Imaging
Though a neuroma is a soft-tissue abnormality and will not be visualized by standard radiographs, the first step in the assessment of forefoot pain is an X-ray to detect the presence of arthritis and exclude stress fractures/reactions and focal bone lesions, which may mimic the symptoms of a neuroma. Ultrasound (sonography) accurately demonstrates thickening of the interdigital nerve within the web space of greater than 3mm, diagnostic of a Morton’s neuroma. This typically occurs at the level of the intermetatarsal ligament. Frequently, intermetatarsal bursitis coexists with the diagnosis. MRI can distinguish conditions that mimic the symptoms of Mortons neuroma, but when more than one abnormality exists, ultrasound has the added advantage of determining the precise source of the patient’s pain by applying direct pressure with the probe. Ultrasound may also be used to guide treatment such as cortisone injections into the webspace, as well as alcohol ablation of the nerve. Treatment
Conservative
Orthotics and improved footwear are the first-line treatments for Morton’s neuroma. In addition to traditional orthotic arch supports, a small foam or fabric pad may be positioned under the space between the two affected metatarsals, immediately behind the bone ends. This pad helps to splay the metatarsal bones and create more space for the nerve so as to relieve pressure and irritation. However, it may also elicit mild uncomfortable sensations of its own, such as the feeling of having an awkward object under ones foot. Toe spreaders are another form of conservative orthotic treatment that may yield relief for Mortons neuroma symptoms.
Mortons neuroma  is a benign neuroma of an intermetatarsal plantar nerve, most commonly of the second and third intermetatarsal spaces (between the second/third and third/fourth metatarsal heads; the first is of the big toe), which results in the entrapment of the affected nerve. The main symptoms are pain and/or numbness, sometimes relieved by ceasing to wear footwear with tight toe boxes and high heels (which have been linked to the condition). The condition is named after Thomas George Morton, though it was first correctly described by a chiropodist named Durlacher.Some sources claim that entrapment of the plantar nerve resulting from compression between the metatarsal heads, as originally proposed by Morton, is highly unlikely, because the plantar nerve is on the plantar side of the transverse metatarsal ligament and thus does not come into contact with the metatarsal heads. It is more likely that the transverse metatarsal ligament is the cause of the entrapment.Though the condition is labeled as a neuroma, many sources do not consider it a true tumor, but rather a perineural fibroma (fibrous tissue formation around nerve tissue). Signs and symptoms
Symptoms include pain on weight bearing, frequently after only a short time. The nature of the pain varies widely among individuals. Some people experience shooting pain affecting the contiguous halves of two toes. Others describe a feeling akin to having a pebble in the shoe or walking on razor blades. Burning, numbness, and paresthesia may also be experienced.