth toes, becomes thickened. That thickening compresses the nerve and produces pain that tends to worsen with activity or in tight shoes. Many people describe a burning pain in the ball of the foot, along with tingling or numbness in the toes.
What Does It Feel Like?
Common symptoms include:
- Burning pain in the ball of the foot, often between the third and fourth toes.
- Tingling or numbness in the toes.
- A sensation of standing on a pebble, or that something is bunched up in the shoe.
- Pain that worsens with activity or in tight, narrow footwear.
How Do You Treat It?
Many patients find relief from conservative care, including footwear modifications, orthotics, rest, and corticosteroid injections. When those options have not helped, shockwave therapy may be the next step.
Shockwave therapy (ESWT)
Extracorporeal shockwave therapy uses high-energy sound waves to stimulate healing in targeted tissue. It is a noninvasive, drug-free treatment that can reduce pain and improve function in chronic forefoot conditions like Morton's neuroma, especially when other conservative options have not worked.
- Targeted. High-frequency impulses are delivered to the affected area.
- No injections or downtime. Treatment is done in-office, and patients return to activity soon after.
- Research-supported. Clinical studies show symptom improvement within one to four weeks for most patients.
What to expect
- Most protocols involve about four sessions, spaced one week apart.
- A typical session delivers around 2,000 impulses at the highest energy level you tolerate, adjusted to your needs.
- Both radial and focused shockwave techniques are effective.
- Side effects are minimal and temporary, usually slight redness or discomfort at the treatment site.
Choosing Radius
At Radius Physical + Sports Rehab, Dr. Tristan Ginkel has treated Morton's neuroma with shockwave therapy, helping patients return to walking, running, and daily activities. Our clinic focuses on musculoskeletal rehabilitation and evidence-based care for chronic pain, soft tissue injuries, and nerve-related foot conditions, and every plan starts with a full-hour diagnostic exam.
About the author
Dr. Tristan Ginkel, DC, FRCms
Sports Chiropractor
Dr. Tristan Ginkel is a passionate and skilled sports chiropractor and Functional Range Conditioning mobility specialist based in Nevada City, California, dedicated to helping patients move better, feel stronger, and perform at their best. Originally from Gilroy, CA, Dr. Tristan brings a warm, personable approach to care—blending cutting-edge techniques with a sincere commitment to each patient’s health journey. Known for his kindness, approachability, and family-first values, he strives to create a supportive and empowering experience for every individual he treats.
More from Dr. Tristan Ginkel →Frequently Asked Questions
Common questions about Morton's neuroma.
What is Morton's neuroma?
Morton's neuroma is a compressive neuropathy of one of the small nerves between the toes (an interdigital nerve), caused by compression and constant irritation at the ball of the foot. Despite the name, it is not a true tumor; the nerve tissue is degenerative rather than neoplastic. It most commonly develops between the third and fourth metatarsal heads. Most people feel pain in the ball of the foot that worsens with walking and in tight shoes.
What are the symptoms of Morton's neuroma, and where in the foot does it hurt?
Pain centers in the ball of the foot, typically in the third web space between the third and fourth toes, and can radiate into the toes during weightbearing. Many people describe burning or sharp pain and a sensation of "walking on a marble." Tingling or numbness in the toes can also occur, though numbness is present in less than half of patients. Symptoms tend to worsen with walking and in tight, high-heeled shoes.
What causes Morton's neuroma and who is most at risk?
Morton's neuroma develops when an interdigital nerve is repeatedly compressed and irritated at the ball of the foot. Contributing factors include narrow toe-box footwear, hyperextension of the toes in high heels, toe deformities, forefoot trauma, and high-impact sporting activities. It is most common in middle-aged women; the incidence is at least five times more common in females than in males, and it most often affects people between the ages of 30 and 60.
How is Morton's neuroma treated without surgery?
Most people have a good recovery with non-surgical care. First-line steps focus on footwear: a wide, soft-soled, low-heeled shoe with a roomy toe box helps relieve pressure on the nerve. A metatarsal pad placed just behind the metatarsal heads can spread the bones and ease mechanical pressure, and custom inserts may help. Steroid injections can occasionally relieve symptoms, though the effect is rarely long-lasting. If symptoms do not improve within 3 to 6 months, surgery may be considered.
Does shockwave therapy (ESWT) work for Morton's neuroma?
The evidence is limited and lower-certainty than for some other conditions, so shockwave therapy is best viewed as one option to consider among conservative measures rather than a first-line step. A small placebo-controlled trial found reduced pain at 1 and 4 weeks after treatment, but the authors concluded only that it "may reduce pain," and neuroma size did not change. A systematic review found a statistically significant improvement but noted limitations in applying the findings, and recommended corticosteroid injection as the primary non-surgical treatment. Some patients do experience relief; a clinician can help weigh whether it fits your situation.
How long does it take to recover from Morton's neuroma?
There is no single recovery timeline, but most people improve with non-surgical treatment. Conservative care — footwear changes, metatarsal padding, activity modification, and sometimes injections — is typically given a trial of about 3 to 6 months. If symptoms have not improved within that window, or if they return, surgery may be discussed. Recovery varies from person to person and depends on how long symptoms have been present and how well early measures relieve pressure on the nerve.
Can I keep running or exercising with Morton's neuroma?
There is no fixed rule, and this is general information rather than advice for your specific case. Because high-impact activity and tight footwear can aggravate symptoms, many people stay active by adjusting their routine — easing off activities that reproduce the pain, switching to wider, low-heeled, soft-soled shoes, and progressing back gradually as comfort allows. Pain that worsens during or after activity is a signal to scale back. A clinician can help you judge what level of activity is reasonable for you.
How can I prevent Morton's neuroma, and what footwear helps?
Footwear is the main lever. Choosing wide shoes with a roomy toe box, a low heel, and a soft sole lets the bones of the forefoot spread out and reduces pressure on the nerve, while avoiding tight, narrow, high-heeled shoes that crowd the toes. Metatarsal pads or inserts can further offload the ball of the foot. Because tight footwear and high heels are recognized contributing factors, these same measures help both prevent and manage symptoms.
The information on this website is general education about musculoskeletal and movement-related conditions. It is not medical advice or a diagnosis, and it cannot tell you what is causing your symptoms. Reading it is not a substitute for an in-person evaluation, and booking a visit does not confirm that your condition is right for our care until a provider has examined you. This information cannot identify every condition, and some urgent problems can feel like musculoskeletal pain. If your symptoms are severe or getting worse, or you are unsure how urgent they are, contact your physician, call 911, or go to the nearest emergency room. When in doubt, seek emergency care.
