Morton’s Neuroma: What It Is, What Causes it, and Minimally Invasive Treatment Options

Morton’s neuroma is a painful condition that affects many people. However, it’s 8 times more common among women than men, and largely affects adults between 30 and 60. It has the potnetial to stop sufferers from participating in the sports they love or simply continuing their active lifestyle. Unfortunately, open surgery is considered the most effective treatment for this condition, removing the affected nerve. We believe there must be a better, less invasive way to treat this condition. Keep reading to find out more about Morton’s neuroma and how we can treat this condition using minimally invasive methods.

What is Morton’s Neuroma?

Also known to many as “interdigital neuroma”, “Morton metatarsalgia”, “interdigital neuritis, or “plantar neuroma”, Morton’s neuroma is a condition that is sometimes considered a benign tumor of a nerve. However, this condition isn’t actually a tumor. Rather, it is a thickening of the tissue surrounding one of the nerves that leads to the toes. As a result of this thickening, you may feel a sharp, burning pain or discomfort in the ball of your foot. You may also experience an inability or reduced ability to perform certain activities. Many patients describe a sensation of having a pebble in their shoe, a fold in their sock, or walking on a marble

What Are the Causes and Symptoms?

The exact cause of Morton’s neuroma is unknown, but it’s most commonly linked to entrapment of digital plantar nerves. When these nerves are compressed or squeezed, they may develop swelling or the formation of abnormal tissue around the nerve as protection.

It most commonly develops in the space between the third fourth toes as a response to irritation, trauma, or excessive pressure. It may also occur between the second and the third toes, but this is less common.

Experts believe that high-heeled or tight shoes may be a leading cause of this condition, which may be why this condition is more common in women. Regularly wearing high heels or too tight shoes increases the pressure placed on your toes and the ball of your foot, leading to compression of the nerves.

Some sports may also cause Morton’s Neuroma. Activities that place high impact on the toes and ball of the foot like jogging or running may repetitively irritate the digital plantar nerves. Other sports that require tight shoes, like skiing or rock climbing, may also cause this irritation.

Finally, foot deformities such as bunions, hammertoes, high arches, or flat arches increase your risk of developing Morton’s neuroma.


There usually aren’t any visible signs or symptoms of this condition. It’s characterized by symptoms that patients feel rathe than see.

The most common symptoms of Morton’s neuroma include:

  • A persistent burning or sharp pain in the ball of the foot. This pain may spread out into the toes, especially when perform weightbearing activities like walking or running. Sufferers rarely feel pain at night.
  • The sensation of walking with a pebble or marble under the ball of the foot is common for most patients.
  • Numbness or an uncomfortable tingling in the toes.
  • At the start of sprint, pain may be felt when pushing off from the starting block.
  • Patients may experience issues with shoes. High-heeled and tight, narrow shoes can aggravate Mortons neuroma.

Morton’s Neuroma Treatment Options

In this section, we’ll discuss typical treatment options for Morton’s neuroma, ranging from conservative to surgical, as well as how our team prefers to treat this condition.

Conservative Treatment

Because footwear is often a cause of this condition, your doctor may recommend changing your shoes to help provide relief. Avoiding high heels and tight, narrow shoes may be able to provide some relief. Wide shoes or shoes with a wide toe box, low or no heels, and a soft sole will allow the bones in your feet to properly spread out, potentially reducing pressure on the digital plantar nerves so they can heal.

Supportive devices such as custom shoe inserts or metatarsal pads and bars, also known as orthoses, can easily be placed into shoes and may provide relief. These inserts separate the the bones and change the location of pressure on the ball of the foot, which will reduce the overall pressure leading to the neuroma.

Corticosteroid injections have the potential to reduce swelling and inflammation of the affected nerve. Nerve ablation injections may also provide some relief by injecting a medication that permanently blocks the nerve from sending pain signals.

Surgical Treatment

If conservative treatment fails to provide you with relief, or your painful symptoms return, your doctor may tell you that surgery is the only option left.

Surgical treatment for Morton’s neuroma are performed to either remove the affected portion of the nerve or release the tissue entrapping the nerve. This is considered the most reliable option for this condition, but minimally invasive options that do not require removal of the nerve are available as well. 

How the Center for Sports Medicine and Wellness treats Morton’s neuroma

At our practice, we know that the first step to providing our patients with the most effective treatment requires properly diagnosing their condition. To do this, Dr. Shiple uses diagnostic musculoskeletal ultrasound. The purpose of this tool is to use sound waves to produce images of tendons, muscles, ligaments, nerves, soft tissues and joints throughout the body. These images are capture in real time, which better allows the images to show the structure and movement of internal organs. Diagnostic Ultrasound is safe, non-invasive, and does not require the use of ionizing radiation.

Once your condition has been properly diagnosed, Dr. Shiple will work with you to determine the most effective treatment plan for your particular needs and condition.

Percutaneous Intratendinous Calcification Removal

Percutaneous intratendinous calcification removal may be an option for your condition. This is a medical procedure or method in which inner organs or other tissues are accessed through a needle-puncture of the skin. Most procedures use an “open” approach, which exposes inner organs or tissue, has a greater chance of complication, and requires a longer recovery time.

Using different tools and techniques, Dr. Shiple can visualize and repair the affected area using one or more small incisions. This approach has many benefits, including reduced risk of injury to surrounding healthy soft tissues, quicker recovery, and minimal scarring. This procedure is minimally invasive and may be the option you need to get back to your sport or your life as quickly as possible.

Ultrasound Guided Nerve Hydrodissection

Ultrasound Guided Nerve Hydrodissection is a technique that is commonly used to treat nerve entrapments such as Morton’s neuroma. This procedure can be used as an alternative to open surgery. Using fluid, nerve hydrodissection releases the entrapped nerve from surrounding muscles or scar tissue. This procedure is a minimally invasive treatment used to treat a variety of issues caused by nerve entrapment. Ultrasound guidance is also used during the procedure to identify the nerve and guide the needle. Following this, a solution is injected around the affected nerve to separate it from whatever is causing the compression. This procedure can alleviate numbness, tingling, and pain caused by nerve entrapment and allows nerves to heal. 

Get Relief From Morton’s Neuroma in Glen Mills, Pennsylvania

Our team at the Center for Sports Medicine and Wellness is proud to be experts in the most advanced minimally invasive and non-surgical treatments for our patients. This is why we offer percutaneous intratendinous calcification removal and ultrasound Guided Nerve Hydrodissection, which can treat conditions like Morton’s neuroma without open techniques.

We understand that our patients’ top priority is to successfully recover from their conditions while getting back to their lives or their sports as quickly as possible. We’re proud to provide the most advanced and least invasive treatment options. 

If you’d like to learn more about our services or contact us to schedule a consultation, please call our office in Glen Mills, Pennsylvania, at (610) 459-4200 or fill out our form. We welcome your inquiry and we look forward to helping you get back to the game of life!

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