Medically reviewed by Dr. Tom Biernacki, DPM — Board-Certified Podiatric Surgeon — Balance Foot & Ankle, Howell & Bloomfield Hills, MI. Last updated April 2026.

Morton’s neuroma — a perineural fibrosis of a common digital nerve of the foot, most commonly in the third interspace (between the third and fourth metatarsal heads) followed by the second interspace — is one of the most common causes of forefoot pain in middle-aged adults, particularly women wearing narrow or high-heeled footwear. Despite the name, it is not a true neuroma but rather a reactive fibrosis around the nerve from chronic compression and friction — producing the characteristic burning, electric, or numb forefoot pain that radiates into the toes and is classically relieved by removing the shoe and rubbing the foot.

Diagnosis

Clinical examination: the Mulder’s click — simultaneous lateral compression of the metatarsal heads with one hand while applying direct pressure in the interspace with the other produces a palpable and sometimes audible click as the thickened nerve is forced between the metatarsal heads; tenderness in the interspace (not on the metatarsal head, as in metatarsalgia); reproduction of the patient’s burning and radiating toe pain with interspace palpation. Web space sensation: reduced sensation in the cleft between the affected toes in advanced cases. Imaging: ultrasound (the preferred imaging modality — identifies the hypoechoic interspace mass and guides injection; neuroma must be >5mm for reliable identification; also identifies bursitis and other interspace pathology); MRI for atypical presentations or surgical planning. Differential diagnosis: Freiberg’s disease (articular pathology vs. interspace mass), plantar plate tear (MTP joint laxity), metatarsalgia (diffuse pain without neuritic quality), intermetatarsal bursitis (communicating bursa — treated identically to neuroma with injection).

Treatment

Conservative: wide toe box footwear; metatarsal pad proximal to the neuroma (distributes metatarsal head pressure); custom orthotics; anti-inflammatory medications. Injection therapy: corticosteroid injection into the interspace under ultrasound guidance — 70–80% response rate for initial injection; typically 2–3 injections separated by 6 weeks if the first provides relief; alcohol sclerosing injection series (4% alcohol every 7–10 days for 7 treatments) — 60–80% success in some series; less systemic side effects than repeated steroids. Surgical excision: for neuroma pain refractory to 6 months of conservative management; dorsal or plantar approach — plantar approach provides better visualization but risks painful plantar scar; excision of the nerve proximal to the bifurcation produces predictable numbness in the web space; 80–85% satisfactory results; residual stump neuromas occur in 5–10%. Dr. Biernacki at Balance Foot & Ankle diagnoses Morton’s neuroma with clinical examination and ultrasound, and provides ultrasound-guided injection therapy before considering surgical excision. Call (810) 206-1402 at our Bloomfield Hills or Howell office for forefoot pain evaluation.

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Frequently Asked Questions

What does Morton’s neuroma feel like?

Morton’s neuroma typically causes a burning, stinging, or electric-shock sensation in the ball of the foot, often radiating to the 3rd and 4th toes. Many patients describe the sensation of stepping on a pebble or having a bunched-up sock underfoot.

Can Morton’s neuroma go away on its own?

Very early-stage neuromas may improve with footwear changes alone. However, established neuromas typically require treatment — padding, orthotics, cortisone injections, or alcohol sclerosing injections. About 20–30% eventually need surgical excision.

What is the success rate of Morton’s neuroma surgery?

Neuroma excision has a 75–85% success rate for long-term pain relief. The risk of permanent numbness in the affected toes should be discussed before surgery. Minimally invasive approaches have similar outcomes with faster recovery.

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Dr. Tom Biernacki, Dr. Carl Jay, and Dr. Daria Gutkin see patients at our Howell and Bloomfield Township offices.

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Morton’s Neuroma Treatment in Howell & Bloomfield Hills

Ball-of-foot pain and toe numbness from Morton’s neuroma can be effectively treated with corticosteroid injections, alcohol sclerosing injections, custom orthotics, or minimally invasive neurectomy when conservative care fails.

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Clinical References

1. Pace A, Scammell B, Dhar S. The outcome of Morton’s neurectomy in the treatment of metatarsalgia. Int Orthop. 2010;34(4):511-515.
2. Thomson CE, Gibson JNA, Martin D. Interventions for the treatment of Morton’s neuroma. Cochrane Database Syst Rev. 2004;(3):CD003118.
3. Mulder JD. The causative mechanism in Morton’s metatarsalgia. J Bone Joint Surg Br. 1951;33-B(1):94-95.

Your Board-Certified Podiatrists

Dr. Tom Biernacki, DPM

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Dr. Carl Jay, DPM

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Dr. Daria Gutkin, DPM

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Dr. Tom Biernacki, DPM

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Dr. Tom Biernacki, DPM is a double board-certified podiatrist and foot & ankle surgeon at Balance Foot & Ankle Specialists in Southeast Michigan. With over a decade of clinical experience, he specializes in heel pain, bunions, diabetic foot care, sports injuries, and minimally invasive surgery. Dr. Biernacki is a member of the APMA and ACFAS, and his patient education content on MichiganFootDoctors.com and YouTube has reached over one million views.