Quietthenervepaininyourfoot.

• A neuroma is irritation and thickening of a nerve in the foot, most often between the third and fourth toes (a Morton’s neuroma).
• It causes burning, tingling, numbness, or the sensation of a fold in your sock or a pebble under the ball of your foot.
• It is usually driven by pressure and compression — tight or narrow shoes, high impact, or foot mechanics that crowd the nerve.
• Physical therapy addresses the mechanics, footwear, and tissue mobility that reduce the irritation.
• No referral is needed in most cases. We see new patients within a few days at Cedar Mill, Tigard, and Milwaukie.

What are neuromas and nerve pain?

A neuroma is an irritated, thickened nerve in the foot. The most common type, a Morton’s neuroma, sits between the long bones of the foot near the base of the third and fourth toes. As the nerve is repeatedly compressed and irritated, it thickens and becomes sensitive, producing the classic burning, tingling, and "something in my shoe" sensation in the ball of the foot.

Neuromas are usually a pressure problem. Narrow or high-heeled shoes squeeze the foot bones together and pinch the nerve; high-impact activity and certain foot mechanics crowd the same space. Tightness and restricted motion in the foot can add to the load on the nerve. The result is a nerve that gets angrier with activity and tight footwear and calmer with space and rest.

At Creekside Physical Therapy, we work to reduce the irritation by improving how the foot moves and loads, freeing up restricted tissue around the nerve, and guiding footwear and offloading strategies. While physical therapy does not shrink the nerve itself, it can meaningfully reduce the pressure and symptoms — and for cases that need an injection or, rarely, a procedure, we coordinate with your physician and support your recovery.

The nerves that supply sensation to the toes run between the long bones of the foot (the metatarsals). At the front of the foot they pass through a relatively tight space under a ligament that connects the bones. When the bones are squeezed together — by narrow footwear, high heels, or the way the foot loads — the nerve gets compressed against that ligament. Repeated compression irritates and thickens the nerve, which is what a neuroma is. Creating more space and reducing repeated compression is central to calming the symptoms.

What it feels like

Neuromas produce a distinctive set of nerve symptoms in the front of the foot:

• Burning or sharp pain in the ball of the foot, often radiating into the toes
• Tingling or numbness in the affected toes
• A feeling like there is a pebble, fold, or bunched sock under the ball of the foot
• Symptoms that worsen in tight or high-heeled shoes and ease when you remove them
• Pain that increases with activity and walking
• Relief when you stop, sit down, and massage the foot
• A clicking sensation between the toes in some cases

Why it develops

Neuromas develop when a foot nerve is repeatedly compressed and irritated. Common contributors:

• Narrow, pointed, or high-heeled shoes that squeeze the foot bones together
• High-impact activity such as running or court sports
• Foot mechanics that crowd the front of the foot (certain arch types, bunions)
• Tightness and restricted motion through the forefoot
• Repetitive pressure from a job that keeps you on your feet
• Prior foot injuries that altered how the forefoot loads
• Weakness in the foot and lower leg that changes load distribution

How we evaluate a neuroma

Your first visit is a one-on-one physical therapy evaluation. Your therapist reproduces and locates the nerve symptoms, tests sensation and forefoot mobility, examines your foot mechanics and footwear, and watches how you walk and load the front of the foot. We do not use imaging; if your symptoms suggest a different nerve problem or you may benefit from a diagnostic injection, we coordinate that with your physician. You leave the same day with a clear explanation and a plan.

How physical therapy treats it

Physical therapy for a neuroma focuses on reducing the pressure and irritation that fuel the nerve symptoms. Your one-on-one plan typically includes:

• Manual therapy and soft-tissue work to free up restricted tissue and improve forefoot mobility
• Footwear guidance toward wider, lower, supportive shoes that stop squeezing the nerve
• Offloading strategies such as metatarsal padding to create space at the irritated nerve
• Strengthening of the foot and lower-leg muscles to improve how load is distributed
• Gait and movement retraining to reduce repeated compression of the forefoot
• Activity modification and a graded return to high-impact activity
• Nerve-mobility techniques where appropriate
• A structured home exercise and self-management program

When to seek care

• Burning, tingling, or numbness in the ball of the foot that has lasted more than a couple of weeks
• Forefoot symptoms that are limiting your walking, running, or work
• Pain that returns every time you wear normal shoes or resume activity
• Numbness that is spreading or worsening — get evaluated medically to clarify the diagnosis
• Symptoms that have not responded to roomier shoes and activity changes

Neuromas and foot nerve pain are treated by Creekside’s physical therapists at all three clinics. When a case needs a diagnostic or therapeutic injection, or rarely a surgical procedure, we coordinate with your physician or surgeon and support your recovery and return to activity.

Frequently asked questions

• Plantar Fasciitis & Heel Pain
  Another common cause of foot pain we evaluate alongside nerve symptoms
• Foot & Ankle Tendinitis
  Forefoot tendon irritation can mimic or accompany nerve pain
• Fractures & Foot Arthritis
  Forefoot arthritis can also cause ball-of-foot pain
• Running Injuries
  High-impact activity is a common neuroma trigger