Morton’s Neuroma · Podiatry on the Gold Coast
That burning between your toes — sorted.
Morton’s neuroma is a thickened nerve between the toes that hurts with every step. We confirm the diagnosis, offload it with the right footwear and orthotics, and refer for injection or surgery only when conservative care isn’t enough.
What a Morton’s neuroma actually is.
A Morton’s neuroma is a thickening of the soft tissue around one of the small nerves running between your toes — usually between the third and fourth toes, sometimes between the second and third. The nerve gets compressed every time the forefoot flexes, and over time it becomes chronically irritated and inflamed.
Classic symptoms: a burning, electric or numb feeling in the ball of the foot that radiates into the toes, often worse in narrow shoes or after long walks. Many people describe “walking on a pebble” or a feeling that their sock is bunched up under the foot.
It’s genuinely uncomfortable, but it’s also one of the most fixable forefoot problems — if it’s caught early and managed properly.
Where you are now
Six stages of Morton’s neuroma we manage.
01
Mild and intermittent.
Pain only in certain shoes or after long days on your feet. Easiest stage to fix — wider toe-box footwear, a metatarsal dome to spread the load, sometimes simple padding. Most mild cases resolve in 4–8 weeks.
02
Moderate and recurring.
Pain a few times a week, regardless of footwear. Custom orthotics with a built-in metatarsal raise offload the nerve more reliably. Pairs well with footwear changes and (sometimes) targeted soft-tissue work.
03
Severe with constant burning.
Pain in every shoe, often at rest, sometimes waking you up. Conservative care still helps, but at this stage we often co-manage with imaging-guided cortisone injection or alcohol sclerosing therapy — both done by a radiologist we refer to.
04
Recurrent after injection.
Cortisone or alcohol injections work for many people but the relief isn’t always permanent. If you’ve had one and the pain is back, we re-assess: sometimes a second injection works; sometimes it’s time to consider surgery.
05
Post-surgical.
If you’ve had a Morton’s neurectomy and need rehab and footwear support during recovery, we run that program. We also see “stump neuromas” from previous surgery and know how to manage them.
06
Multiple neuromas or unclear diagnosis.
Bilateral neuromas, multiple sites in the same foot, or symptoms that don’t quite fit. We’ll work through the differential — metatarsalgia, capsulitis, stress fracture, nerve entrapment elsewhere — before locking in the treatment plan.
How we manage it
Conservative first. Escalate stepwise.
01
Confirm the diagnosis.
Squeeze test, palpation, sometimes ultrasound. Morton’s neuroma has a few imitators (metatarsalgia, capsulitis, stress fracture) — we rule them out so we’re treating the actual problem.
02
Offload before injecting.
Footwear, metatarsal dome, orthotic with a forefoot raise. Most mild and moderate cases respond to this combination alone. We give the conservative approach 6–8 weeks before escalating.
03
Escalate when needed.
If conservative care plateaus, we refer for imaging-guided cortisone injection or alcohol sclerosing. Surgery (neurectomy) is the last step — effective but with real downsides, so we don’t reach for it first.
The honest comparison
Three ways people handle a Morton’s neuroma.
01
Ace — stepwise conservative care.
Diagnose, offload, escalate only if needed. We do the offloading work properly (custom orthotics, footwear advice) and refer for injection or surgery only when conservative care has been given a fair shot.
02
Straight-to-injection.
Cortisone works fast and many GPs reach for it as the first answer. The trade-off is that repeated injections weaken surrounding tissue and the pain often returns. Worth doing the conservative work first.
03
Surgery-first.
Neurectomy gives reliable relief but leaves a permanent area of numbness and carries a 10–20% rate of recurrence as “stump neuroma.” Worth keeping in reserve for cases that genuinely don’t respond to non-surgical care.
Is this you?
If this sounds like you, book in.
01
Burning between the toes that won’t go away.
Sounds like Morton’s neuroma. Most cases respond well to conservative care in the first 4–8 weeks once you have the right footwear and offloading. Worth coming in early.
02
You’ve tried wider shoes but it’s still there.
Wider shoes alone often aren’t enough — the neuroma needs active offloading from a properly-positioned metatarsal dome or custom orthotic. That’s the missing piece for most people.
03
You’re weighing up injection or surgery.
Worth a second opinion focused on whether you’ve actually exhausted conservative options. Sometimes you have; sometimes there’s another month of better orthotic work to try before going invasive.
Questions we get asked
Common Morton’s neuroma questions.
01 How is Morton’s neuroma diagnosed?
Mostly clinically — the squeeze test (a click and pain when we compress the forefoot side-to-side) is highly specific. Ultrasound confirms it if there’s any doubt. Most cases don’t need imaging to start treatment.
02 Will I need surgery?
Probably not. The majority of Morton’s neuromas respond to conservative care or to a single cortisone injection. Surgery is reserved for cases that haven’t responded to 3–6 months of structured non-surgical management.
03 Are orthotics really worth it for this?
For most moderate cases — yes. The metatarsal dome positioned correctly under the affected interspace is genuinely effective at offloading the nerve. Off-the-shelf domes work for some people; custom orthotics work for more.
04 What shoes should I wear?
Wide toe box, soft upper, supportive midsole, low heel. Avoid pointed-toe shoes, high heels, and anything that compresses the forefoot. Specific brands depend on your foot — we’ll go through options at the assessment.
05 How long does cortisone last?
Typically 3–12 months for Morton’s neuroma. Some people get permanent relief; others need repeat injections; others need to escalate to alcohol sclerosing or surgery. We track outcomes carefully so we know when to push to the next step.
06 Is it covered by private health?
Yes — podiatry consults and custom orthotics are claimable under your podiatry extras. We HICAPS on the spot with every major fund.
HICAPS on the spot with every major fund — plus DVA, NDIS & Medicare EPC.
Stop the burn before it stops you.
