Why Does It Feel Like There’s a Rock in My Shoe?

(A Guide to Ball-of-Foot Pain)

You’ve felt it. It’s that sharp, annoying pain in the ball of your foot that makes you stop and take your shoe off, convinced a small pebble or a bunched-up sock is the culprit.

But every time you check, there’s nothing there.

This “phantom pebble” feeling is one of the most common and frustrating symptoms we hear. It’s not in your head; it’s a classic sign of a neuroma, and it’s one of the most treatable conditions in all of podiatry. If you’re tired of guessing, here is the explanation for your pain, courtesy of Kentlands Foot & Ankle Center.

What is a Morton’s Neuroma?

A Morton’s Neuroma isn’t a tumor or a “growth,” despite its name. It’s a pinched, irritated, and swollen nerve that runs between the long bones in your foot (the metatarsals).

• This nerve is normally very small. But when it’s repeatedly compressed or irritated, it becomes inflamed and thickens.
• When you walk, that thickened nerve gets “pinched” between the bones, sending a sharp, burning, or tingling pain signal to your toes.

Do You Have a Neuroma? A Symptom Checklist

The symptoms are very distinct. You’re likely dealing with one if you experience:

• The “Pebble” Sensation: The #1 sign. A persistent feeling of walking on a small rock, a fold in your sock, or a marble.
• Burning or Tingling: The pain often radiates from the ball of your foot into your third and fourth toes.
• Numbness: You may feel a “pins and needles” or a lack of sensation in your toes.
• Pain That Gets Worse with Shoes: The pain is minimal when you’re barefoot but becomes agonizing when you wear tight, narrow, or high-heeled shoes.
• Pain That Gets Better with Massage: You feel an almost-immediate sense of relief when you take your shoe off and rub the painful area.

This “shoe on/shoe off” pattern is the key. The nerve is fine when your foot is spread out, but it gets pinched when you put it in a shoe that squeezes those metatarsal bones together.

How Do We Treat a Neuroma?

The good news is that neuroma treatment is extremely effective, and we almost always start with conservative, non-surgical options. The goal is simple: stop the squeeze.

1. Shoe Changes: The first step is getting you into shoes with a wide, deep toe box. This simple change gives your bones room to spread out, stopping the nerve from getting pinched.
2. Strategic Padding: We can use a simple metatarsal pad. This small, raised pad sits behind the ball of your foot, not on it. This “lifts and separates” the metatarsal bones, creating more space for the nerve.
3. Custom Orthotics: This is the true, long-term fix. We can create a custom-molded orthotic with a built-in metatarsal pad that perfectly supports your foot’s mechanics and permanently offloads the pinched nerve.
4. Shockwave Therapy: In some cases that require more substantial but non-invasive methods, shockwave therapy can promote healing in the damaged nerve tissue.

Don’t Walk on That “Rock”!

Stop taking your shoe off at your desk or in your car trying to find a rock that isn’t there. We can give you a definitive diagnosis (often in a single visit) and create a simple, conservative plan to get rid of that pain for good.

Get in touch for a comprehensive foot examination with Kentlands Foot & Ankle Center podiatrist Dr. Jon M. Sherman. To make your appointment, please call our office at 301-825-9697. You can also contact us online.