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[Conditions](https://durgical.com/en/conditions/) · [Lower limb](https://durgical.com/en/anatomy/region/lower-limb/)

# Morton neuroma

Morton neuroma is a painful thickening of a nerve between the toes, usually the third and fourth; it is scarring from compression, not a tumour.

Updated 2026-10-29

## Structures involved

Tap one to see what it is and open it in 3D.

- [Toe nerves](https://durgical.com/en/anatomy/common-plantar-digital-branches-of-medial-plantar-nerve/)
- [Medial plantar nerve](https://durgical.com/en/anatomy/medial-plantar-nerve/)
- [Third metatarsal](https://durgical.com/en/anatomy/third/)
- [Fourth metatarsal](https://durgical.com/en/anatomy/fourth/)
- [Lateral plantar nerve](https://durgical.com/en/anatomy/lateral-plantar-nerve/)
- [MTP ligaments and plantar plate](https://durgical.com/en/anatomy/collateral-metatarsophalangeal-ligaments/)
- [Third toe](https://durgical.com/en/anatomy/third-toe/)
- [Fourth toe](https://durgical.com/en/anatomy/fourth-toe/)
- [Lumbricals](https://durgical.com/en/anatomy/lumbrical-muscles-of-foot/)

## Why it happens

- [Fibrosis in organs: TGF-β and the myofibroblast](https://durgical.com/en/general-pathology/fibrosis-in-organs-tgf-and-the-myofibroblast/)
- [Peripheral nerve: endoneurium, perineurium, epineurium; myelin](https://durgical.com/en/histology/peripheral-nerve-endoneurium-perineurium-epineurium-myelin/)

## What it is

A painful thickening of a common plantar digital nerve, most often in the third web space between the third and [fourth metatarsal](https://durgical.com/en/anatomy/fourth/) heads. It is perineural fibrosis from compression, not a true tumor.

## Who gets it

Most common in middle-aged women, which is linked to narrow and high-heeled shoes. It is usually one-sided.

## Causes

- Repeated compression of the digital nerve under the deep transverse metatarsal ligament
- Narrow, high-heeled or tight shoes
- Repetitive forefoot loading (running, sports with push-off)
- Intermetatarsal bursitis and local inflammation

## Risk factors

- Female sex
- High heels and pointed shoes
- Running or court sports
- Hallux valgus and other forefoot deformities
- Hypermobile forefoot

## Pathophysiology

In the third web space the nerve joins branches of the medial and lateral plantar nerves, so it is thicker and less mobile. Each step squeezes it between the metatarsal heads and against the deep transverse metatarsal ligament. Repeated injury causes fibrosis, nerve swelling and degeneration of nerve fibers.

## Symptoms and signs

- Burning or sharp pain in the ball of the foot, often spreading to the third and fourth toes
- Feeling of walking on a pebble or a folded sock
- Numbness or tingling of the adjacent toes
- Pain worse in tight shoes and relieved by removing the shoe and rubbing the foot

## Diagnosis

**Clinical**
Tenderness in the web space, not on the metatarsal heads. The Mulder click: squeezing the metatarsal heads together while pressing the web space reproduces pain and a palpable click.

**Tests**
No lab test; a diagnostic injection of local anesthetic into the web space can support the diagnosis.

**Imaging**
Ultrasound or MRI shows the mass in the web space; X-rays rule out fracture, arthritis or other bone causes.

## Differential diagnosis

- Metatarsalgia or plantar plate injury
- Metatarsal stress fracture
- Metatarsophalangeal joint synovitis
- Freiberg disease of the metatarsal head
- Tarsal tunnel syndrome
- Peripheral neuropathy

## Goal of treatment

Reduce compression on the nerve and relieve pain so the person can walk and wear shoes comfortably.

## Treatment

**Conservative**
Wide, low-heeled shoes, a metatarsal pad placed behind the metatarsal heads and orthoses to spread the metatarsals.

**Medical**
NSAIDs for pain; neuropathic pain agents in selected cases.

**Procedure**
Corticosteroid injection into the web space, often ultrasound-guided; other injection and ablation techniques are used, with evidence that varies.

**Surgical**
Excision of the neuroma (neurectomy) or decompression by releasing the deep transverse metatarsal ligament when conservative care fails.

## Complications

- Persistent numbness of the toes after excision
- Stump neuroma (painful regrowth of the nerve end)
- Fat pad atrophy or [skin](https://durgical.com/en/anatomy/skin/) thinning after repeated steroid injections
- Recurrent pain

## Prognosis

Many patients improve with footwear changes and injections. Surgery helps most of those who do not respond, at the cost of permanent numbness between the toes.

## Prevention

- Wide shoes with a low heel
- Gradual changes in running load

## Test yourself

Think of the answer, then tap the question to see it.

## In which web space is Morton neuroma most often found?

The third web space, between the third and fourth metatarsal heads.

## What is the Mulder click?

Pain and a palpable click when the metatarsal heads are squeezed together while the web space is pressed, as the thickened nerve slips between them.

## Is Morton neuroma a true tumor of the nerve?

No. It is perineural fibrosis and nerve degeneration caused by repeated compression.

## Which ligament compresses the nerve in Morton neuroma?

The deep transverse metatarsal ligament, which joins the metatarsal heads.

## What typical complaint do patients describe when walking?

A feeling of walking on a pebble, with burning pain spreading to the toes and relief after removing the shoe.

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## Related conditions

- [Hallux valgus (bunion)](https://durgical.com/en/conditions/hallux-valgus/)
- [Metatarsal fractures (including stress fractures)](https://durgical.com/en/conditions/metatarsal-fractures/)
- [Tarsal tunnel syndrome](https://durgical.com/en/conditions/tarsal-tunnel-syndrome/)
- [Plantar Fasciitis](https://durgical.com/en/conditions/plantar-fasciitis/)

Educational information, not medical advice. For any symptom, see a health professional.

Sources: [Morton Neuroma](https://www.ncbi.nlm.nih.gov/books/NBK470249/) (StatPearls (NCBI Bookshelf), 2026).

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Representative model, for educational purposes only.

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Source: https://durgical.com/en/conditions/morton-neuroma/
License: CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). Cite as: DurgiPedia (durgical.com), https://durgical.com/en/conditions/morton-neuroma/