Morton’s neuroma is an inflamed, thickened nerve between the toes — most commonly between the 3rd and 4th metatarsals. Classic patients describe the feeling of a stone in the shoe, sometimes with electric shoots into the toes, often worse in narrow footwear. The first line of treatment is rarely surgical: wider, lower-heeled shoes, a metatarsal pad, an ultrasound-guided steroid injection. Most patients settle with that combination, sometimes with more than one injection over time. The minority who don’t respond — and where MRI or ultrasound confirms a neuroma of meaningful size — are reasonable candidates for surgery. Two main approaches: nerve decompression (release of the tight intermetatarsal ligament that compresses the nerve, leaving the nerve in place) and nerve excision (the swollen segment of nerve is removed). Decompression preserves the nerve but has a higher recurrence rate. Excision is more reliable but leaves a permanent area of numbness between the toes — a trade most patients accept readily.