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

Answering the Most Common Neuroma Questions

Morton’s neuroma — a painful thickening of the nerve between the metatarsal bones, most commonly between the third and fourth toes — prompts many questions before patients commit to treatment. At Balance Foot & Ankle in Howell and Bloomfield Township, Michigan, we address these questions thoroughly before recommending any intervention.

Is It Actually a Tumor?

No. Despite the name, Morton’s neuroma is not a true tumor — it is a perineural fibrosis (scar-like thickening around the nerve) that develops from repetitive compression and trauma. The term “neuroma” is somewhat misleading but has persisted in clinical use. No cancer risk is associated with this benign condition.

How Is It Diagnosed?

Diagnosis is primarily clinical — the characteristic history (burning, electric pain between specific toes, sensation of walking on a marble or pebble, relief by removing shoes) combined with a positive Mulder’s click test (compressing the metatarsal heads together while pressing up on the web space produces a palpable click with pain reproduction) is highly specific. Diagnostic ultrasound confirms the neuroma, measures its size (which correlates with treatment response), and guides injection therapy. MRI is reserved for atypical cases or when other pathology must be excluded.

What Are All the Treatment Options?

Conservative: wide-toed footwear eliminating forefoot compression, metatarsal pad (placed just behind the ball of the foot), and over-the-counter insoles. These succeed in mild cases (smaller neuromas). Corticosteroid injection: US-guided injection into the affected web space reduces inflammation and fibrosis. Success rate approximately 50-60% at 1 year with 1-3 injections. Sclerosing alcohol injection: a series of 3-7 injections with dilute ethanol progressively sclerose the nerve. Success rates of 60-80% in favorable cases, avoiding surgery. Surgery (neurectomy): surgical excision of the neuroma through a dorsal or plantar approach. Success rates of 80-90%. The nerve is permanently removed, leaving permanent numbness in the adjacent toe surfaces — typically well-tolerated and preferable to ongoing pain.

Will It Come Back After Surgery?

True recurrence is uncommon after complete surgical excision. However, residual or recurrent neuroma (a stump neuroma at the cut nerve end) occurs in a small percentage of patients and can be more painful than the original neuroma. Careful surgical technique minimizes this risk. Symptoms occurring at a different web space after surgery represent a new neuroma, not recurrence of the treated one.

How Long Until I’m Pain-Free?

Conservative treatment and injections may require 4-8 weeks to achieve maximal effect. Surgical recovery involves protected weight-bearing for 2-4 weeks with full activity at 4-8 weeks. Most patients who successfully respond to any treatment achieve long-term pain-free status. Contact Balance Foot & Ankle at (810) 206-1402 to discuss which treatment approach is most appropriate for your specific situation.

Foot or Ankle Pain? We Can Help.

Balance Foot & Ankle — Howell & Bloomfield Township, MI

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Morton Neuroma Pain? Get Expert Treatment Today

Morton neuroma causes sharp, burning pain in the ball of your foot that feels like standing on a pebble. Dr. Tom Biernacki offers ultrasound-guided injections, custom orthotics, and minimally invasive procedures to eliminate neuroma pain without lengthy recovery.

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Clinical References

1. Betts LO. Morton metatarsalgia: neuritis of the fourth digital nerve. Medical Journal of Australia. 1940;1:514-515.
2. Thomas JL, et al. Diagnosis and treatment of forefoot disorders: Morton intermetatarsal neuroma. Journal of Foot and Ankle Surgery. 2009;48(2):251-256.
3. Pastides P, et al. Morton neuroma: a clinical versus radiological diagnosis. Foot and Ankle Surgery. 2012;18(1):22-24.

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Dr. Tom Biernacki, 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.