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Morton’s Neuroma: Interdigital Neuroma Diagnosis, Injection Technique, and Surgical Excision

Morton’s neuroma (interdigital neuroma) responds to conservative treatment in 80% of cases. Surgery is the last resort, after metatarsal pads, wide shoes, injections, and alcohol sclerosis fail.

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 interdigital neuroma 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

MICHIGAN PODIATRIST INSIGHT

The most important clinical decision with Mortons Neuroma Interdigital Neuroma Diagnosis Injection Excision 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: Interdigital Neuroma Diagnosis, Inje 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.

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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 fibrotic perineural thickening of the common digital nerve in the intermetatarsal space, most commonly the third (between the 3rd and 4th metatarsal heads) — is the most common nerve problem of the forefoot, producing a distinctive burning, electric, or cramping pain in the forefoot that is reproduced by wearing narrow shoes and relieved by removing footwear and massaging the foot. The ‘neuroma’ is a misnomer — histologically, the lesion is perineural fibrosis (scar tissue encasing the nerve) rather than a true neoplasm.

Anatomy, Pathophysiology, and Diagnosis

Anatomy: the common digital nerve to the third web space receives contributions from both the medial and lateral plantar nerves (at the bifurcation point between the 3rd and 4th metatarsal heads) — this anatomical redundancy makes the third interspace nerve larger than other web space nerves and explains its predilection for neuroma formation; the interdigital nerves pass plantar to the transverse intermetatarsal ligament (TIML) — the nerve is compressed against the TIML from below by ground reaction force and from above by the TIML itself during dorsiflexion of the MTP joints. Symptoms: burning, electric, or cramping forefoot pain in the 3rd (most common) or 2nd web space; relief with shoe removal and massage; Mulder’s click — compression of the forefoot in the medial-lateral plane while dorsiflexing the metatarsal heads produces a palpable/audible click and reproduction of pain; sensitivity 90% for the click sign. Ultrasound: hypoechoic ovoid lesion in the intermetatarsal space, narrowest between the metatarsal heads; lesions >5mm correlate with clinical significance; ultrasound confirms diagnosis and guides injection. MRI: for equivocal cases or to rule out adjacent MTP joint pathology.

Treatment

Conservative: wide toe-box footwear; metatarsal pad to spread the metatarsal heads and reduce intermetatarsal nerve compression; corticosteroid injection (ultrasound-guided: 76% short-term relief, 56% sustained at 1 year; three sequential injections at 4-week intervals for maximum benefit); sclerosing alcohol injection series (75–80% response rate at 1–2 year follow-up). Surgical excision: indicated after failed conservative care — dorsal or plantar approach intermetatarsal nerve excision with adequate proximal resection (2–3cm of nerve proximal to the lesion) to prevent stump neuroma formation; 85% patient satisfaction; dorsal approach avoids plantar scar. Dr. Biernacki at Balance Foot & Ankle treats Morton’s neuroma with ultrasound-guided injection and surgical excision at our Bloomfield Hills and Howell offices. Call (810) 206-1402.

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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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Differential 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.

Watch: Dr. Tom explains

Dr. Tom Biernacki explains

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Pros & Cons of Conservative Care for foot care

Advantages

  • ✓ Conservative care first
  • ✓ Same-week appointments
  • ✓ Multiple insurance accepted

Considerations

  • ✗ Self-treatment can mask issues
  • ✗ See a podiatrist if pain >2 weeks

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Ready to Get Back on Your Feet?

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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Balance Foot & Ankle surgeons are affiliated with Trinity Health Michigan, Corewell Health, and Henry Ford Health — three of Michigan’s largest health systems.