Pain guide · Foot pain

Morton's neuroma: shoes, pads, injections and what exercise can do

Morton's neuroma is an irritated, thickened nerve between the toes, usually the 3rd and 4th. It causes a shooting, stabbing or burning pain, a feeling of standing on a pebble, and sometimes tingling or numbness, and it is worse in tight or high-heeled shoes.

Wider shoes and a pad placed just behind the ball of the foot come first, and they help about 1 in 3 people. This guide sets out what injections and surgery can and can't do, why scans can mislead, and an honest word on exercise: no trial has tested it, so the plan here keeps you active and looks after your calves and feet without pressing on the sore spot.

3-stage exercise plan When to get help 17 sourcesUpdated 21 October 2026

When to get help first

Exercise is for pain that has been checked or is clearly mild and settling.

Get urgent medical help if

Same day: you have diabetes and a new foot problem, such as an ulcer or wound, signs of infection, or a hot, swollen foot with a change in colour, even if it doesn't hurt. Contact your diabetes foot team or GP: NICE asks for these to reach a specialist foot service within 1 working day, and a suspected Charcot foot is kept off weight until it has been checked.
Same day: a sudden, very painful, hot, swollen, red joint, often the big toe, especially with a high temperature, feeling shivery or being unable to eat. It may be gout, but it could be a joint infection (septic arthritis), which is urgent.
Same day: skin on the foot that is painful, hot and swollen. It could be a skin infection (cellulitis).
Call 999 or go to A&E: after an injury, you heard a crack, the foot or ankle has changed shape or points at an odd angle, a bone is sticking out, there is a bad cut over it, you're in severe pain, or the toes look blue or white, feel numb or are cold to touch. These can mean a broken bone. Don't drive yourself.

See a doctor or physiotherapist if

See a GP if the pain is severe or stopping you doing normal activities, is getting worse or keeps coming back, hasn't improved after 2 weeks of looking after it yourself, or comes after a recent foot injury or foot or ankle surgery.
Tingling, weakness or numbness in your foot.
One spot on a foot bone that hurts with every step and later at night: a possible stress fracture.
Any foot pain if you have diabetes: foot problems can be more serious.
Pain that has lasted 3 months despite changing your shoes and using insoles: see a doctor, as one NHS trust advises.

Understand it

What it is

The NHS describes a thickening of tissue around a nerve between the toe bones that has been irritated or damaged, usually between the 3rd and 4th toes. A Cochrane review calls it a harmless (benign) enlargement of the nerve, usually in the third web space and less often the second.

Despite the name, it isn't a tumour. A specialist review points out that, under the microscope, removed neuromas look the same as nerves from feet without pain, apart from being wider. It behaves more like a squeezed, irritated nerve.

Sources 1, 2, 3

Symptoms

A shooting, stabbing or burning pain between the 3rd and 4th toes, a feeling like a pebble or lump stuck under the foot, and sometimes tingling or numbness. It is worse when you move the foot and in tight or high-heeled shoes, and it often gets worse over time. An NHS trust adds that taking the shoe off, resting and massaging the foot can ease it, and that it may come and go over years.

A clinician presses into the web space and squeezes the forefoot; a painful click there (Mulder's click) supports the diagnosis. In one series cited by a review, these tests were positive in more than 92% of neuromas confirmed at surgery.

Sources 1, 4, 3

Who gets it

About 3 in 4 people with it are women, most often aged 40 to 60. In the main UK injection trial, the average age was 53 and 85% were women. It is linked with tight, pointy or high-heeled shoes, with running and other activities that load the feet, and with flat feet, high arches, bunions and hammer toes. Tight calf muscles are more common in people with pain in the front of the foot.

Sources 4, 3, 5, 1

What a scan does and doesn't showStrong evidence

The diagnosis is made from your story and an examination; an ultrasound or MRI (magnetic resonance imaging) scan is rarely needed. Scans can mislead, because neuroma-like findings are common in feet that don't hurt:

On MRI, 30% of 70 people without symptoms had a neuroma. The authors suggested it matters only if it is 5 mm or more across and matches the examination.
On ultrasound, 54% of 48 people without symptoms had a thickened nerve, in both feet in 35%. The authors called an ultrasound neuroma unreliable unless it matches the examination.
In 161 people with pain in one foot, 76% had a neuroma-like lesion in the other foot too, and its size wasn't linked with symptoms.
After surgery, neuroma-like tissue showed on MRI in 26% of web spaces that didn't hurt.
In 26 people with pain between the toes, MRI showed an inflamed fluid sac (bursitis) more often than a neuroma (14 against 5), and 4 of 13 people without pain had changes too.

Sources 6, 7, 8, 9, 10, 4

What else it can be

Pain in the ball of the foot from other causes (metatarsalgia, covered in the ball of foot pain guide), problems with the joints at the base of the toes, a stress fracture of a foot bone, an inflamed fluid sac (bursitis), gout, or nerve problems from the back or from diabetes. More than one can be present.

Sources 3, 10, 1

How it usually goesEmerging evidence

It often gets worse over time if nothing changes, but it can come and go. About 1 in 3 people get better with changes of footwear and metatarsal pads: across two small studies, 32% were treated successfully this way at about 4.5 months. In an older series of 115 people treated in stages (shoes and pads, then an injection, then surgery), 85% felt better and 21% ended up having surgery.

Sources 1, 4, 11, 12

What helps, and how strong the evidence is

Shoes and pads firstEmerging evidence

The NHS advises resting and raising the foot, ibuprofen or paracetamol, wide comfortable shoes with a low heel and soft sole, soft insoles or pads (ask a pharmacist for metatarsal pads), losing weight if you need to, and cutting down running and jumping. An NHS trust adds that the pad should sit behind the ball of the foot, not directly under it. A Welsh NHS podiatry service adds laced or strapped shoes with stiffer soles and a slight rocker, heels no higher than about 25 mm, and insoles with a metatarsal support built up over a week.

How well this works has hardly been tested. Across two small, low-quality studies, it succeeded in 32% (14% in one and 38% in the other), in line with the NHS trust's figure of about 1 in 3.

Sources 1, 4, 13, 11

Steroid injections: a short-term benefit in one trial, uncertain overallMixed evidence

In a UK trial of 131 people, a steroid and local anaesthetic injection, guided by ultrasound, improved overall foot health more than the anaesthetic alone at 3 months, by about 14 points on a 100-point scale.

Cochrane's 2024 review of 6 trials (373 people) is less sure: steroid with anaesthetic may make little or no difference to pain at 3 to 6 months compared with anaesthetic alone, and the certainty of that evidence is low. Side effects included thinning or lightening of the skin (each about 4 in 100) and thinning of the fat pad under the foot (about 3 in 100).

The reviews conflict on ultrasound guidance. A 2019 specialist review found it didn't seem to make injections more successful; Cochrane's 2024 review found guided injections probably reduce pain more than unguided ones (moderate certainty, 2 trials, 116 feet). The same 2019 review notes that about half of people given steroid injections may need surgery within 2 years. In one small trial, the odds of success at 6 months were 6 times higher with injections than with shoes and pads.

Sources 5, 2, 3, 11

Other injections and treatments: small studies onlyMixed evidence

Alcohol injections, radiofrequency treatment (heating the nerve), freezing (cryotherapy) and botulinum toxin have been studied only in case series of limited quality, and shockwave therapy did no better than a dummy treatment in one trial. In a hospital's records, 26% of people treated with radiofrequency later had surgery and 33% had it repeated. The NHS keeps steroid or alcohol injections, and surgery, for very severe symptoms or when other treatments haven't worked.

Sources 11, 14, 1

Manipulation by a therapist: one small trialEmerging evidence

In one trial of 40 people, six sessions of foot and ankle joint manipulation and mobilisation over 3 weeks eased pain more than a dummy treatment, by about 15 points on a 100-point scale, but pain was measured only at the end of treatment. An NHS trust says it has been found to help in some cases.

Sources 11, 4

Exercise: no trialsMixed evidence

No trial has tested exercise for Morton's neuroma. The calf stretching and foot strengthening on this page rest on one NHS podiatry leaflet, which suggests calf stretches, toe and forefoot massage, a foot roller and foot-muscle strengthening, and one expert review, which lists stretching of the calf and the small foot muscles and notes that tight calves are more common with pain in the front of the foot.

So treat the plan below as a sensible, low-risk way to keep the foot and calf in good order and stay active while shoes and pads do the main work, not as a proven treatment.

Sources 2, 11, 13, 3

Surgery: usually helps, but not for everyoneEmerging evidence

Removing the nerve (neurectomy) is for symptoms that persist after other treatment. A review found good or excellent results in 70 to 80%, but consistently only about half had no pain afterwards, about 30% were better with some pain left, and about 1 in 10 were worse. In 81 people followed for 15 years, results were excellent or good for 77% of feet and poor for 8%, and 72% had numbness between the toes, which didn't affect satisfaction. In another 120 people, 51% had good or excellent results and 40% poor, with worse results for the second web space.

Across 8 studies, a cut on the sole left numbness less often than one on the top of the foot (49% against 62%) but a tender scar more often (17% against 6%). An NHS trust adds that painful scars happen in about 5 in 100, and the problem comes back later in 1 in 4 of those who got better.

Sources 3, 15, 16, 17, 2, 4

How much pain is OK while you exercise?

No burning, tingling or numbnessEmerging evidence

For general exercise, mild to moderate discomfort, no more than about 5 out of 10, that settles within an hour and is no worse the next morning, is fine. That figure is an editorial starting point, as on this site's other foot pages.

The nerve rule matters more: stop any movement that brings on burning or shooting pain, tingling or numbness between the toes, and change it rather than push through. Build up new insoles gradually over a week, and stop using them if they cause new pain, as an NHS podiatry service advises.

Sources 1, 13

The exercise plan: 3 stages

Start at the first stage. Each move opens a full guide with a 3D demo.

Stage 1

Ease the pressure, keep moving (about weeks 0 to 2)

Change your shoes and add a metatarsal pad behind the ball of the foot first, and swap running and jumping for cycling or swimming, as the NHS advises. This plan isn't a treatment: it keeps you active while shoes and pads do the work. Doses are editorial unless marked.

Stationary cycling demonstrated on the 3D figure

3D demoStationary cyclingBeginner · Cardio machine

20 to 30 min · In place of running and jumping

Harder: Air bike intervals

Wall calf stretch (gastrocnemius) demonstrated on the 3D figure

3D demoWall calf stretch (gastrocnemius)Beginner · A wall

3 holds of 30 s each side, once or twice a day · Calf stretches come from one NHS podiatry leaflet and one expert review; the dose is ours

Easier: Seated calf stretch with a towel · Harder: Contract-relax hamstring stretch (PNF)

Soleus wall stretch demonstrated on the 3D figure

3D demoSoleus wall stretchBeginner · A wall

3 holds of 30 s each side · As above

Easier: Seated calf stretch with a towel · Harder: Contract-relax hamstring stretch (PNF)

Towel toe curl demonstrated on the 3D figure

3D demoTowel toe curlBeginner · Other / check instructions + A bench or box

2 sets of 10, seated · Foot-muscle strengthening from the same NHS leaflet; stop if it brings on burning or tingling

Harder: Short foot + toe splay

Move on when: Walking in your new shoes and pads is comfortable.

Follow along: a timer, a cue and the next move, one step at a time.

Stage 2

Strength without pressing on the forefoot (about weeks 2 to 6)

Strengthen the calf and lower leg in ways that keep weight off the sore spot. Doses are editorial.

Seated bent-knee calf raise (soleus raise) demonstrated on the 3D figure

3D demoSeated bent-knee calf raise (soleus raise)Beginner · A bench or box

3 sets of 15

Harder: Slow calf raise

Slow calf raise demonstrated on the 3D figure

3D demoSlow calf raiseBeginner · A wall

3 sets of 10 · Stop short of full tiptoe, as this move's own caution advises for pain in the ball of the foot

Easier: Seated bent-knee calf raise (soleus raise) · Harder: Standing dumbbell calf raise

Tibialis raise demonstrated on the 3D figure

3D demoTibialis raiseBeginner · No equipment

2 to 3 sets of 10 to 15 · Works the shin, not the forefoot

Harder: Single-leg tibialis raise

Single-leg stand demonstrated on the 3D figure

3D demoSingle-leg standBeginner · A wall

3 holds of 30 s each leg · In your supportive shoes

Easier: Tandem stance and heel-to-toe walk · Harder: Single Leg Reach Matrix

Move on when: None of these brings on burning, tingling or the pebble feeling, and 30 minutes of walking is comfortable.

Follow along: a timer, a cue and the next move, one step at a time.

Stage 3

Back to your usual activity (from about week 6)

Build walking first, then running if you run, in the shoes and pads that helped. Doses are editorial.

Treadmill walking demonstrated on the 3D figure

3D demoTreadmill walkingBeginner · Cardio machine

Build your walking time

Harder: Treadmill jogging

Treadmill jogging demonstrated on the 3D figure

3D demoTreadmill joggingIntermediate · Cardio machine

Walk-jog intervals, if you run · Once walking is comfortable

Easier: Treadmill walking · Harder: Sprint intervals

3D demoStep-upBeginner · A step

3 sets of 8 to 10 each side

Easier: Low step-up · Harder: Dumbbell step-up

Single-leg calf raise from a step demonstrated on the 3D figure

3D demoSingle-leg calf raise from a stepIntermediate · A step + A wall

2 to 3 sets of 8 to 10 each leg, to half height · Only if comfortable, after controlled raises on the floor

Easier: Slow calf raise · Harder: Single-leg pogo hops

Move on when: Keep going. If the pain still stops you after 12 weeks of good shoes and pads, ask a GP or podiatrist about a guided injection or other options.

Follow along: a timer, a cue and the next move, one step at a time.

What to change for now

Shoes and pads that help

Wide shoes with room for the toes, a low heel (no more than about 25 mm) and a cushioned sole, or a stiffer sole with a slight rocker, fastened with laces or a strap. Leave out tight, pointy, high-heeled and thin-soled shoes. A metatarsal pad sits just behind the ball of the foot, not directly under the sore spot; insoles with a raised metatarsal dome work the same way. A pharmacist or podiatrist can help you place them.

Sources 1, 4, 13

Massage and rolling

Taking the shoe off and massaging the foot can ease an attack, and an NHS podiatry service suggests toe and forefoot massage and rolling the sole on a ball or rolling pin. Roll the arch rather than pressing hard on the sore web space (our caution).

Sources 13, 4

Positions to swap, and why

Habit or position	Why it matters	Instead
Tight, pointy, high-heeled or thin-soled shoes	They are on the NHS list of shoes to avoid.	A wide toe box, a low heel and a cushioned or slightly rockered sole.
A pad placed right under the sore spot	The pad works from just behind the ball of the foot.	Ask a pharmacist or podiatrist to help you place it.
Full tiptoe calf raises	Rising right onto the toes loads the front of the foot, as this move's own caution says.	Stop short of full tiptoe, or do seated calf raises.Try: Seated bent-knee calf raise (soleus raise)
Kneeling with the toes tucked under	It bends the toes back and loads the front of the foot (our caution).	A wall calf stretch instead.Try: Wall calf stretch (gastrocnemius)
Gripping or curling the toes hard	It may squeeze the web space (our caution).	Gentle towel curls, stopping at any tingling.Try: Towel toe curl
Rolling a ball hard under the ball of the foot	Pressing on the nerve may set it off (our caution).	Roll the arch instead, gently, if it feels good.
Running and jumping during a flare	The NHS advises cutting down high-impact activity.	Cycling or swimming.Try: Stationary cycling

Routines to follow

Foot and ankle strengthening routine: toes, arches, calves and balance

A 15-minute barefoot routine for stronger toes, arches, calves and ankles, finishing with balance. You need only a towel, a wall and a resistance band.

15 minBeginner11 movesA wall, Other / check instructions

Low-impact leg workout (no jumping)

A gentle leg strength routine with no jumping: sit-to-stands, step-ups, wall sits, bridges and calf raises.

20 minBeginner7 movesA bench or box, A step

More moves for this area

Questions people ask

What does Morton's neuroma feel like?

A shooting, stabbing or burning pain between the toes, usually the 3rd and 4th, and a feeling of standing on a pebble. It is worse in tight or high-heeled shoes and may come with tingling or numbness.

Do Morton's neuroma exercises work?

No trial has tested them. Calf stretches and gentle foot exercises are a sensible way to keep active, and an NHS podiatry leaflet and an expert review suggest them, but shoes and pads do the main work.

What shoes help?

Wide shoes with room for your toes, a low heel and a cushioned or slightly stiff sole with a little rocker. Avoid tight, pointy, high-heeled and thin-soled shoes.

Where does a metatarsal pad go?

Just behind the ball of the foot, not directly under the sore spot. A pharmacist or podiatrist can help you place it.

Do steroid injections work?

The evidence is mixed. A UK trial found better foot health at 3 months, but a Cochrane review found that adding a steroid to the anaesthetic may make little or no difference to pain, with low certainty. Reviews disagree on whether ultrasound guidance helps, and about half of people who have steroid injections may need surgery within 2 years.

How successful is surgery?

About 70 to 80% have good or excellent results, but only about half are free of pain, and about 1 in 10 are worse. Numbness between the toes afterwards is common.

Do I need a scan?

Usually not. Neuroma-like changes show on scans in about a third to a half of people without symptoms, so the examination matters more than the scan.

Can I keep running?

Cut down running and jumping while it's sore, as the NHS advises. Then build back gradually, for example with walk-jog intervals, in the shoes and pads that helped.

Is it the same as metatarsalgia?

Not quite. Metatarsalgia means pain in the ball of the foot from any cause, and Morton's neuroma is one cause, an irritated nerve between the toes. The ball of foot pain guide covers the other causes.

How long does Morton's neuroma last?

It often gets worse over time if nothing changes, but about 1 in 3 people improve with shoes and pads. See a GP if it isn't better after 2 weeks of looking after it yourself.

Related exercise guides

Ankle and foot guide

Other pain guides

Sources

Exercise education, not a diagnosis or treatment plan. It is written from the guidelines and studies listed above; review by a clinician is pending. If your pain follows an injury, is severe, is getting worse, or comes with any warning sign listed on this page, get it assessed. Health disclaimer.