Morton Neuroma

Definition

What is a Morton neuroma?

A Morton neuroma (also known as Morton neuralgia) is a painful thickening of a nerve in the forefoot area, most commonly between the third and fourth metatarsal bones, and less frequently between the second and third toes. Morton neuroma is one of the most common causes of midfoot pain while walking. Medically, it is a so-called neuroma — an irritation or densification of nerve tissue that runs between the toes. The thickening arises from repeated pressure, friction, or overload and can lead over time to chronic nerve pain in the foot.

Many affected people describe in Morton neuroma reports that the pain feels as if a small stone or a folded sock is in the shoe. Typical is a burning, stabbing, or electric shock-like pain in the ball of the foot that can radiate into the toes. Some also report tingling or numbness between the toes. In advanced stages, the pain can become so severe that even light walking or wearing tight shoes is uncomfortable.

In general, Morton neuroma is well treatable — the earlier the diagnosis is made, the better the inflammation and thickening of the nerve can be contained.

Cause of Morton neuroma

The causes of Morton neuroma are closely linked to modern lifestyle and changed environmental conditions. Our ancestors moved in an integrated and intensive way to obtain food — through hunting, gathering berries, or farming. These activities mostly took place barefoot on natural, uneven ground.

The greater range of motion and varying ground surfaces promoted increased muscular activity and strengthened the foot and leg muscles. At the same time, the soft natural ground acted as a shock absorber and reduced pressure on the soles. This maintained a natural balance between stability, mobility, and relief.

Over the millennia, lifestyle has changed massively. Today, lack of exercise and a predominantly sedentary daily life are widespread, which among other things favors the development of foot deformities. When movement does occur, it is usually on hard, flat surfaces such as concrete or asphalt — often in rigid, supportive shoes. These altered conditions affect both the quantity and quality of movement and can contribute to the development of a Morton neuroma. The following describes the effects of these changes on the development of Morton neuroma pain.

Lack of exercise and sedentary lifestyle

Modern lifestyle, characterized by lack of exercise and a sedentary daily routine, misloads the musculoskeletal system. This can promote the development of Morton neuroma symptoms. The following changes play a central role:

• Weakened muscles

  A sedentary lifestyle and lack of exercise over time lead to weakening of muscles throughout the body — especially in the feet. The foot muscles stabilize the arches and provide balance as well as healthy posture. With insufficient load, small muscles, tendons, and ligaments that maintain the transverse and longitudinal arches atrophy. This can lead to sinking of the transverse arch and overload the forefoot, increasing the likelihood of Morton neuroma pain.
  Weak muscles can also negatively affect overall posture. Postural faults in the knees, hips, or back transfer additional loads to the feet via muscular chains and intensify Morton neuroma complaints.
  

• Foot deformities

  Weakened muscles favor foot deformities. A common problem is the splayfoot, where the metatarsal bones spread apart and the transverse arch collapses. This leads to an uneven distribution of pressure in the forefoot, particularly between the second and third or the third and fourth rays, where a Morton neuroma typically develops. The pressure load can lead to irritation, inflammation, and nerve pain in the foot.
  Sinking of the longitudinal arch also weakens the foot’s natural shock-absorbing function. This additionally creates pressure peaks under the metatarsal heads that are responsible for Morton neuralgia pain. The overall foot statics become more unstable, causing misloading, altered gait patterns, and additional complaints in the forefoot area.
  

• Fascial dysfunction

  Fasciae are connective tissue sheaths that surround and stabilize muscles, tendons, and joints. Lack of exercise, poor posture, or a sedentary lifestyle can lead to shortening, thickening, or adhesions.

• In the foot, especially at the plantar fascia, fasciae influence the stability of the foot arch and shock absorption. Dysfunctions can increase mechanical load on the metatarsal heads and thus cause Morton neuroma symptoms such as burning, stabbing, or tingling.
  Fasciae act in continuous chains. Disturbances in myofascial tension, e.g., along the posterior chain from the foot to the neck, can transfer tension to the forefoot and favor deformities that typically promote the development of a Morton neuroma.
  
• Joint stiffness

  Joint stiffness caused by lack of movement can exacerbate Morton neuroma pain. Reduced mobility of the small foot joints, especially the metatarsophalangeal joints, alters the foot’s roll-off behavior. Pressure shifts to the forefoot, particularly the metatarsal heads, causing friction, microinjuries, and inflammation. Reduced joint mobility therefore contributes substantially to the development of Morton neuralgia.

Hard, flat floors and rigid, supportive shoes

Our feet are evolutionarily designed to move on natural, uneven surfaces where foot muscles, joints, and fasciae constantly compensate and adapt. Modern environmental conditions have a significant impact on the load of the musculoskeletal system. Hard, flat floors and rigid, supportive shoes change the biomechanics of every step and thus contribute decisively to the development of Morton neuroma pain. The following mechanisms are central:

• Force impact

  When walking on natural, compliant surfaces such as meadows, sand, or moss, impact energy is gently absorbed and damped by the ground. Hard surfaces like concrete or asphalt reflect this energy almost completely back into the foot, significantly increasing the load on foot structures.
  
  This problem is aggravated by modern shoes with stiff, thick soles or supportive insoles. These restrict the foot’s natural mobility — particularly of the metatarsophalangeal joints and the foot arch. If the foot cannot spring sufficiently, the load concentrates on the metatarsal heads, the typical location where a Morton neuroma develops.
  The natural fat pad under the metatarsal heads serves as a shock absorber. Hard floors and stiff shoes impair this protective function: impact forces are transmitted unfiltered, the pad becomes overloaded, shifts, or loses cushioning, increasing stress on the sensitive structures beneath the metatarsal heads.
  In addition, muscles have less time to react to sudden load. The transverse and longitudinal arches cannot be sufficiently stabilized, which increases pressure on the forefoot and promotes the development of Morton neuralgia.

• When walking barefoot on natural ground, the heel can sink in a controlled manner. The load increases gradually, and the foot muscles actively stabilize the transverse and longitudinal arches. On hard floors combined with rigid shoes, the ground reaction force acts abruptly on the foot. The muscles have little time to react, and the foot collapses uncontrollably after heel strike. This overloads the forefoot with its sensitive metatarsal heads.
  
  Furthermore, restricted roll-off movement causes the acting forces to be distributed unevenly. This leads to increased load on the metatarsal heads, enhances Morton neuroma symptoms such as burning, stabbing, or pressure pain, and reduces forefoot blood circulation. In the long term, this unnatural movement sequence also promotes the breakdown of foot and leg muscles and exacerbates the problem.

• Weakened muscles

  Hard, flat floors and rigid shoes fundamentally change natural foot mechanics and lead in the long term to weakening of foot-stabilizing muscles. On uneven ground the foot is constantly challenged; small muscles activate to stabilize the transverse and longitudinal arches and control the roll-off. On hard, flat floors this stimulus almost completely disappears.
  
  Weak muscles lead to sinking of the transverse arch, formation of splayfoot, and unphysiologically high pressure on the metatarsal heads. At the same time the natural fat pad loses its protective function, and the foot extensors cannot control the forefoot during roll-off. This increases overload and favors the development of a Morton neuroma.

Symptoms of a Morton neuroma

It is important to mention that the following lists the most common Morton neuroma symptoms. The list is not exhaustive; atypical complaints are also possible. Morton neuroma symptoms depend on factors such as pain sensitivity, cause, severity of the condition, and individual constitution. For a definitive diagnosis, a physician should be consulted.

• Burning or stabbing pain under the metatarsal heads: Typical in the area between the third and fourth toe or the second and third toe. Often described as burning or stabbing pain.
• Pressure pain when walking or standing: The pain increases under load, especially when rolling over the forefoot.
• Sensation of a “stone” in the shoe: Patients often report the impression of a foreign object in the shoe — characteristic of Morton neuralgia.
• Burning, tingling, or “pins and needles” in the forefoot: Nerve irritation from overload can lead to neuropathic complaints.
• Numbness in the toes: Chronic pressure on the nerve can cause sensory disturbances, especially in the middle toes.
• Increased pain when walking barefoot on hard ground: Without cushioning, load on the sensitive structures increases.
• Pain when wearing tight or stiff shoes: Shoes with stiff soles or little forefoot space increase pressure on the metatarsal area.
• Painful calluses or thickened skin: Reactive thickening of the skin can occur due to chronic overload at specific pressure points.
• Increasing pain throughout the day: Complaints increase with load and fatigue of the foot muscles.
• Toe deformities (e.g., claw toes): Malloading or muscular imbalance can lead to misalignments.
• Pain during sporting activity: Running, jumping, or rapid push-off often significantly worsen Morton neuroma symptoms.
• Restricted forefoot mobility: Pain leads to protective postures or limited toe mobility.
• Radiating pain into adjacent foot areas: Malloading or compensation patterns can also cause painful strain on neighboring structures.
• Morning stiffness in the forefoot: After rest periods the forefoot feels stiff — overloaded structures need time to “warm up.”
• Inability to walk or stand for long distances: Even moderate load can cause pain and limit walking distance.
• Local warmth or swelling: Inflammatory processes around the metatarsal heads may appear as warmth or swelling.
• Loss of natural roll-off: Pain or muscular imbalances disturb physiological roll-off over the forefoot.
• Avoidance postures or altered gait: Affected people often develop compensatory walking patterns, leading to secondary problems in the knee, hip, or back.

Conventional therapies - What helps with Morton neuroma

There are various approaches to treat Morton neuroma. Below are some Morton neuroma therapies. The list is not exhaustive; often several measures are combined. Medical consultation is recommended to determine the individually appropriate Morton neuroma treatment.

• Shoe insoles (e.g., with a metatarsal pad): Relieve the metatarsal heads and reduce pressure on the nerve.
• Physiotherapy: Strengthening foot muscles, stretching shortened structures, and gait training.
• Padding (e.g., gel pads): Alleviate acute complaints by targeted shock absorption.
• Cold therapy: Cooling reduces local blood flow and nerve conduction velocity, which reduces swelling, inflammation, and pain around the irritated nerve.
• Anti-inflammatory medications: They relieve inflammation and swelling around the affected nerve, reducing pain.
• Weight reduction (if overweight): Reduces mechanical load on the forefoot.
• Activity modification: Temporarily avoiding load-bearing activities such as long walks on hard surfaces, jogging, or prolonged standing to prevent overload.
• Manual therapy / mobilization: Improve mobility of foot joints and reduce blockages.
• Morton neuralgia acupuncture: Reduction of complaints by influencing pain transmission in the nervous system, improving blood flow, and reducing inflammation.
• Taping / kinesiotape: Supports foot statics, relieves the forefoot selectively, and can provide short-term relief of Morton neuroma pain.
• Barefoot training: Strengthens foot muscles and improves foot perception.
• Morton neuroma foot exercises: Strengthening foot muscles to reduce load on the nerve.
• Electrotherapy / ultrasound: For pain relief and to promote blood circulation.
• Shockwave therapy: Loosens adhered or thickened tissue around the nerve and stimulates blood flow and healing processes.
• Cortisone injections: Cortisone has an anti-inflammatory and decongestant effect around the irritated nerve, which can significantly reduce pain.
• Orthopedic modifications: Adjustments to shoes or insoles to correct deformities and reduce forefoot pressure.
• Morton neuroma surgery: In surgery for a Morton neuroma, the entrapped nerve is exposed and either the constricting ligamentous portion is cut or — in severe damage — the thickened nerve segment is removed.
• Osteotomies or other foot-preserving procedures: For structural problems when conservative measures are insufficient.

Often these measures unfortunately do not lead to a long-term reduction in Morton neuroma pain because the actual causes are not eliminated. Therefore, the goal of any Morton neuroma treatment should be to address the underlying causes. As described above, lack of exercise, a sedentary lifestyle, hard, flat floors, and rigid, supportive shoes play a central role.
The kybun mechanism of action proves to be a particularly suitable Morton neuroma therapy because it addresses the mentioned causes and can reduce pain in the long term through gentle movement, natural damping, and improved foot mechanics.

kybun mechanism of action - What helps with Morton neuroma

kybun products aim to reduce the health-damaging consequences of hard, flat floors, rigid supportive shoes, and a sedentary lifestyle. The elastic-springy properties of kybun products both relieve and activate the feet. The relief ensures that acute Morton neuroma pain is noticeably reduced. The simultaneous activation of the foot muscles treats the causes of the Morton neuroma so that complaints can be alleviated in the long term. This makes kybun shoes particularly suitable for people with Morton neuroma, as they support through the following mechanisms:

• Optimized pressure distribution

  People with Morton neuroma symptoms often complain of localized pressure points while walking and standing, especially on hard floors or in shoes with a stiff sole. Load on the metatarsal heads and the affected nerve is amplified during roll-off, leading to stabbing, burning, or dull pain.
  When wearing kybun shoes, the entire foot sole is enclosed by an elastic-springy material. The feet sink gently into the flexible sole, creating an even pressure distribution. Local pressure peaks in the forefoot — particularly on the sensitive metatarsal heads and the nerve — are significantly reduced. The result is a noticeable relief that effectively alleviates Morton neuroma pain.

• Activation of foot muscles through elastic-springy property

  The elastic-springy properties of kybun products create a targeted instability when walking and standing that encourages the body to perform subtle, continuous compensatory movements. This unconscious muscular activity particularly activates the deep foot and leg muscles.
  Strong foot muscles stabilize the transverse and longitudinal arches, relieve the foot joints, and distribute the forces generated while walking evenly. Especially in the forefoot, where a Morton neuroma is often located, this leads to pressure relief of the nerves and metatarsal heads. Physiological muscle tension also prevents uncontrolled collapse of the forefoot after heel strike, protecting sensitive structures from mal- and overloading.

Balance and EMG

Balance ability was measured with a force plate by the movement of the center of mass from front to back (ant-post) and laterally (med-lat) while standing. In parallel, electromyography (EMG) recorded muscular activity.

• Natural foot roll-off thanks to muscle activation

  A physiological roll-off movement — from the heel over the midfoot to the big toe joint — ensures even loading of all foot structures. The elastic-springy kybun soles allow the heel to sink in gently, causing the load to occur gradually. The muscles are activated in time, stabilize the foot, and enable a controlled, pain-free roll-off.
  This protects the fat pad under the forefoot and the sensitive metatarsal heads, reduces local pressure peaks, and ensures a harmonious forward movement.

• Reduction of force impact from hard floors

  When striking the ground in kybun shoes, the ground reaction force is damped by the elastic-springy sole and transferred to the body with a delay. As a result, peak loads on nerves, metatarsal heads, and connective tissue are reduced. Additionally, the time-delayed force impact enables an early activation of stabilizing muscles, supporting the damping and supportive function of the foot arch and protecting the forefoot from overload.
  Moreover, kinetic energy is temporarily stored and actively used for a controlled roll-off, thereby sustainably reducing load on the forefoot and thus Morton neuroma pain.

• Protection against fascial dysfunction

  The fasciae in the foot stabilize muscles, tendons, and joints. In unphysiological movement patterns or with hard ground reaction, adhesions and overload can occur, leading to nerve irritation and pain in the forefoot.

• The kybun soles enable a gentle roll-off, reduce impact forces, and distribute pressure evenly. This relieves the fasciae, promotes blood flow, and supports regeneration of connective tissue, thereby alleviating Morton neuroma symptoms.
  
• Blood circulation improvement through increased activity

  The elastic-springy material increases natural movement activity while walking, stimulates muscles, and improves blood circulation in the forefoot area. Better supply with oxygen and nutrients as well as efficient removal of metabolic waste reduce irritation and pain. This strengthens the load-bearing structures around the Morton neuroma.

Usage tips for Morton neuroma

Before you wear kybun shoes for the first time, you should follow some usage tips. Correct application can help alleviate Morton neuroma pain. Targeted complementary therapy, such as Morton neuroma foot exercises, can additionally support the effect and is explained in the next section.

• Make sure when buying shoes that there is enough width space so that your foot is not constricted. Even a slight pressure can trigger or worsen nerve pain in the foot.
  
• Increase wearing time slowly: Initially wear kybun shoes only as long as your body tolerates. Take breaks if the feet fatigue or Morton neuroma symptoms increase. Morton neuroma treatment takes time. The activating effect of kybun products trains the foot muscles and can cause so-called initial reactions, especially at the beginning.
  
• Control the heel strike consciously: Press your heel slowly and controlled into the elastic-springy material so that the heel sinks and the foot and calf muscles tense. A controlled heel strike prevents uncontrolled collapse of the forefoot and protects the sensitive metatarsal heads and the nerve from excessive load. Initially roll off the forefoot gently, especially with acute pain.
  
• Small, controlled steps with reduced forefoot roll-off: Start with short, consciously controlled steps to get used to walking in kybun shoes and relieve the forefoot. With increasing adaptation, range of motion and step frequency can be slowly increased.
  
• Roll-off over the forefoot: Over time you can intensify roll-off over the forefoot as long as it does not cause or increase nerve pain. The goal is a controlled and natural roll-off over the big toe joint.
  
• Also use our insole with the mobile metatarsal pad to relieve the forefoot additionally.
  
• Complement with targeted exercises: Combine wearing kybun shoes with specific exercises to enhance the effectiveness and increase the likelihood of improvement of Morton neuroma complaints. These exercises can be part of a holistic Morton neuroma therapy and help reduce pressure on the metatarsal heads and the affected nerve.

Helpful exercises for Morton neuroma

To strengthen the effect of kybun shoes and increase the likelihood of improvement of Morton neuroma complaints, we recommend the following exercises. The selection is not exhaustive and can be supplemented by further Morton neuroma exercises. In general, for all exercises: Morton neuroma symptoms must not worsen. If pain occurs beyond the normal level, the exercise must be stopped. Pleasant and releasing “pain” outside the affected nerve area of the Morton neuroma (e.g., in the calf) is desirable.
The exercises are divided into the following areas: “Proper walking in kybun shoes,” “muscle length training,” “fascia rolling,” and “strengthening.” Ideally, the different areas are used complementarily as therapy for Morton neuroma.

Proper walking in kybun shoes
The quality of each step is crucial to reduce Morton neuroma pain and avoid mal- and overloading of the forefoot. kybun shoes optimally support this.

Controlled heel strike

• Press the heel slowly and controlled into the elastic-springy material to create pre-tension in the foot and calf muscles.
• Set down the midfoot and forefoot slowly so that the forefoot is loaded physiologically.
• Initially take rather small steps to avoid overloading the forefoot.

Controlled roll-off

• Light roll-off in the forefoot, without actively pushing off strongly, to avoid pressure peaks on the sensitive metatarsal heads and nerves.
• Test the range of motion during roll-off cautiously so that Morton neuroma pain does not occur or increase.
• Increase range of motion where possible and transition into a gentle, active roll-off.

Muscle length training
Targeted stretching of foot and calf muscles is important because Morton neuroma complaints often arise from tightness and tension.

Sole of the foot

• Take the foot in both hands.
• Actively pull the forefoot toward the shin to stretch the sole.
• Hold 3 × 30 seconds, repeat 1–2 × daily.

Calf muscles

• Start in a lunge position, keep the rear heel on the floor.
• Perform the exercise ideally on a soft surface.
• Slowly bend the front knee forward until a pulling sensation in the calf is felt.
• 3 × 30 seconds per side, perform 1–2 × daily.

Fascia rolling
Fascia training supports unloading of the forefoot because Morton neuroma is often associated with tension of the posterior chain (sole, calves).

Sole of the foot

• Roll the sole actively with a fascia roller or ball from the heel to just before the metatarsal heads; consciously avoid the affected nerve.
• Perform slowly and controlled, adjust pressure individually.
• Roll out focal adhesions more intensively or hold the position briefly.
• 3 minutes per foot, 1–2 × daily.

Calf muscles

• One leg bent, place the other on the fascia roller; increase pressure by placing both legs on top.
• If wrist pain occurs, perform the exercise on the forearms.
• Roll the calf actively from the heel to just below the knee.
• Perform slowly and controlled, adjust pressure, treat adhesions locally.
• At least 3 minutes per side, 1–2 × daily.

Strengthening

Targeted strength training strengthens the foot arch and muscles, improves damping function, and reduces pressure on the metatarsal heads — especially important with Morton neuralgia.

Transverse arch foot muscles

• Lay a towel flat on the floor and place the foot at the start.
• Use the toes to grip the towel and pull it toward the foot.
• 3 sets of 8–12 repetitions per foot, 2–3 × weekly.

Big toe lifts and toe lifts

• Stand with feet hip-width apart.
• Big toe lifts: actively lift the big toe while keeping all other toes on the ground.
• Toe lifts: keep the big toe on the ground, actively lift and lower all other toes.
• The ball of the foot and heel remain on the ground at all times.
• Perform alternately with one foot.
• 3 sets of 8–12 repetitions per foot, 2–3 × weekly.