A neuroma is a thickened, swollen mass of nerve tissue that forms when a nerve is damaged, compressed, or irritated. Despite sometimes being called a “tumor,” a neuroma is not cancerous. It is a disorganized overgrowth of nerve fibers, connective tissue, and surrounding cells that develops as the body attempts to repair an injured nerve. Neuromas can form almost anywhere in the body, but they most commonly affect the foot, and they range from painless lumps to intensely painful growths that interfere with daily life.
How a Neuroma Forms
When a nerve is cut, crushed, or chronically compressed, the damaged end tries to regrow. Normally, regenerating nerve fibers extend outward in an organized fashion to reconnect with their target. But if something blocks that path, such as scar tissue, the sprouting fibers grow in random directions and tangle together. This disordered bundle of regenerating nerve fibers, scar tissue, and specialized nerve-supporting cells (called Schwann cells) creates the mass known as a neuroma.
The process involves an overproduction of the structural material that normally surrounds nerves. As this material builds up and remodels into permanent scar tissue, it traps the nerve fibers inside a dense, sensitive nodule. In painful neuromas, inflammatory signals and certain wound-healing cells accumulate within the mass, which helps explain why some neuromas cause severe pain while others remain silent.
Types of Neuromas
The term “neuroma” covers several distinct conditions. They fall into three broad categories.
Traumatic Neuromas
These develop after a nerve is physically injured, whether from an accident, a surgical incision, or an amputation. Stump neuromas, which form at the cut end of a nerve after a limb is removed, are a well-known example. Elective hand surgery is a surprisingly common trigger, with the nerves along the thumb side of the wrist and the inner ankle being especially vulnerable. Morton’s neuroma, the most frequently diagnosed type, is also classified as a traumatic neuroma. It forms between the bones of the forefoot, most often in the space between the third and fourth toes, where the nerve is repeatedly compressed.
True Nerve-Sheath Tumors
Unlike traumatic neuromas, these are actual growths of the cells that wrap around nerves. The best known is the acoustic neuroma (also called vestibular schwannoma), a slow-growing tumor on the nerve connecting the inner ear to the brain. It typically causes ringing in the ear, gradual hearing loss on one side, and balance problems. These tumors are benign but can create serious symptoms as they press on nearby brain structures.
Genetic Syndrome Neuromas
Some inherited conditions cause neuromas to develop throughout the nervous system. Neurofibromatosis, for example, produces numerous nerve tumors across both the brain and spinal cord and the nerves running through the rest of the body. These require ongoing monitoring because of their number and location.
Morton’s Neuroma: The Most Common Type
When most people search for “neuroma,” they’re looking for information about Morton’s neuroma, which accounts for a significant share of forefoot pain. It affects roughly 30 to 33 percent of people who seek care for foot pain. Women are diagnosed at least five times more often than men, with peak incidence between ages 25 and 55. The average age at diagnosis is around 45.
The neuroma develops where a nerve passes between the long bones of the foot (the metatarsals). Repeated compression squeezes the nerve against the ligament above it, and over time the nerve thickens and becomes painful.
What It Feels Like
The hallmark sensation of Morton’s neuroma is feeling like you’re standing on a marble or a small stone that you can’t shake out of your shoe. Beyond that, symptoms include stabbing, shooting, or burning pain in the ball of the foot that gets worse with activity. Many people notice a pins-and-needles tingling or outright numbness in the two toes on either side of the neuroma. Stretching the toes can trigger pain, and some people feel a distinct click in the forefoot when walking. The pain tends to build gradually over weeks or months rather than appearing suddenly.
Symptoms often flare during activities that put pressure on the forefoot, like running, walking on hard surfaces, or standing for long periods. Taking your shoe off and rubbing the ball of the foot usually brings temporary relief.
Risk Factors and Causes
Footwear is the single biggest modifiable risk factor. Shoes with a narrow toe box squeeze the metatarsal bones together, compressing the nerve between them. High heels make this worse by shifting body weight forward onto the ball of the foot, increasing the pressure even further. This footwear pattern is the leading explanation for why Morton’s neuroma is so much more common in women.
Foot structure also plays a role. People with bunions, hammertoes, flat feet, or unusually high arches place extra stress on the forefoot nerves. Repetitive impact from running or court sports adds to the cumulative compression. Any combination of these factors can push a nerve past its tolerance threshold and set the stage for thickening.
How It’s Diagnosed
A physical exam is often enough to suspect Morton’s neuroma. Your doctor will press between the metatarsal heads and squeeze the forefoot side to side. A palpable click during this maneuver, along with pain that radiates into the toes, strongly suggests a neuroma.
When imaging is needed to confirm the diagnosis or rule out other causes of forefoot pain (like a fluid-filled sac called a bursa or a stress fracture), MRI is the more reliable option. Studies comparing MRI to surgical findings show it detects neuromas about 83 percent of the time. Ultrasound is faster and cheaper but catches only about 57 percent of cases, meaning it misses nearly half. Your doctor may choose one or both depending on how clear the clinical picture already is.
Non-Surgical Treatment
The first and simplest step is changing your shoes. Footwear should have a wide toe box, a flat or low heel, and a thick, supportive sole. This alone can reduce nerve compression enough to ease symptoms. Cushioned insoles or custom orthotic pads that lift and separate the metatarsal heads take pressure off the nerve from below.
If shoe changes aren’t enough, corticosteroid injections can reduce inflammation around the nerve and provide meaningful relief. In one study tracking patients for an average of nearly five years, the original injection remained effective in 36 percent of cases. That means roughly a third of people get lasting benefit from a single injection, while others may need repeat injections or additional treatment.
Other conservative options include icing the area, temporarily reducing high-impact activities, and stretching the calf and foot to improve forefoot mechanics. Many people find that a combination of these approaches keeps symptoms manageable without surgery.
When Surgery Is Considered
Surgery typically enters the conversation after several months of conservative treatment have failed to provide adequate relief. The most common procedure is neurectomy, in which the surgeon removes the thickened segment of nerve. This eliminates the neuroma but leaves a patch of permanent numbness between the affected toes, since the nerve responsible for sensation in that area is gone.
Recovery varies. Some people return to normal activity within a few weeks, while others need several months before swelling and sensitivity fully settle. A known risk of neurectomy is the formation of a new neuroma at the cut end of the remaining nerve (a stump neuroma), which can cause recurring pain. Some patients report persistent hypersensitivity that gradually fades over the first year but doesn’t disappear entirely.
Less invasive surgical options, such as releasing the ligament that presses down on the nerve rather than removing the nerve itself, are sometimes used when the neuroma is caught early enough that the nerve may still recover once the pressure is relieved.
Preventing Neuromas
For Morton’s neuroma specifically, prevention comes down to protecting the forefoot from chronic compression. Choose shoes that are long enough, wide in the toe area, and as flat as possible. A sole with some thickness and moderate stiffness absorbs impact better than a thin, flexible one. If you run or play sports that involve repetitive forefoot loading, rotating your shoes and using metatarsal pads can spread the force more evenly across the ball of the foot. Addressing structural issues like bunions or hammertoes early, before they shift the mechanical load onto the interdigital nerves, also lowers risk over time.