Morton’s neuroma
Why does the ball of my foot burn and feel like I am standing on a pebble?
Irritation of a nerve between the toes, usually the third and fourth. Footwear changes are the first step.
What it feels like
Burning, sharp or electric pain in the ball of the foot, often between the third and fourth toes, with numbness in the toes or a feeling of standing on a pebble. It is usually worse in tight or high-heeled shoes and eased by taking them off.
What is actually happening
A small nerve between the toes becomes compressed and thickened where it passes between the bones of the forefoot. Narrow footwear and repeated forefoot loading are common contributors.
How it is assessed
Assessment includes the location of pain, a squeeze test across the forefoot, sensation in the toes, footwear and loading, and screening of other causes of forefoot pain such as joint or bone stress problems.
How it is treated
Changing to wider, lower-heeled shoes and using a metatarsal pad are sensible first steps, although research on them is limited. A systematic review found the most support for a corticosteroid injection given by a physician, which may be considered if symptoms persist, and surgery is an option for ongoing symptoms. Physiotherapy addresses footwear, loading and foot strength.
What to do first
Wear wider shoes with a low heel and a cushioned sole, avoid narrow or tight footwear, and have it assessed.
Where this is assessed
- The Runner's Academy St. Clair West · Mon/Wed/Fri · 3:00 PM – 6:30 PM Book at Runner's Academy
- Athlete's Care Sports Medicine Centres Yonge & Eglinton · Mon/Wed/Fri · 8:00 AM – 2:00 PM Book at Athlete's Care
References
This page is based on the following clinical practice guidelines and research.