Morton’s Neuroma · Kitchener, Waterloo & Cambridge
Morton’s neuroma is a thickening of the tissue around a nerve between the toes, usually the third and fourth, that causes burning or stabbing pain in the ball of the foot. The usual first step is roomier, low-heeled shoes and a soft pad under the forefoot, although the research behind every treatment for it is limited. At CARESPACE a physiotherapist or a chiropractor is the place to start, and both treat at the first visit.
What Morton’s neuroma is
A nerve that runs between the toe bones becomes irritated or damaged where it is pinched, and the tissue around it thickens. Researchers describe it as a compression problem of that nerve, most often in the space between the third and fourth toes. It is benign, meaning it is not cancer. In UK primary-care figures it is seen more often in women than in men.
Symptoms of Morton’s neuroma
- A shooting, stabbing or burning pain between the third and fourth toes
- A feeling that a pebble or lump is stuck under your foot
- Tingling or numbness in the toes
- Cramping in the forefoot
- Symptoms that are worse when you move the foot or wear tight or high-heeled shoes
What causes Morton’s neuroma
Footwear heads the list: tight, pointed or high-heeled shoes, in which the nerve is pinched between the toe joints and the shoe. A hockey skate laced tight all winter or a narrow safety boot worn through a long shift can pinch in the same way as a dress shoe. Running and other sports that put pressure on the feet can contribute, and so can other foot problems: flat feet, high arches, bunions and hammer toes.
How Morton’s neuroma is diagnosed
Usually from your description and an examination of the foot. The diagnosis can reliably be made from the clinical presentation and testing, with ultrasound as an accurate and cost-effective scan when one is needed. Scans are arranged through a physician or nurse practitioner.
Morton’s neuroma has no emergency signs in what we read. The NHS advises seeing a doctor if the pain is severe or stops you doing normal activities, is getting worse or keeps coming back, has not improved after two weeks of looking after it yourself, comes with any tingling, weakness or numbness in the foot, or follows a recent foot injury or foot or ankle surgery.
What the evidence says about treating Morton’s neuroma
- One review covers the field. A 2019 systematic review of non-surgical treatment: 25 studies, seven of them randomized trials and 18 case series, with 16 of the 25 rated low quality. Its conclusion is that high-quality evidence for any one treatment was not found.
- Shoes and pads are the usual first step, and barely tested. Care is normally staged, starting with wider, low-heeled shoes and a metatarsal pad. Only two low-quality studies have looked at this, and in the single trial fewer people did well with footwear changes and padding than with a corticosteroid injection. No harms were reported.
- Joint manipulation and mobilisation: one small positive trial. Twenty people per group; six sessions of manipulation and mobilisation of the foot and ankle joints over three weeks reduced pain more than sham ultrasound. It ranks, with corticosteroid injection, as having the strongest evidence for pain reduction, but people were followed for only about six weeks, so the result should be interpreted with caution.
- Orthotic wedges: no clear effect. One trial of 21 people compared two insoles that tilt the foot in opposite directions and found no significant difference in pain.
- Shockwave: not supported. The one small trial showed no statistically significant reduction in pain.
- Injections and nerve procedures have been studied more often than hands-on care, mostly in case series. They are covered below.
What a doctor may offer
These are medical treatments, not provided at CARESPACE. They are for very severe symptoms, or for when other treatments are not working.
- Corticosteroid injection. Two pooled trials showed a reduction in pain that was statistically significant but small, and it may not be large enough to matter. Reported side effects include thinning and colour change of the skin and loss of the fat pad.
- Alcohol injections. Case series only.
- Radiofrequency ablation. The UK’s National Institute for Health and Care Excellence found no major safety concerns, but evidence of benefit that is limited in quantity and quality. It says the procedure should only be used with special arrangements for clinical governance, consent and audit or research.
- Surgery, by referral to a foot and ankle surgeon.
How each CARESPACE service treats Morton’s neuroma
Physiotherapy
A physiotherapist can check whether the pain fits a neuroma, then start with the first item on the list of causes: your shoes. That can mean looking at toe-box width, heel height and sole against the shape of your foot, and trying a metatarsal pad. Mobilisation of the foot and ankle joints may be added, with advice on which impact activities to cut back for now.
Chiropractic
The one trial of hands-on care for Morton’s neuroma used manipulation and mobilisation of the foot and ankle joints, twice a week for three weeks. A chiropractor can offer that kind of treatment, along with the same footwear and padding advice. The trial was small and short, so it is a reason to try this approach, not a promise that it works.
Other services people ask about
Custom orthotics: in the UK a podiatrist may provide soft pads or insoles made to take pressure off the painful area, but the only trial of orthotic wedges found no clear effect, so an orthotic is not an automatic next step. Shockwave therapy is not supported by the one trial there is. Massage appears among the home measures that may relieve symptoms in British Columbia’s health advice, but no trial of it, or of acupuncture, was found.
Where most people start
Start with a physiotherapist or a chiropractor. Bring the shoes you wear most.
How your team works together
Morton’s neuroma is mostly looked after by one practitioner. If shoes, padding and hands-on treatment have not helped enough, the next step is medical: your practitioner can tell you when it is time to ask a physician about injections or a surgical opinion.
Browse by service: physiotherapists and chiropractors.
What to expect at your first visit
- Where and when it hurts. Which toes, what the pain feels like, and which shoes or activities set it off.
- The foot. Clinical tests of the forefoot to see whether they bring on your pain, and a look at arch height, bunions and toe position.
- Your shoes, including work boots or skates: width at the toes, heel height and sole.
- A first treatment and a plan to leave with: padding, footwear changes, any hands-on treatment, and when to review.
What you can do at home
- Wear wide, comfortable shoes with a low heel and a soft sole.
- Avoid tight, pointed shoes, high heels and thin soles.
- Use soft insoles or pads in your shoes. A pharmacist can show you metatarsal pads.
- Rest and raise the foot when you can.
- Cut back on impact activities such as running and jumping for now.
- If you are overweight, losing weight is part of the advice too.
- A pharmacist can also advise on a pain reliever.
How long it takes, and whether it comes back
No typical recovery time is given in what we read, and no figure for how often it returns. Two weeks is the NHS marker: if looking after it yourself has made no difference by then, have it assessed. With no agreed standard treatment, expect to try the simple measures first and review how they are working.
Morton’s neuroma treatment in Kitchener, Waterloo and Cambridge
Kitchener. Physiotherapy in Kitchener and Chiropractic in Kitchener. Locations: Victoria North, Fischer-Hallman, Westmount East and Deer Ridge.
Waterloo. Physiotherapy in Waterloo and Chiropractic in Waterloo. Locations: Weber North, Uptown Waterloo and Waterloo GoodLife.
Cambridge. Physiotherapy in Cambridge. Locations: Hespeler Road.
The city pages linked above show the locations and practitioners for each service, with their next availability.
Common questions
What shoes should I wear with Morton’s neuroma?
Wide at the toes, low in the heel and soft in the sole. The ones to avoid are tight, pointed shoes, high heels and thin soles.
Do I need an ultrasound or MRI?
Usually not. The diagnosis is normally made from your symptoms and an examination. Ultrasound is the scan used when there is doubt.
Can I keep running?
Avoid or reduce impact activities such as running and jumping while the foot is sore, and check that your running shoes are wide enough at the toes.
When are injections or surgery considered?
When symptoms are very severe or other treatments are not working. Both are arranged through a physician.
Is Morton’s neuroma the same as plantar fasciitis?
No. Morton’s neuroma is nerve pain in the ball of the foot, between the toes. Plantar fasciitis is pain under the heel or along the arch.
Where can I see someone about Morton’s neuroma in Cambridge?
A physiotherapist in Cambridge: our location there is on Hespeler Road. Book online or call 519-208-2273 and our Central Reception Team will find the closest location with an opening.
Do I need a referral?
No. Book online or call 519-208-2273. You pay at each visit and receive a receipt for your extended health plan. More on fees and insurance →
Sources
- Matthews BG, Hurn SE, Harding MP, Henry RA, Ware RS. The effectiveness of non-surgical interventions for common plantar digital compressive neuropathy (Morton’s neuroma): a systematic review and meta-analysis. Journal of Foot and Ankle Research, 2019.
- NHS. Morton’s neuroma. Reviewed June 2025.
- National Institute for Health and Care Excellence. Radiofrequency ablation for symptomatic interdigital (Morton’s) neuroma (IPG539). 2015.
- HealthLink BC. Morton’s neuroma. Current as of November 2022.
Related conditions
Plantar Fasciitis
Stress Fractures
Ready to book?
Book online with a physiotherapist or chiropractor, or call 519-208-2273 and our Central Reception Team will match you with the right person and the closest location.