Morton's neuroma

A Morton neuroma is a benign but painful swelling of a small nerve either between the second and third or third and fourth metatarsals. It is caused by recurrent trauma to the nerve usually due either to abnormal biomechanics in the foot, overuse, or a combination of the two. It is common in distance runners. It is characterised by pain in the forefoot, often ‘burning” in nature, which may be felt shooting into the toes. It is usually worse when wearing tight shoes. Numbness of the affected toes may develop later.

Making the diagnosis may require an ultrasound scan or MRI to exclude other causes of similar forefoot pain such as metatarsalgia. Treatment options include footwear modification or orthotics (insoles) to offload the area, steroid injection to shrink the neuroma or surgery to remove it.