Morton’s Neuroma Cortisone Injection — Do They Work?

✅ Medically reviewed by Dr. Thomas Biernacki, DPM — Board-Certified Podiatrist · Last updated April 6, 2026

Watch: Morton’s Neuroma Injection & Treatment

Table of Contents

• Cortisone Injections for Morton’s Neuroma: Do They Work?
• How the Injection Works
• What to Expect During the Procedure
• Success Rates & Limitations
• Risks & Side Effects
• Cortisone vs. Other Injection Options
• After the Injection: Maximizing Results
• Best Products for Morton’s Neuroma
• When Injections Aren’t Enough
• FAQ
• Sources

Cortisone Injections for Morton’s Neuroma: Do They Work?

If you’ve been diagnosed with a Morton’s neuroma and conservative measures (wider shoes, metatarsal pads, orthotics) haven’t provided enough relief, cortisone injections are often the next step. They’re one of the most commonly performed procedures for neuroma treatment — and they can provide meaningful relief — but it’s important to understand both what they can and can’t do.

Cortisone (corticosteroid) injections reduce the inflammation surrounding the thickened nerve, which is what produces the burning, tingling, and shooting pain. However, they don’t shrink the neuroma itself. This means the relief is often temporary — once the anti-inflammatory effect wears off, symptoms can return if the mechanical factors causing the irritation haven’t been addressed. The injection works best as part of a comprehensive treatment plan, not as a standalone solution.

How the Injection Works

The injection delivers a corticosteroid (typically dexamethasone or betamethasone) mixed with a local anesthetic directly into the intermetatarsal space where the neuroma sits — most commonly between the 3rd and 4th metatarsal heads. The corticosteroid is a powerful anti-inflammatory that reduces the perineural fibrosis (scar tissue) and inflammation surrounding the enlarged nerve.

The local anesthetic (lidocaine or marcaine) provides immediate pain relief that lasts a few hours, which also serves as a diagnostic tool — if the injection immediately eliminates your pain, it confirms the neuroma is the source. The corticosteroid takes 3–7 days to reach full effect, so there’s often a brief “gap” between when the anesthetic wears off and the steroid kicks in where symptoms may temporarily return.

What to Expect During the Procedure

The injection takes about 5 minutes and is performed in the office. Here’s the step-by-step process at Balance Foot & Ankle:

We clean the top of the foot with an alcohol swab. The injection is given from the top (dorsal) of the foot, between the metatarsal heads — this approach is less painful than injecting from the bottom because the skin on top is thinner and less sensitive. You’ll feel a brief pinch as the needle enters the skin, then pressure as the medication is deposited. The entire injection takes about 15 seconds.

Many patients are surprised by how quick and tolerable the procedure is — it’s significantly less painful than the neuroma symptoms themselves. You can walk immediately after the injection and return to normal activities right away. We recommend avoiding intense exercise for 24–48 hours to allow the medication to settle into the tissue.

Success Rates & Limitations

Research on cortisone injections for Morton’s neuroma shows variable results depending on the study and patient population. Here’s what the evidence tells us:

Outcome Measure	Result
Short-term relief (1–3 months)	50–80% of patients report significant improvement
Long-term relief (12+ months)	30–50% maintain improvement without further intervention
Best candidates	Neuromas <5mm on ultrasound; shorter symptom duration; first injection
Poorer candidates	Neuromas >8mm; symptoms for >1 year; multiple previous injections
Number of injections recommended	Maximum 2–3 in the same interspace per year

The size of the neuroma matters significantly. Small neuromas (under 5mm) respond best to cortisone injections because the inflammation-to-nerve-thickening ratio is higher — there’s more reversible inflammation and less irreversible fibrosis. Larger neuromas (over 8mm) have more structural nerve damage that cortisone can’t address, which is why they respond less predictably to injections.

Risks & Side Effects

Cortisone injections in the foot are generally safe, but potential side effects include temporary increased pain for 24–48 hours after injection (a “cortisone flare”), skin depigmentation (lightening) at the injection site, fat pad atrophy (thinning of the cushioning under the metatarsal heads) with repeated injections, and very rarely, weakening of the plantar plate (the ligament under the MTP joint).

Fat pad atrophy is the most clinically significant concern and the primary reason we limit cortisone to 2–3 injections per interspace. Losing the natural cushioning under the ball of the foot can create a new problem (metatarsalgia) while attempting to treat the neuroma. This is why we consider alternative injection options (see below) for patients who need ongoing treatment beyond 2–3 cortisone rounds.

Cortisone vs. Other Injection Options

Injection Type	How It Works	Best For	Sessions Needed
Cortisone (corticosteroid)	Reduces inflammation around the nerve	First-line treatment; small neuromas; acute flare-ups	1–3 injections
Alcohol sclerosing	Dehydrates and shrinks the neuroma tissue directly	Neuromas that respond temporarily to cortisone; patients wanting to avoid surgery	4–7 weekly injections (series)
Platelet-rich plasma (PRP)	Growth factors promote tissue healing and reduce inflammation	Emerging treatment; limited evidence for neuroma specifically	1–3 injections
Radiofrequency ablation	Uses heat to destroy the nerve, eliminating pain signals	Chronic neuromas in patients who want to avoid open surgery	Single procedure

Alcohol sclerosing injections are our most commonly used alternative to cortisone. A series of 4–7 weekly injections of dilute alcohol (4%) is delivered into and around the neuroma under ultrasound guidance. The alcohol chemically destroys the nerve tissue, effectively shrinking the neuroma. Studies show a success rate of 60–89% for avoiding surgery, making it an excellent intermediate option between cortisone and surgical excision.

After the Injection: Maximizing Results

A cortisone injection works best when you simultaneously address the mechanical factors that irritated the nerve in the first place. Without these changes, the neuroma will continue to be compressed and inflamed, and the injection’s benefits will be short-lived.

Switch to wider shoes — the metatarsal heads need room to spread apart so they’re not squeezing the neuroma between them. This is the single most important change you can make. Add a metatarsal pad to your insole, positioned just behind the metatarsal heads — it spreads the bones apart, creating more space for the nerve. Wear orthotics with a built-in metatarsal support to provide consistent offloading with every step. Avoid high heels and narrow-toe shoes, which compress the forefoot and negate the injection’s benefits.

Best Products for Morton’s Neuroma

When Injections Aren’t Enough

If cortisone and/or alcohol sclerosing injections haven’t provided lasting relief — and you’ve made the appropriate shoe and orthotic changes — surgical excision (neurectomy) is the definitive treatment. Surgery involves removing the enlarged nerve through a small incision on the top of the foot. The procedure takes about 30 minutes, is performed as an outpatient, and has a success rate exceeding 80%.

The trade-off is permanent numbness in the adjacent sides of the two toes that the nerve supplied. Most patients find this numbness much preferable to the burning, shooting neuroma pain — and many say they barely notice it after a few months. Recovery involves 2–3 weeks in a surgical shoe followed by transition to regular footwear.

For a complete overview of all Morton’s neuroma treatments (conservative through surgical), see our comprehensive Morton’s neuroma guide.

Frequently Asked Questions

How many cortisone injections can I get for Morton’s neuroma?

Most podiatrists recommend a maximum of 2–3 cortisone injections in the same intermetatarsal space, spaced at least 3 months apart. Beyond this, the risk of fat pad atrophy and plantar plate weakening increases significantly. If two injections haven’t provided lasting relief, it’s generally more effective to transition to alcohol sclerosing injections or discuss surgical options rather than continuing with cortisone.

How long does a cortisone injection last for Morton’s neuroma?

This varies widely between patients. Some experience relief for just a few weeks, others for several months, and a fortunate group gets permanent relief from a single injection (particularly those with small neuromas caught early). On average, meaningful relief lasts 6–12 weeks. The duration tends to be longer when the injection is combined with shoe modifications, metatarsal pads, and orthotics — because these address the mechanical compression that’s irritating the nerve.

Does the injection hurt?

There’s a brief pinch when the needle enters the skin on the top of the foot, followed by a pressure sensation as the medication is injected. The entire process takes about 15 seconds. Most patients rate it a 3–4 out of 10 on a pain scale — significantly less painful than the neuroma symptoms themselves. The local anesthetic mixed with the cortisone provides immediate numbness to the area. Some patients experience a temporary increase in pain 24–48 hours after injection (a “steroid flare”) before the full anti-inflammatory effect takes hold.

Can I walk after a cortisone injection in my foot?

Yes — you can walk immediately after the injection and drive yourself home. The local anesthetic may make the ball of your foot feel numb for 1–2 hours, so be mindful of uneven surfaces. We recommend avoiding intense exercise or prolonged standing for 24–48 hours to allow the medication to settle into the tissue. Regular walking and daily activities are fine from the moment you leave the office.

Sources

• Thomson CE, Gibson JN, Martin D. Interventions for the treatment of Morton’s neuroma. Cochrane Database Syst Rev. 2004;(3):CD003118.
• Markovic M, Crichton K, Read JW, et al. Effectiveness of ultrasound-guided corticosteroid injection in the treatment of Morton’s neuroma. Foot Ankle Int. 2008;29(5):483-487.
• Dockery GL. The treatment of intermetatarsal neuromas with 4% alcohol sclerosing injections. J Foot Ankle Surg. 1999;38(6):403-408.
• Mahadevan D, Venkatesan M, Bhatt R, Bhatia M. Diagnostic accuracy of clinical tests for Morton’s neuroma compared with ultrasonography. J Foot Ankle Surg. 2015;54(4):549-553.

The Bottom Line

Cortisone injections are a reasonable and often effective option for Morton’s neuroma — but they work best as part of a comprehensive approach that includes wider shoes, metatarsal pads, and orthotics. Small neuromas caught early respond best. If two injections provide only temporary relief, alcohol sclerosing injections offer a middle ground before considering surgery. And if you do need surgery, modern neurectomy is a reliable procedure with excellent outcomes. The most important factor in treatment success isn’t which injection you choose — it’s making the shoe and orthotic changes that prevent the nerve from being compressed in the first place.

Clinical References

1. Thomson CE, Gibson JN, Martin D. Interventions for the treatment of Morton’s neuroma. Cochrane Database Syst Rev. 2004;(3):CD003118.
2. Mahadevan D, Venkatesan M, Bhatt R, Bhatia M. Diagnostic accuracy of clinical tests for Morton’s neuroma compared with ultrasonography. J Foot Ankle Surg. 2015;54(4):549-553.
3. Markovic M, Crichton K, Read JW, Lam P, Slater HK. Effectiveness of ultrasound-guided corticosteroid injection in the treatment of Morton’s neuroma. Foot Ankle Int. 2008;29(5):483-487.

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