September 29, 2026

It feels like a pebble in your shoe, except the pebble is still there after the shoe comes off. That burning, bunched-up pain in the ball of your foot is often Morton's neuroma, and it tends to linger until something about your footwear or foot mechanics changes.

Morton neuroma treatment usually starts small. The American Academy of Orthopaedic Surgeons reports that conservative care for Morton's neuroma relieves symptoms for up to about half of patients. Surgery, reserved for pain that won't settle, succeeds 80 to 95% of the time.

That leaves one practical question: how long to give each step before moving on. This guide walks through Morton's neuroma treatment in order, what each option involves, and the signs it's time to see a podiatrist.

What Morton's neuroma is, and how to tell it's the likely cause

Morton's neuroma is a thickening of the tissue around one of the nerves that run between your toes. It usually forms between the third and fourth toes. It's more common in women, and narrow shoes, high heels and high-impact sports like running all load the same spot.

The classic Morton's neuroma symptoms are:

• Burning pain in the ball of the foot that shoots into the toes
• A feeling of standing on a marble or a folded-over sock
• Tingling or numbness in two neighboring toes
• Pain that eases when you take off your shoes and rub the foot

To confirm it, a specialist presses between your toes and squeezes the forefoot, which often reproduces the pain and sometimes a click. Ultrasound can show the neuroma, and an X-ray rules out a stress fracture or arthritis, which can feel similar early on.

Once the diagnosis is clear, Morton neuroma treatment follows a predictable order, starting with your shoes.

Step 1: shoes, pads and activity changes

Morton neuroma treatment starts by taking pressure off the nerve, mostly through your shoes.

• Wear shoes with a wide toe box, a low heel and a cushioned sole.
• Add a metatarsal pad, a small dome placed just behind the painful spot, to lift and separate the forefoot bones.
• Swap running or court sports for cycling or swimming while the nerve calms down.
• Ask your doctor whether a short course of an anti-inflammatory makes sense.

Give these changes several weeks. Many of the "how I cured my Morton's neuroma" stories online come down to this step: new shoes and a well-placed pad. It doesn't work for everyone, though, and if the pad keeps sliding or your foot shape keeps loading the same spot, orthotics come next.

Step 2: orthotics

Orthotics do the same job as a metatarsal pad but hold the correction in place every time you wear shoes. The feature that matters for Morton's neuroma is support just behind the ball of the foot that spreads the metatarsal bones apart.

You have two routes. An over-the-counter arch support with a metatarsal pad is a reasonable first try. A custom orthotic makes more sense when a store-bought pad keeps shifting, or when flat feet or a high arch keep driving pressure into the forefoot. This comparison of custom orthotics and over-the-counter insoles covers fit and durability.

If shoes and orthotics still leave you sore, the next step in Morton neuroma treatment is usually an injection.

Step 3: injections

A cortisone injection is the most common next treatment for Morton's neuroma when footwear changes aren't enough. The shot combines a steroid with a numbing agent and goes into the space between the affected toes. Orthopaedic surgeons report short-term relief in 50 to 70% of patients.

How the injection is given may matter as much as what's in it. A 2024 Cochrane review of Morton's neuroma treatments found that ultrasound-guided injections probably reduce pain and improve function more than injections placed without imaging. The same review found little difference between a steroid-plus-anesthetic shot and anesthetic alone. Before a Morton's neuroma injection, ask whether it's ultrasound-guided.

Relief from a steroid shot can fade, and repeated injections can thin the fat pad under the ball of the foot, so your podiatrist will limit how many you get. When the pain keeps coming back, Morton neuroma treatment moves toward the nerve itself.

Step 4: nerve ablation and cryoablation

Ablation treats the nerve directly without an incision. A podiatrist can use a series of alcohol injections (chemical ablation), radiofrequency energy or freezing (cryoablation) to quiet the nerve, usually in the office with local anesthetic.

Orthopaedic surgeons report improvement in 70 to 80% of patients after chemical or radiofrequency ablation. The evidence is thinner than for other foot neuroma treatment options, though: the Cochrane review couldn't include the radiofrequency or cryotherapy studies it found. If you're weighing ablation as a Morton neuroma treatment, ask how often the specialist performs it.

Step 5: Morton's neuroma surgery

Morton's neuroma surgery is for pain that continues after months of conservative care, or pain that limits how far you can walk. A foot and ankle surgeon typically chooses between two outpatient procedures:

• Neurectomy removes the short section of nerve that contains the neuroma.
• Decompression releases the ligament above the nerve so it has more room, leaving the nerve in place.

Orthopaedic surgeons report success rates of 80 to 95%. A meta-analysis summarized in StatPearls' review of Morton neuroma outcomes found 74% of patients pain-free after neurectomy and 68% after decompression.

Morton's neuroma surgery recovery usually means a week or two in a protective shoe or boot while the incision heals, then a gradual return to regular shoes. After a neurectomy, expect some permanent numbness between the two toes. Symptoms return in 5 to 20% of patients, sometimes from a new neuroma at the cut nerve end.

Bring these questions to ask before surgery to your consultation, especially about which approach fits your Morton neuroma treatment plan.

When to see a podiatrist instead of waiting

You don't have to work through these steps alone. See a podiatrist if:

• Pain hasn't improved after a few weeks of wider shoes and a metatarsal pad
• Numbness between your toes is constant or spreading
• You've started walking differently to avoid the pain
• The forefoot is swollen or bruised, which points to a stress fracture rather than a neuroma

At the first visit, expect an exam, possibly an ultrasound, and a Morton neuroma treatment plan that starts at the right step for you. If you're unsure whether to book with a podiatrist or an orthopedic specialist, either can diagnose and treat it. It also helps to read how orthotics compare with surgery before that conversation.

Morton's neuroma treatment options compared

Here's how the Morton neuroma treatment options compare.

Shoe changes and metatarsal pads come first for everyone and involve no downtime.

Custom orthotics suit feet whose shape keeps loading the forefoot, also with no downtime.

A cortisone injection, ideally ultrasound-guided, helps when pain outlasts footwear changes.

Ablation, whether alcohol, radiofrequency or cryoablation, is an in-office option for people hoping to avoid surgery, with less supporting evidence.

Surgery, by neurectomy or decompression, is for pain that continues after months of care. Plan on one to two weeks in a protective shoe before returning to regular footwear.

Getting the right treatment for your foot

Morton neuroma treatment moves in order: shoes and pads, then orthotics, then an injection, then ablation, and surgery only when pain won't settle. Many people improve in the first steps. A clear diagnosis early helps you skip the treatments that won't help your foot.

If ball-of-foot pain is changing how you walk, find a podiatrist near you and start with an exam.