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You know that sharp, burning pain that feels like you’re walking on a pebble inside your shoe—except there’s nothing there?
That’s one of the classic signs of Morton’s neuroma, a painful nerve irritation in the ball of your foot.
If you’ve tried changing shoes, taking breaks, or adding pads with little success, you’re not alone.
At Unpain Clinic, we meet people every week who say, “It feels like fire under my toes, and nothing seems to fix it.” The good news? There are effective, science-backed ways to treat it—and to understand why it keeps coming back. Let’s dive into what the research shows, what you can do at home, and how we approach Morton’s neuroma treatment differently here at Unpain Clinic.
Despite the name, Morton’s neuroma isn’t a tumor—it’s a nerve irritation that usually occurs between the third and fourth toes. Over time, the nerve thickens and becomes sensitive, sending those familiar burning or electric-shock sensations whenever you walk.
Common causes include:
Tight or narrow shoes squeezing your toes together
High heels shifting pressure to the forefoot
Repetitive impact (like running or dancing)
Foot mechanics that overload one part of the forefoot
Past injuries or joint stiffness in the foot or ankle
The nerve sits in a small tunnel under a ligament between the toes. When that space narrows—because of pressure, swelling, or tight shoes—the nerve gets trapped, irritated, and inflamed.
And here’s the tricky part: even if you rest or change shoes, if the mechanical stress stays the same, the pain tends to return.
Researchers have tested nearly everything—from injections and shockwave therapy to orthotics and surgery. Let’s break down what the evidence actually shows in plain language.
Several studies found that a single cortisone injection can reduce pain for a few months (Matthews et al., 2019). However, for about one-third of patients the pain returns later (Thomson et al., 2020). It can be a good short-term option, but it doesn’t address the underlying mechanics.
In a randomized trial, patients who received ESWT had significant pain reduction within 4 weeks (Yoon et al., 2016). Shockwave likely helps by improving blood flow, calming nerve irritation, and supporting tissue repair. Other reviews show short-term benefits up to three months—especially when combined with biomechanical correction.
Gentle joint and soft-tissue work around the toes and midfoot has solid evidence for reducing pain (Matthews et al., 2019). A 2019 study showed significant improvements after targeted manipulation and mobilization (Toscano et al., 2019).This works because freeing stiff joints decreases the compression on the irritated nerve.
Custom insoles with a metatarsal pad help spread the bones apart and take pressure off the nerve (Kwon et al., 2019). Shoes with a wide toe box, soft soles, and low heels are essential. Even small design tweaks can make big differences.
Newer treatments such as radiofrequency ablation, cryoablation, or botulinum toxin injections show promise in small studies —but more research is needed (Thomson et al., 2020).
At Unpain Clinic, we take a whole-body, non-invasive approach. Instead of only calming the nerve, we ask a different question: “What’s making this nerve angry in the first place?”
Step 1: Relieve Pain and Irritation
We use True Shockwave Therapy™—both radial and focused forms—to target the irritated nerve and surrounding tissues. It helps reset the local inflammation and promote small-vessel healing so we can start addressing the root cause. We often combine it with neuromodulation (like NESA XSignal therapy) to calm overactive nerve signals and reduce hypersensitivity.
Step 2: Restore Movement and Load Balance
Once pain starts to settle, we work on foot mechanics.
Manual therapy helps unlock stiff toe joints and release the fascia around the nerve.
We then teach you how to move and load your feet evenly again—because if the pressure stays the same, the pain returns.
Step 3: Strengthen and Re-educate Your Feet
Your foot has over 30 muscles that stabilize every step you take.
We’ll show you how to strengthen the small intrinsic muscles, improve balance, and restore healthy push-off patterns.
When these muscles do their job, the nerve finally gets the space it needs to heal.
Step 4: Prevent Recurrence
We finish with education on footwear, posture, and training habits—so you can keep walking, running, and living comfortably without constant flare-ups.
A 45-year-old recreational runner came to us after months of stabbing pain between her third and fourth toes. She’d already tried new shoes, pads, and rest—nothing worked.
During her Initial Assessment, we found stiffness in her fourth toe joint and tightness through her calf and low back that changed how she loaded the foot. We started a 3-week True Shockwave™ series with gentle mobilization, neuromodulation, and custom home exercises. After three weeks, she reported about 60 percent less pain and could walk her dog again without wincing.
At eight weeks, she was back to light running, and at three months, her symptoms were minimal.
Her secret? She kept doing her exercises and stayed consistent. (Results vary for every person, but her progress shows how addressing the why behind the pain changes everything.)
While professional care is key, here are gentle things you can do between visits:
👟 Choose Your Shoes Wisely
Wide toe box—let those toes breathe.
Soft soles and cushioning under the ball of the foot.
Low heel drop (avoid high heels).
Metatarsal pad or bar under the ball of the foot for off-loading.
🦶 Simple Exercises You Can Try
1.Toe Spreads – Open your toes wide, hold 5 seconds, repeat 10×.
2.Towel Curls – Grab a towel with your toes and pull it toward you.
3.Short Foot Exercise – Pull the ball of your foot toward your heel without curling toes.
4.Calf Stretch – Keep heel down, lean forward until you feel a stretch.
5.Nerve Glide – Gently flex and extend toes while moving ankle up and down—never into sharp pain.
⚖️ Move Mindfully
Avoid high-impact jumping for now.
Gradually increase walking distance instead of pushing through pain.
If pain flares, pause and rest; don’t force it.
Burning, tingling, or numbness between your toes; pain worse in tight shoes; relief when barefoot; and sometimes a clicking feeling when squeezing your forefoot.
Yes! Strengthening foot and hip muscles improves mechanics, which takes pressure off the nerve. Studies show exercise and mobilization are effective first-line options.
Some people improve within weeks; others need two to three months of consistent care. The goal isn’t just pain relief—it’s changing how your foot functions.
Only if conservative options fail. Many people do well with non-surgical treatments like shockwave therapy, orthotics, and manual therapy.
Usually yes—just modify intensity and wear proper shoes. Avoid activities that sharply increase symptoms until your nerve calms down.
Morton’s neuroma can make every step feel like walking on glass—but it doesn’t have to stay that way.The key isn’t just numbing the pain; it’s understanding why that nerve is irritated and creating space for it to heal.
At Unpain Clinic, we blend science with experience—combining shockwave therapy, manual treatment, neuromodulation, and personalized exercises to help you move freely again.
Book Your Initial Assessment NowAt Unpain Clinic, we don’t just ask “Where does it hurt?” — we uncover “Why does it hurt?”
If you’ve been frustrated by the cycle of “try everything, feel nothing,” this assessment is for you. We take a whole-body approach so you leave with clarity, not more questions.
✅ What’s Included
Comprehensive history & goal setting
Orthopedic & muscle testing (head-to-toe)
Motion analysis
Imaging decisions (if needed)
Pain pattern mapping
Personalized treatment roadmap
Benefit guidance
🕑 Important Details
60 minutes, assessment only
No treatment in this visit
👩⚕️ Who You’ll See
A licensed Registered Physiotherapist or Chiropractor
🔜 What Happens Next
If you’re a fit, we schedule your first treatment and start executing your plan.
🌟 Why Choose Unpain Clinic
Whole-body assessment, not symptom-chasing
Root-cause focus, not temporary relief
Non-invasive where possible
No long-term upsells — just honest, effective care
🎯 Outcome
You’ll walk out knowing:
What’s wrong
Why it hurts
The fastest path to fix it
Author: Uran Berisha, BSc PT, RMT, Shockwave Expert
