Morton's neuroma

What it means

Between the long bones that lead to your toes (the metatarsals) run small nerves that give sensation to the toes. When one of these nerves — most often the one between the third and fourth toes — gets squeezed repeatedly, the tissue wrapped around it thickens and scars. This thickened, irritated bundle is what's called a Morton's neuroma. Despite the name, it isn't a true tumor of nerve cells; it's better described as a reactive swelling, a bit like a callus forming around a nerve instead of on skin.

Why it appears on a CT or MRI report

MRI and ultrasound are the usual ways to see it, showing a small, well-defined mass of soft tissue sitting between two metatarsal heads, typically in the third web space and occasionally the second. Reports give its size in millimetres and note whether fluid is trapped in the joint capsule nearby (intermetatarsal bursitis), which often travels alongside it. CT is less useful for this soft-tissue finding and is usually not the first choice unless it was done for another reason and picked this up incidentally.

What it usually means

A neuroma found on a scan doesn't automatically mean it's the source of pain — small ones turn up on imaging of feet that don't hurt at all, particularly in people who wear narrow shoes for years. When it is symptomatic, the classic pattern is a burning or aching pain in the ball of the foot, often radiating into two toes, worse in tight or high-heeled shoes and better barefoot. Some people describe it as feeling like there's a pebble or a fold in their sock under the foot. Most cases respond well to conservative care: switching to wider, lower shoes, a metatarsal pad or custom insole to spread the bones apart, and activity changes. A steroid injection can calm a flare. Surgery — removing the thickened tissue or releasing the ligament compressing it — is kept for cases that don't settle after a genuine trial of conservative treatment, usually several months.

When to follow up

If the finding is mild and pain is manageable, start with shoe changes and a supportive insole before seeking further treatment — many people improve within weeks. See a podiatrist, foot and ankle specialist, or your doctor if the pain persists beyond a few months, is limiting how much you can walk or exercise, or keeps returning despite shoe changes. Numbness that doesn't resolve, spreading pain, or a lump you can feel and press to reproduce the pain are all worth discussing at that visit. This finding is not urgent and does not need an emergency evaluation.

A plain-language way to picture it

Imagine a garden hose running between two closely spaced stepping stones. Every time weight presses down, the stones pinch the hose a little. Do that thousands of times a day, day after day, and the hose develops a thickened, tender lump right where it gets squeezed. Widening the gap between the stones — the equivalent of roomier shoes and a spreading insole — takes the pressure off and lets the irritation settle.