Neuroma
NERVE PAIN & FOREFOOT PRESSURE
A neuroma is an irritated or thickened nerve in the forefoot that can cause burning, tingling, numbness, or the feeling of walking on a pebble. Symptoms often worsen in tight shoes or during activity and may need evaluation when they keep returning.
- Burning or tingling in the ball of the foot
- Numbness between the toes
- Pebble-like feeling with walking
- Symptoms often worsen in tight shoes
Evaluation & Next Steps
- Clear severity assessment and next steps
- Supportive care and recovery guidance
- Care across 4 Las Vegas locations
Call: (702) 703-4340
Hours: Mon–Fri: 8am–5pm
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Quick Summary
Key takeaway: A neuroma is a painful nerve irritation, most often in the forefoot, that can cause burning, tingling, numbness, or pressure between the toes.
Evaluation focuses on symptom location, footwear pressure, nerve irritation, toe spacing, and whether conservative care, orthotics, injections, or surgical discussion may be appropriate.
Overview
What is a Neuroma?
A neuroma occurs when a nerve in the forefoot becomes irritated, compressed, or thickened. Morton’s neuroma commonly develops between the third and fourth toes, but similar nerve pain can occur in other areas of the foot.
Why Evaluation Matters
Neuroma symptoms can overlap with metatarsalgia, stress injury, arthritis, tendon problems, or other forefoot conditions. Evaluation helps confirm the likely source of pain and guides treatment before symptoms become more limiting.
Symptoms
Neuroma symptoms often come and go at first. Many people notice forefoot pain during walking, running, or wearing narrow shoes, with relief after removing the shoe or resting.
Burning Forefoot Pain
Pain may feel burning, sharp, or electric near the ball of the foot or between the toes.
Tingling or Numbness
Numbness, tingling, or altered sensation may spread into nearby toes.
Pebble-Like Sensation
Some patients feel like a small stone, fold, or wrinkle is under the foot.
Shoe-Related Symptoms
Tight, narrow, or high-heeled shoes may make pressure and nerve pain worse.
Seek care now if…
Seek prompt evaluation if forefoot pain is worsening, numbness is persistent, walking is limited, swelling or bruising is present, or symptoms do not improve with footwear changes and rest.
Causes & Risk Factors
Neuromas usually develop from repeated irritation or compression around a nerve in the forefoot. Foot shape, footwear, activity, and nearby joint or soft-tissue mechanics can all contribute.
Common Causes
- Repeated nerve compression
- Forefoot pressure while walking
- Tight or narrow shoes
- Toe crowding or altered mechanics
The irritated nerve may become more sensitive over time, especially when pressure continues during activity or shoe wear.
Risk Factors
- High heels or narrow toe boxes
- Repetitive forefoot loading
- Flat feet or high arches
- Bunions or hammertoes
- Prior foot injury
- High-impact activity
- Long periods on the feet
Diagnosis
Diagnosis starts with symptom location, footwear history, and a focused foot exam. Imaging may be recommended when symptoms suggest another cause of forefoot pain or when treatment planning requires more detail.
Typical Evaluation
- Symptom and shoe review
- Forefoot pressure exam
- Toe spacing and nerve checks
- Rule out stress injury
- Imaging when needed
What to Bring
- Shoes that trigger symptoms
- Activity or walking notes
- Prior foot imaging
- Treatments already tried
- Treatment goals
Treatment Options
Treatment depends on symptom severity, footwear pressure, activity demands, and whether the nerve irritation improves with conservative care. Many patients start with pressure reduction and shoe or orthotic changes.
Related care: Treatment planning may include footwear changes, padding, orthotics, activity modification, injections, imaging review, or surgical discussion when symptoms remain limiting.
Conservative Care
- Activity modification
- Ice or anti-inflammatory guidance
- Padding or metatarsal support
- Symptom monitoring
Footwear / Orthotics
- Wider toe-box shoes
- Lower heel pressure
- Custom orthotics when appropriate
- Metatarsal pads
Surgery Consideration
- Persistent nerve pain
- Failed conservative care
- Severe shoe limitation
- Confirmed neuroma symptoms
Recovery & Follow-Up
- Track symptom response
- Adjust footwear support
- Monitor numbness or recurrence
- Review next steps if pain persists
Recovery
Recovery depends on how long symptoms have been present, how much pressure is placed on the forefoot, and whether the nerve irritation responds to conservative care or requires additional treatment.
What Helps Most
- Pressure reduction: Reduce forefoot compression during walking.
- Footwear changes: Use shoes with enough toe-box room.
- Orthotic support: Pads or inserts may reduce nerve irritation.
- Activity pacing: Limit triggers while symptoms calm down.
- Follow-up care: Reassess if symptoms persist or return.
When to Follow Up
- Pain persists: Symptoms continue despite shoe changes.
- Numbness increases: Toe sensation is worsening.
- Walking is limited: Daily activity becomes harder.
- Shoe tolerance drops: Fewer shoes feel comfortable.
- Symptoms recur: Pain returns after initial improvement.
Frequently Asked Questions
A neuroma may feel like burning, tingling, numbness, or a sharp pain in the ball of the foot. Some people describe feeling like they are stepping on a pebble.
Neuromas often develop from repeated pressure or irritation around a nerve in the forefoot. Tight shoes, high heels, foot structure, and repetitive activity can contribute.
Yes. Wider shoes, lower heels, padding, and orthotics may reduce pressure on the irritated nerve and help control symptoms.
Diagnosis usually includes a symptom review, footwear history, and focused foot exam. Imaging may be used when another cause of forefoot pain needs to be ruled out.
No. Many neuromas are first treated with conservative care such as footwear changes, padding, orthotics, activity modification, or injections when appropriate.
You should be evaluated if burning, tingling, numbness, or pebble-like pain keeps returning, limits walking, or does not improve with shoe changes and rest.
Locations
LVVIS West Side Consultation Office
8930 W Sunset Rd, Suite 350
Las Vegas, NV 89148
Consultations and vascular evaluations
LV2 Limb & Vascular Division
8930 W Sunset Rd, Suite 350
Las Vegas, NV 89148
Limb preservation and podiatry partnership care
LVVIS East Procedure Office
2250 E Flamingo Rd, Suite 100
Las Vegas, NV 89119
Procedures, diagnostics, and circulatory care
LVVIS West Side Surgical Center
6120 S Fort Apache Rd, Suite 100
Las Vegas, NV 89148
Advanced vascular and interventional procedures