In short
Morton's neuroma is thickened tissue around a nerve between the toes, most often the third and fourth. It causes burning pain, tingling or numbness and a feeling of walking on a pebble. Wider shoes, a metatarsal pad and injections help many people. Our clinic also offers ultrasound-guided cryotherapy, which freezes the nerve without an operation, and surgery when needed.
What is a Morton’s neuroma?
Despite the name, it is not a true tumour of the nerve. The tissue around one of the nerves running to the toes becomes thickened (perineural fibrosis), usually between the third and fourth toes, and sometimes between the second and third. The thickened nerve is squeezed between the metatarsal bones as you walk.
What causes it?
Repeated pressure or irritation of the nerve. Contributing factors include:
- Footwear. Tight, narrow shoes and high heels squeeze the forefoot. Steel toe-capped work boots can do the same.
- Foot shape. Flat feet, high arches, bunions and hammer toes change how load passes through the forefoot.
- Repetitive impact. Running, court sports and long hours standing or walking on hard floors.
- Tight calf muscles, which increase load on the ball of the foot.
- Injury or previous foot surgery.
What are the symptoms?
- Sharp or burning pain in the ball of the foot, often between the third and fourth toes
- Tingling, pins and needles or numbness spreading into the toes
- A feeling of walking on a pebble or a marble in your shoe
- Pain that eases when you take your shoe off and rub your foot, then returns with activity
How is it diagnosed?
Diagnosis is based on your symptoms and examination, usually confirmed with an ultrasound scan, which can also guide treatment.
Treatment without surgery
- Footwear. Wider shoes with a low heel.
- Metatarsal pads and insoles to spread the bones and take pressure off the nerve.
- Taping to offload the area.
- Pain relief with anti-inflammatory medicines.
- Steroid injection, often ultrasound-guided, which can settle symptoms for a period.
Cryotherapy (cryoablation)
Cryotherapy freezes the thickened nerve with a fine probe placed under ultrasound guidance. Freezing interrupts the nerve’s ability to send pain signals. Over time the nerve recovers, often without the painful thickening. It is a day-case procedure under local anaesthetic, without an incision.
Surgery
If other treatments have not worked, surgery is an option:
- Nerve decompression. Releasing the ligament that squeezes the nerve.
- Neurectomy. Removing the affected section of nerve. This reliably relieves pain but leaves permanent numbness between the two toes.
Images from Prof Mason's practice
X-rays shown with patient identifiers removed. Results vary between patients.
Common questions
What are the benefits of cryotherapy?
Cryotherapy is minimally invasive and is done as an outpatient under local anaesthetic, using ultrasound to guide a fine probe to the nerve. Most people resume normal activities within a few days. Unlike removing the nerve, it aims to preserve sensation once the nerve recovers, and the risk of infection is low.
What is recovery like after cryotherapy?
Usually quick. Mild discomfort, bruising or swelling at the treatment site is common. Most people are back in normal shoes and daily activities within a week, and should avoid high-impact exercise for a little longer.
What are the risks of cryotherapy?
Temporary bruising, swelling and numbness are the most common. Rarely, numbness lasts longer, or symptoms return if the nerve regenerates, in which case treatment can be repeated or surgery considered.
Who performs cryotherapy at the clinic?
Dr Kimberly Lam, consultant radiologist, is one of a small number of specialists in the UK offering ultrasound-guided cryoablation for Morton’s neuroma. The team has published its early clinical and radiological results.
Talk it through with a specialist
Consultations at Spire Liverpool, Salford and the Isle of Man. New patients £250.
Consultant Foot and Ankle Surgeon, MB BCh, PhD, FRCS (Tr&Orth), FRCS (Glasg), SFHEA, FFSTEd. GMC 6074953. Hunterian Professor, Royal College of Surgeons of England.
Page last reviewed 25 October 2026. This information is general and does not replace an assessment.
Prof Mason's published research on this topic
Peer-reviewed papers by Prof Mason and his colleagues. Links open the paper or its PubMed record.
- Lam K, Singh A, Sirikonda S, Narang Y, Ghany J, Mason L, Lampridis V. Cryoablation of Morton's neuroma: an early clinical and radiological outcome study. Journal of Foot and Ankle Surgery (Asia-Pacific), 2023.