Why Does It Feel Like I Have a Pebble in My Shoe?

You’ve checked your shoe a dozen times, but nothing’s inside. You could swear, though, that there’s a pebble under your toes — you can feel it, and it’s painful.

Here at Chicagoland Foot and Ankle, our board-certified podiatrists understand what you’re feeling — and why. It’s called Morton's neuroma, and you’re not imagining the foot pain and other symptoms. Here, we explain the condition and what you can do about it.

What is Morton’s neuroma?

Morton’s neuroma is an inflamed nerve in your foot. More specifically, it’s an enlargement of the nerves between the metatarsal bones that connect your foot to your third and fourth toes.

If you have Morton’s neuroma, the affected nerve becomes thickened and swollen, making it difficult and painful to walk. You feel the pain on the ball of your foot, between your toes. It might feel like there’s a stone in your shoe or you’re stepping on a marble.

Morton’s neuroma is a common condition, with around 1 in 3 people developing it at some point in their life.

A note about names

Although the condition is called Morton’s neuroma, the “neuroma” part is a bit misleading. Neuromas are noncancerous tumors that develop on nerves in the body. Extra nerve tissue grows alongside the healthy, regular nerve tissue.

But Morton’s neuroma isn’t new tissue growing, and it’s not really a tumor. What happens is your existing nerve tissue swells and thickens, putting pressure on the nerve and causing pain and a feeling that something’s gotten in your shoe.

Treating Morton’s neuroma

If you don’t treat Morton’s neuroma, it can cause chronic pain, or even nerve damage, in the affected foot, so make an appointment at Chicagoland Foot and Ankle as soon as you start experiencing symptoms. The sooner we diagnose and treat the problem, the less likely it will be that you’ll have complications.

The most common Morton’s neuroma treatments include:

Footwear changes 

Switch to shoes with a wide, deep toe box to take pressure off the affected nerve.

Shoe pads

Over-the-counter shoe pads cushion the area around the nerve, relieving pressure.

Orthotic devices

Custom-made orthotics slip into your shoes and provide support by keeping your feet aligned and your toes in the correct position.

Pain relievers

Nonsteroidal anti-inflammatory drugs (NSAIDs) reduce pain and swelling by tackling the inflammation that causes them.

Icing

Applying ice or cold packs also reduces inflammation and relieves pain. Wrap the ice or cold pack in a thin towel to avoid direct skin contact.

Corticosteroids

Corticosteroids are prescription anti-inflammatories. We inject the medication into the problem area.

Surgery is the option of last resort, when all conservative treatments have failed to relieve your symptoms and walking becomes extremely painful. There are a few possible techniques if you go this route.

A neurectomy, where the surgeon removes part of the affected nerve, is the most common procedure for Morton’s neuroma.

Cryogenic neuroablation is another option. The surgeon uses extreme cold to destroy a targeted amount of nerve cells. This reduces the nerve’s inflammation and, therefore, its sensitivity.

Radiofrequency ablation is a third option. The surgeon uses an electrical current to destroy a small amount of the affected nerve tissue. This prevents the nerve from sending pain signals to the brain.

If you feel like there’s always a pebble in your shoe, chances are good you have Morton’s neuroma. At Chicagoland Foot and Ankle, we can help.

To schedule an appointment with one of our board-certified foot and ankle specialists, give us a call at any of our locations (Mount Greenwood and Portage Park areas of Chicago, as well as Orland Park and New Lenox, Illinois), or book online today.