MSK · Forefoot

Forefoot Pain — Morton’s Neuroma or Something Else?

Pain in the ball of the foot gets labelled Morton’s neuroma more often than it is one. Ultrasound is unusually good here — it can see the difference.

Person removing a shoe and pressing the ball of the foot

Morton’s neuroma is a thickening of the nerve between the toes, usually between the third and fourth. It causes burning or shooting pain in the ball of the foot, often with numbness in the adjacent toes and the sensation of a pebble underfoot. It is worse in narrow shoes and relieved by taking them off and rubbing the foot.

Except a great deal of forefoot pain is not that. The joints, the plantar plate that stabilises them, the bones and the bursae all sit in the same small area and produce overlapping symptoms — which is exactly why imaging that separates them is useful.

Differentials

What else causes pain in the ball of the foot

What you notice Commonly Ultrasound?
Burning or shooting pain with numb toes, worse in tight shoes, eased by removing them Morton’s neuroma Yes — seen and measured
Pain under one toe joint with swelling, the toe starting to drift or lift Plantar plate injury Yes — seen well
Aching across the ball of the foot after long standing or walking Metatarsalgia — overload rather than one structure Partly — helps exclude others
Pain worsening steadily through activity in a runner, focal bony tenderness Possible stress fracture No — needs X-ray or MRI
Swollen painful joints in both feet, morning stiffness elsewhere May be inflammatory — see your GP Supportive only

Foot pain that needs a doctor first

A hot, red, swollen forefoot with fever, foot pain in someone with diabetes or reduced sensation, or pain that stops you weight bearing after an injury needs prompt medical assessment rather than a booked scan. Diabetic foot problems in particular are assessed urgently through your GP or diabetes team.

The Scan

Why ultrasound suits the forefoot

The structures here are millimetres beneath the skin, which plays to ultrasound’s strengths. A scan identifies a neuroma, measures it, and shows which web space it sits in — information that matters if an injection or surgery is being considered. It can also apply pressure across the foot while scanning to reproduce the click that comes from a neuroma being squeezed, which no static image can do.

Beyond neuromas, it assesses the plantar plate under each toe joint, finds bursae between the metatarsal heads, and shows joint swelling. The limit is bone: a stress fracture will not appear, so if your pain builds steadily through activity and there is focal bony tenderness, ask your GP about X-ray or MRI instead.

At IUS London

How the appointment runs

  1. 1
    BookingNo referral, no preparation. 30 minutes. Tell us exactly where it hurts and which toes are affected.
  2. 2
    The scanEach web space examined from above and below, with pressure applied across the foot to reproduce symptoms where that helps.
  3. 3
    What we assessNeuromas measured and located by web space, plantar plates under each joint, bursae, and joint swelling.
  4. 4
    ResultsExplained on screen as we scan, written report usually within two hours — the detail a podiatrist or foot surgeon needs to plan treatment.
FAQs

Your questions answered

Can ultrasound diagnose Morton’s neuroma?
Yes — it shows the thickened nerve, measures it, and identifies which web space it is in. It can also apply pressure during the scan to reproduce your symptoms, which supports the diagnosis in a way a still image cannot.
Does size determine treatment?
Size is one factor among several — symptoms, footwear, response to conservative measures and how much it limits you all count. Smaller neuromas often respond to footwear changes and offloading; treatment decisions belong with a podiatrist or foot surgeon.
Is it really a tumour?
No, despite the name. It is a benign thickening of the tissue around the nerve caused by compression and irritation, not a growth in the cancer sense.
What is a plantar plate injury?
Damage to the ligament under a toe joint that keeps the toe stable and straight. It causes pain under the joint and the toe can start to lift or drift sideways. It is frequently mistaken for a neuroma, and ultrasound tells them apart.
Will wider shoes fix it?
Footwear with a broad toe box and a lower heel takes pressure off the forefoot, and for many people that plus offloading is genuinely enough. It is the sensible first step before considering anything invasive.
Can you inject it during the scan?
No — we provide diagnostic imaging only. Our report gives your podiatrist or foot surgeon the location and measurements they need if an injection or surgery is being considered.
Related

Where to go from here

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Plantar fasciitis and what else causes first-step pain.

Read the guide →AchillesAchilles Pain

Tendinopathy or rupture — and how the two are told apart.

Read the guide →ScansOther MSK Scans

Calf, hamstring, groin and other soft tissue areas.

See scans →

Know which structure it is

Every web space examined with pressure applied to reproduce symptoms, plantar plates and bursae assessed in the same 30-minute appointment — explained on screen as we scan, report usually within two hours.

From £169
Foot ultrasound scan

Foot scan

5a Lucerne Mews
Kensington, London W8 4ED
3 mins from Notting Hill Gate

This article is general information about forefoot pain, not individual medical advice. A hot swollen foot with fever, foot pain in someone with diabetes or reduced sensation, or inability to weight bear after injury needs prompt medical assessment — see NHS guidance on Morton’s neuroma and foot pain. Ultrasound does not show stress fractures; we do not offer X-ray, MRI, injections or surgery.

Written and clinically reviewed by the HCPC-registered sonographers who perform this scan at IUS London — a CQC-registered diagnostic ultrasound clinic (Provider ID 1-2775844974). Your own findings are explained to you at the scan and set out in your report.

Author: Yianni Kiromitis, Senior Sonographer, HCPC RA38415 — over 20 years’ experience in NHS and private ultrasound
Medically reviewed: 9 August 2026