What Is a Neuroma and Why Does It Make Your Foot Burn?

Let’s say you’re walking through the store or pushing through a workout when you suddenly feel a sharp, burning, or tingling pain in the ball of your foot like your sock is bunched up or there’s a pebble stuck in your shoe. You take your shoe off, and… nothing. That mystery pain might not be in your sock. It might be in your nerve.

That’s a neuroma.

More specifically, it’s often something called a Morton’s neuroma, a condition where a nerve between your toes becomes thickened, irritated, and painfully compressed. It’s a lot more common than people think, and the good news is there are some great conservative ways to manage it before jumping to surgery.

Let’s break it down.

What is a neuroma?

A neuroma is a thickened, inflamed nerve most commonly located between the third and fourth toes. When too much pressure or friction is applied to that nerve over time, it becomes irritated and starts to swell, creating a burning, tingling, or stabbing pain in the forefoot.

You might feel:

• Pain or numbness in the ball of your foot

• A pebble-like sensation when walking

• Tingling or burning that radiates into your toes

• Relief when removing your shoes or massaging your foot

Morton’s neuroma is the most common type, but neuromas can technically occur in other areas of the foot as well.

What causes it?

Neuromas usually develop over time, and several factors can lead to them:

• Narrow or tight shoes that compress the toes

• High heels that overload the forefoot

• Flat feet or high arches that change abnormal pressure patterns

• Repetitive impact from running, sports, or walking on hard surfaces

• Foot deformities

In most cases, it’s a combination of a few of these

How do we treat neuromas without surgery?

Here’s the good news: most people can manage neuromas without the need for surgery if the condition is caught early and treated properly. The goal is to reduce pressure on the nerve and give it a chance to calm down.

1. Shoe changes
   Wear shoes with a wide toe box, good arch support, and extra cushioning in the forefoot. Avoid high heels and shoes with tight, pointed fronts.

2. Custom orthotics
   These inserts are designed to redistribute pressure and take load off the neuroma. A metatarsal pad is often added just behind the ball of the foot to reduce nerve irritation with each step.

3. Activity modification
   If running, jumping, or prolonged walking make things worse, take a short break and substitute with low-impact activity like biking or swimming until the nerve calms down.

4. Padding and offloading
   Felt or gel pads can be placed in your shoes to relieve pressure. This is especially helpful if you’re not ready for custom orthotics.

5. Anti-inflammatory care
   Topical pain creams, oral NSAIDs (like ibuprofen), and occasional ice massage may reduce inflammation and pain.

6. Cortisone injections
   If conservative measures don’t offer enough relief, a targeted steroid injection can reduce swelling and improve symptoms

When is surgery necessary?

Surgical removal of a neuroma is usually a last resort, but in severe cases that don’t respond to conservative care, it can be effective. The procedure involves removing the damaged portion of the nerve, which relieves pain but may leave a small area of numbness in the toes.

We typically recommend surgery only after several months of failed non-surgical treatment, and after confirming the diagnosis with imaging or ultrasound if needed.

Final thoughts

Neuromas are small, but they can cause big problems if left untreated. The key is early intervention, adjusting your shoes, relieving pressure, and letting the nerve recover before the damage becomes permanent.

If you’ve been feeling that burning or stabbing pain in your foot, don’t ignore it. The earlier we address it, the better the results.

Your feet carry you through life. Let’s take care of them.