Why Does It Feel Like There's a Pebble in My Shoe? Understanding Morton’s Neuroma

What Is Morton’s Neuroma?

Morton’s neuroma is a thickening of the tissue around one of the nerves leading to your toes, usually between the third and fourth toes. This thickening can cause sharp, burning pain in the ball of your foot, along with numbness or tingling in your toes. It often feels like you're standing on a pebble or have something stuck in your shoe.

This condition is more common in women and people who wear narrow or high-heeled shoes regularly. It’s also frequently seen in runners or those who spend a lot of time on their feet.

Common Symptoms

• Sharp, burning pain in the ball of the foot
  
  
• Tingling or numbness in the toes
  
  
• A feeling of "bunched-up sock" or a small stone underfoot
  
  
• Pain that worsens with activity or tight shoes
  
  

These symptoms often come and go at first but may become more constant over time if the condition is not treated.

What Causes It?

Morton’s neuroma is usually caused by repetitive irritation or pressure on the nerve between the metatarsal bones (long bones in the foot). Risk factors include:

• Wearing tight, narrow, or high-heeled shoes
  
  
• High-impact sports like running or court sports
  
  
• Foot deformities such as flat feet, high arches, or bunions
  
  

How Is It Diagnosed?

A podiatrist will usually make the diagnosis based on your symptoms and a physical exam. They may press on the foot to try to reproduce the pain or feeling of a "click" between the toes. Sometimes imaging like ultrasound or MRI is used to confirm the diagnosis or rule out other issues.

Treatment Options

The good news? Most people improve with non-surgical treatment. Here’s what podiatrists often recommend:

1. Footwear Changes

Switch to shoes with:

• A wide toe box
  
  
• Cushioned soles
  
  
• Low or no heels
  
  

Avoid anything that squeezes the forefoot, like pointy-toe dress shoes.

2. Metatarsal Pads or Orthotics

Special inserts can help reduce pressure on the nerve. These are often custom-made and designed to redistribute weight across the ball of the foot.

3. Activity Modification

Limiting high-impact activities and giving your feet rest can reduce irritation. Cross-training with low-impact exercises like swimming or cycling may help.

4. Anti-Inflammatory Medications

Over-the-counter NSAIDs (like ibuprofen) can reduce pain and inflammation in mild cases.

5. Corticosteroid Injections

If pain persists, a podiatrist may recommend a corticosteroid injection into the affected area. This can significantly reduce inflammation and pain, sometimes for months at a time.

Final Thoughts

If you’re experiencing that “pebble-in-the-shoe” feeling, don’t ignore it. Morton’s neuroma is treatable, and early intervention can help you avoid more invasive treatments down the road. Consult with Dr. Gireesh Reddy or Dr. Sirisha Pokala at Restore Foot & Ankle Specialists by calling (469) 573-3427 or by booking an appointment online.  Your feet shouldn’t hurt. Let’s fix that.