What is Morton's Neuroma?

Morton's Neuroma is a benign thickening (fibrosis) of the common digital plantar nerve, most commonly between the 3rd and 4th metatarsal bones. Nerve compression causes burning pain, numbness, and a sensation of a foreign body in the foot.

Surgical treatment — neuroma excision — leads to permanent loss of sensation in the toes and does not rule out recurrence.

Symptoms:

Burning, shooting pain in the forefoot
Numbness and tingling in the 3rd-4th toes
Sensation of a “pebble in the shoe”
Pain worsening in narrow shoes and with prolonged walking
Relief when removing shoes and massaging
Positive Mulder's test (click on foot compression)

Risk Factors:

Narrow shoes, high heels
Transverse flatfoot
Hallux valgus
Excess weight

Morton’s neuroma: treatment options and what is known about them

The treatment plan is made by the clinic doctor after an examination and a review of your images. The table shows the options usually discussed for this diagnosis and how well they have been studied.

Option	What to expect	How well studied
Braces, splints, insoles	Offload and stabilise, reduce pain under load	Moderate evidence
Corticosteroid injection	Quickly reduces inflammation and pain, the effect is often temporary; frequent injections are undesirable	Limited or conflicting evidence
Painkillers and NSAIDs	Ease pain during flare-ups; long-term use is limited by side effects	Moderate evidence
PRP / CGF	—	Not usually used for this diagnosis
Neuroma removal	If conservative treatment does not help or there is an indication	When indicated — the doctor decides

We send your request to several partner clinics. Some will suggest conservative treatment or injections, others surgery; each clinic quotes its own conditions and price. We help you compare the options.

Regenerative methods: realistic expectations

With nerve compression, mild and moderate symptoms often improve with a night splint or comfortable shoes with insoles, and after a corticosteroid injection. If numbness is constant, muscle weakness appears or nerve conduction findings worsen, waiting is not advisable. Regenerative injections have hardly been studied for these diagnoses.

When surgery is discussed. Surgery (nerve decompression or neuroma removal) is discussed for constant numbness, weakness or if conservative treatment has not helped for 3–6 months.

If an injection helps, the effect usually builds up over 6–12 weeks, and the result is assessed after 2–3 months. No clinic can guarantee a result.

Good to know: diagnosis, self-help, outlook

How to tell Morton’s neuroma from similar conditions

Morton’s neuroma typically causes burning, numbness and a “pebble in the shoe” feeling between the 3rd and 4th toes, worse in tight shoes and better after taking them off and massaging the foot. Metatarsalgia hurts under the metatarsal heads without numbness, and a stress fracture causes point tenderness on the bone after increased load. Ultrasound or MRI confirms the diagnosis.

What you can do yourself

Wear shoes with a wide toe box and low heel and use insoles with a metatarsal pad that spreads the metatarsal heads. Reduce running and jumping during flare-ups and lose weight if you are overweight.

Outlook and timelines

Suitable footwear and insoles help many patients within a few months. An ultrasound-guided corticosteroid injection reduces pain for weeks to months. If treatment fails, surgery is discussed — decompression or removal of the neuroma; after removal, lasting numbness between the toes is possible.

Who it is not suitable for and possible risks

Contraindications

Active infection — at the injection site or systemic, with fever.
Active cancer or ongoing chemotherapy.
Blood clotting disorders or a low platelet count. Anticoagulants are discussed with the physician.
Pregnancy and breastfeeding — the procedure is usually postponed.
A corticosteroid injection into the same area in recent weeks.
A complete tendon or ligament rupture with loss of function — surgical repair is usually needed.

Possible risks

Pain and swelling at the injection site for 1–3 days.
Bruising where blood or fat tissue is taken.
Rarely, infection. The procedure is therefore performed under sterile conditions with ultrasound or X-ray guidance.
The effect may be absent or smaller than expected.

If any of these apply to you, mention it in your request. The coordinator will check with the clinic physician whether treatment is possible. Contact a coordinator.

Scientific evidence

Studies of regenerative methods show mixed results. Clinic physicians rely on research including the following:

Monto RR. Platelet-rich plasma and plantar fasciitis. Sports Med Arthrosc Rev, 2013.
Sheth U et al. Efficacy of autologous platelet-rich plasma use for orthopaedic indications: a meta-analysis. J Bone Joint Surg Am, 2012.

Next steps: Treatment methods · Treatment cost · How treatment in Germany is organised

Frequently Asked Questions About Morton's Neuroma Treatment

Morton’s neuroma: can surgery be avoided?

With mild to moderate symptoms, often yes: a splint or suitable shoes, injections. With constant numbness and weakness, surgery is usually recommended.

Morton’s neuroma: do PRP and cell-based methods help?

There is almost no data. Splints, orthotic insoles, corticosteroid injections and surgery are better studied.

When can I expect a result after an injection?

If an injection helps, relief usually builds up over 6–12 weeks. The result is assessed after 2–3 months; not everyone needs a repeat procedure. No clinic can guarantee a result.

Morton’s neuroma: when is surgery needed?

Surgery (nerve decompression or neuroma removal) is discussed for constant numbness, weakness or if conservative treatment has not helped for 3–6 months. The decision is made by the clinic doctor.

How does RegenPAS help organise treatment?

RegenPAS is a patient service centre in Munich, not a clinic. We review your images and symptoms and send a request to several partner clinics at once. Clinics that can accept you send their own conditions and price; prices differ between clinics, and you choose the option that suits you. The coordinator replies within 24 hours, and a clinic physician’s preliminary opinion follows in 1–3 business days. We then arrange the appointment, visa invitation, interpreter, transfers and accommodation. Treatment decisions are made by the clinic physician. Contact a coordinator.

What is needed for a preliminary assessment?

Your MRI (or CT, X-ray) report and the images if you have them, plus a short description of your symptoms and previous treatment. Send them via the form on the website — the assessment is free and without obligation: the coordinator replies within 24 hours, and the clinic physician’s preliminary opinion follows in 1–3 business days.

How much does treatment cost and how long do I need to stay in Munich?

The cost depends on the method, the diagnostics needed and the clinic itself: prices differ between clinics. We request offers from several clinics and send you their conditions and quotes so you can compare. Price guidance is on the treatment cost page. For an outpatient procedure, 2–3 days in Munich are usually enough: examination, procedure and follow-up visit.

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Clinic and method matching — free of charge

Describe your case and attach your MRI report. We will identify clinics that use the relevant methods and forward your request to them. No obligation; we reply within 24 hours.

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