Morton’s neuroma — burning pain in the ball of the foot like walking on a marble — responds to conservative treatment in 80% of cases. Surgery is the last resort, after metatarsal pads, wide shoes, and injections.
You’re in the right place. Dr. Tom Biernacki, DPM, FACFAS — board-certified foot & ankle surgeon with 3,000+ surgeries — explains exactly what Morton’s neuroma treatment outcomes means and what works. Call (810) 206-1402 for same-day appointment at Howell or Bloomfield Hills.
Medically reviewed by Dr. Tom Biernacki, DPM · Board-Certified Podiatric Surgeon · Last reviewed: April 2026 · Editorial Policy
The most important clinical decision with Morton Neuroma Diagnosis Injection Surgery Outcomes isn’t which treatment to start with — it’s identifying the correct subtype. That changes everything. Call (810) 206-1402.
Quick Answer
Morton’s Neuroma: Diagnosis, Injection Therapy, and Su relates to Morton’s neuroma — typically caused by nerve compression between toes. Most patients improve in 8-12 weeks conservative with conservative care. Same-week appointments in Howell + Bloomfield Hills: (810) 206-1402.
Medically reviewed by Dr. Tom Biernacki, DPM — Board-certified foot & ankle surgeon, 3,000+ surgeries performed. Updated April 2026 with current clinical evidence. This article reflects real practice experience from Balance Foot & Ankle Specialists in Howell and Bloomfield Hills, Michigan.
Quick Answer
Morton’s neuroma is a thickening of nerve tissue between the third and fourth toes causing burning pain, numbness, or the sensation of a pebble under the ball of the foot. Wide toe-box shoes with a metatarsal pad resolve 70% of cases; the rest benefit from cortisone or sclerosing injections.
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Medically reviewed by Dr. Tom Biernacki, DPM — Board-Certified Podiatric Surgeon — Balance Foot & Ankle, Howell & Bloomfield Hills, MI. Last updated April 2026.
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Medically Reviewed by Dr. Tom Biernacki, DPM — Board-Certified Podiatrist, Balance Foot & Ankle Specialists, Michigan. 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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Our board-certified podiatrists treat this condition at two convenient locations. Same-day appointments often available.
In-Office Treatment at Balance Foot & Ankle
If home care isn’t resolving your Morton’s neuroma, a visit with a board-certified podiatrist is the fastest path to accurate diagnosis and a personalized plan. At Balance Foot & Ankle Specialists, Dr. Tom Biernacki, Dr. Carl Jay, and Dr. Daria Gutkin offer same-day and next-day appointments at both our Howell and Bloomfield Hills offices. We perform on-site diagnostic ultrasound, digital X-ray, conservative care, advanced regenerative treatments, and minimally invasive surgery when indicated.
Call (810) 206-1402 or request an appointment online. Most insurance plans accepted, including Medicare, Blue Cross Blue Shield, Aetna, Cigna, and United Healthcare.
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When to See a Podiatrist
A Morton’s neuroma that doesn’t respond to metatarsal pads and wider shoes within 6-8 weeks usually needs a cortisone injection or — for stubborn cases — alcohol sclerosing or nerve decompression. Balance Foot & Ankle diagnoses neuromas with in-office ultrasound and treats them without surgery in most cases. Don’t keep walking on a burning, tingling forefoot — the nerve irritation compounds the longer it’s untreated.
Call Balance Foot & Ankle: (810) 206-1402 · Book online · Offices in Howell & Bloomfield Hills
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.
Need Treatment at Balance Foot & Ankle?
Dr. Tom Biernacki, Dr. Carl Jay, and Dr. Daria Gutkin see patients at our Howell and Bloomfield Hills offices.
Book Online or call (810) 206-1402
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Howell Office
4330 E Grand River Ave
Howell, MI 48843
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Bloomfield Hills Office
43494 Woodward Ave, #208
Bloomfield Hills, MI 48302
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Book Your AppointmentDifferential Diagnosis: What Else Could It Be?
Several conditions share symptoms with Morton’s Neuroma and are commonly misdiagnosed in the first office visit. Considering these alternatives is part of every Balance Foot & Ankle exam:
- Capsulitis (2nd MTP). Pain at 2nd-toe base rather than between toes; drawer test positive.
- Stress fracture. Single-point tenderness over a metatarsal shaft, not between toes.
- Freiberg’s infraction. AVN of metatarsal head, classic radiograph flattening.
If your symptoms don’t fit the textbook pattern, ask your podiatrist which differentials they ruled out — that conversation often shortcuts months of trial-and-error treatment.
In Our Clinic
The classic Morton’s neuroma patient in our clinic is a 40- to 60-year-old woman who describes burning or “walking on a marble” in the 3rd intermetatarsal web space, often worsening in narrow or high-heeled shoes. We confirm with a Mulder’s click test (sometimes supplemented by ultrasound). The first line of treatment is always a metatarsal pad placed PROXIMAL to the neuroma + a wide-toe-box shoe. Many patients improve just from that — we don’t reach for injections or surgery right away. When conservative care fails after 6–12 weeks, a single corticosteroid or alcohol sclerosing injection is our next step.
Most Common Mistake We See
The most common mistake we see is: Adding a cushioned insole instead of a metatarsal pad. Fix: place the metatarsal pad PROXIMAL to (behind) the metatarsal heads — not directly under them.
Warning Signs That Need Same-Day Care
Seek immediate evaluation at Balance Foot & Ankle if you experience any of the following:
- Point tenderness on a single metatarsal suggesting stress fracture
- Unable to bear weight
- Progressive numbness up the foot
- Visible deformity or cross-over toe
Call (810) 206-1402 — same-day and next-day appointments at our Howell and Bloomfield Hills offices.
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Advantages
- ✓ Conservative care first
- ✓ Same-week appointments
- ✓ Multiple insurance accepted
Considerations
- ✗ Self-treatment can mask issues
- ✗ See a podiatrist if pain >2 weeks
Dr. Tom’s Recommended Products for foot care
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Same-day appointments in Howell + Bloomfield Hills. Most insurance accepted. Dr. Tom Biernacki, DPM & team.
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About Your Care Team at Balance Foot & Ankle
Dr. Tom Biernacki, DPM · Board-Certified Foot & Ankle Surgeon. Specializes in conservative-first care, minimally invasive bunion surgery, and complex reconstruction.
Dr. Carl Jay, DPM · Accepting new patients. Specializes in sports medicine, athletic injuries, and routine podiatric care.
Dr. Daria Gutkin, DPM, AACFAS · Accepting new patients. Specializes in surgical reconstruction and pediatric podiatry.
Locations: 4330 E Grand River Ave, Howell, MI 48843 · 43494 Woodward Ave Suite 208, Bloomfield Hills, MI 48302
Hours: Mon–Fri 8:00 AM – 5:00 PM · (810) 206-1402
Frequently Asked Questions
When should I see a podiatrist?
If symptoms persist past 2 weeks, affect your normal activity, or are accompanied by red-flag symptoms (warmth, redness, swelling, inability to bear weight).
What does treatment cost?
Most diagnostic visits and conservative treatments are covered by Medicare and major insurers. Out-of-pocket costs vary by your specific plan.
How quickly can I get an appointment?
Most non-urgent cases see us within 5 business days. Urgent cases (sudden pain, possible fracture) typically same or next business day.
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Same-week appointments at our Howell and Bloomfield Hills offices. Board-certified podiatric surgeons. Most insurance accepted.
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Or call: (810) 206-1402
Dr. Tom Biernacki, DPM is a board-certified foot & ankle surgeon (ABFAS & ABPM) 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 made him one of the most-followed foot & ankle educators on YouTube.