A neuroma (most commonly a Morton’s neuroma) is a thickening of nerve tissue between the toes—usually between the 3rd and 4th toes.
It develops from repetitive irritation and compression of the nerve, which is exactly what can happen when you suddenly increase running volume.
What Does a Neuroma Feel Like?
Patients describe it in very specific ways:
- Burning pain in the ball of the foot
- Tingling or numbness into the toes
- Feeling like you’re “stepping on a pebble”
- Pain that worsens in tighter running shoes
- Relief when shoes are removed or the foot is massaged
At first, it may only show up during longer runs. Over time, it can start affecting shorter runs—or even walking.
Why 5K Training Triggers It
Training programs often ramp up:
- Distance
- Frequency
- Speed work
But what doesn’t always change?
- Shoe fit
- Foot mechanics
- Forefoot pressure
Running places significant load through the forefoot during push-off. If the space between the metatarsals is already tight, that nerve gets compressed repeatedly.
More miles + tight space = irritated nerve
The Biggest Mistake Runners Make
They push through it.
Because early on:
- The pain comes and goes
- It seems manageable
- It doesn’t affect every run
But neuromas are one of those conditions where ignoring it early makes it harder to calm down later.
What You Can Do Right Now
If you’re early in your symptoms, small changes can make a big difference:
1. Check Your Shoes
Most running shoes are narrower than you think.
Look for:
- A wider toe box – a toe box that is shaped like your foot
- Less compression across the forefoot – look for shoes with a mesh toe box
- Enough room for your toes to spread – wide enough that you can move your toes easily.
This alone can reduce pressure on the nerve.
2. Add a Neuroma Pad
A simple metatarsal (neuroma) pad:
- Offloads pressure from the nerve between the toes
- Spreads the metatarsal heads that are squeezing the nerve
- Reduces irritation with each step
Placement matters—this is where guidance from a podiatrist can help. Even one millimeter in any direction can impact how the nerve responds to the pad.
3. Consider Custom Orthotics
If foot mechanics are contributing:
- Orthotics can redistribute pressure off of the nerve back onto the arch
- Improve alignment to the front of your foot
- Reduce repetitive stress on the nerve between the toes.
Orthotics can be moved from shoe to shoe as long as the sock liner is removable. Custom devices are helpful for runners increasing mileage.
In-Office Treatment Options
When symptoms persist or progress, this is where we step in. We take care to get an x-ray and ultrasound to confirm the diagnosis.
Class IV Laser Therapy
Laser treatment can:
- Reduce inflammation around the nerve
- Improve circulation
- Help calm symptoms without injections
Class IV laser is painless, non-invasive and works well for patients who want to stay active while treating the problem. We recommend weekly treatments for 5 weeks or until the pain has resolved. Surgery is very rarely indicated.
The Goal Isn’t to Stop Running
It’s to keep you running—comfortably.
The earlier you address a neuroma, the more likely you can continue training without interruption.
Waiting until the pain is constant or affecting daily activity makes treatment more involved.
When to Get It Checked
If you notice:
- Pain in the ball of your foot during runs
- Tingling or numbness in your toes
- Relief when you take your shoes off
…it’s worth evaluating sooner rather than later. It is much easier to treat a neuroma in the earlier stages than when it becomes chronic.
If you’re training for a 5K and your foot is starting to push back, don’t ignore it.
At Lighthouse Foot and Ankle Center, we help runners:
- Identify the cause of forefoot pain
- Stay active during treatment
- Get back to training with minimal setbacks
📍 23 Spring St. Suite B, Scarborough, Maine
📞 207-774-0028
🌐 www.lighthousefootandankle.com
