Private morton's neuroma clinic in London, same-day physiotherapy.

What it feels like

• Burning, sharp or electric pain in the ball of the foot, radiating into two adjacent toes
• the sense of a pebble, marble or rucked sock underfoot
• numbness or tingling in the affected toes
• worse in tight or narrow shoes and heels, better with shoes off and rubbing the foot
• worse on walking, standing and running; relieved by rest
• sometimes a click felt when the forefoot is squeezed

First-line treatment

1. Change the footwear. Wide toe box, low heel, cushioned sole. This alone resolves a proportion of cases and no other treatment works well without it.
2. Use a metatarsal pad or dome, placed behind the ball of the foot rather than under it, to spread the metatarsal heads apart.
3. Reduce the aggravating activity temporarily — running, standing all day, high-impact classes.
4. Ice and anti-inflammatory gel after activity.
5. Calf stretching and foot strengthening, which reduce forefoot loading.

If injection does not settle it

• A second injection, usually no more than two or three in total.
• Alcohol or radiofrequency ablation of the nerve, used in some centres.
• Surgery — either releasing the ligament compressing the nerve, or removing the neuroma. Removal leaves permanent numbness between the affected toes, which most people accept readily in exchange for losing the pain.
• Recovery from surgery is around four to six weeks in a supportive shoe, with swelling for longer.