You might have experienced that feeling like you have a rock in your shoe. Now, imagine if that rock was under your foot and you couldn’t get rid of it.

That’s how it feels for people dealing with Morton’s neuroma — an inflammation of a nerve running along the bottom of the foot. The condition typically affects the nerve between the second and third or third and fourth toes.

“Nobody is really sure why it happens,” says Dr. Will Whiteside, a foot and ankle orthopedist with Tidelands Health. “It could be caused by compression from wearing too-tight shoes or the nerve can be irritated for some other reason.”

Normally, nerves in the bottom of your foot are the size of a spaghetti strand. A nerve affected by Morton’s neuroma can swell to the size of a macaroni noodle, Dr. Whiteside says. The swollen nerve can often create the feeling like you’re walking on a marble. The pain is more pronounced when wearing shoes than it is when walking barefoot.

Morton’s neuroma gets more common as we age. Research suggests that high-heeled or too-tight shoes can contribute to developing it. As a result, women tend to experience it more than men.

“It’s not like if you wear a shoe one or two times you’ll have a problem, but everyday wear can add up,” Dr. Whiteside says.

People dealing with the condition often find relief by switching to flat shoes with wider toe boxes that give their feet room to expand when they walk.

Diagnosing Morton’s neuroma can be as simple as pressing on the ball of the foot between the toes. If you feel pain, that’s a clue that you may be dealing with Morton’s neuroma. It’s important to consult with your physician to rule out any other possible causes of the discomfort.

“An X-ray can help make sure there’s nothing else going on,” Dr. Whiteside says.

In some cases, an injection of corticosteroid and a numbing agent can relieve symptoms for several months.

While surgery can help resolve Morton’s neuroma, a less invasive first step is to get people to switch their shoes, Dr. Whiteside says.

“We usually try them with a wider shoe and get them to stretch their Achilles heel to loosen up their calf muscles,” Dr. Whiteside says. “That helps take some of the load off of the foot.”

Metatarsal pad shoe inserts may also offer some relief.

If those strategies don’t bring relief, surgery may help.

“You can do surgery where you basically remove the nerve from that part of the foot,” Dr. Whiteside says. Removing the nerve gets rid of the pain but leaves that part of the foot numb.

“I try to treat non-surgically with an injection, pads and stretching,” Dr. Whiteside says. “Surgery’s not that common, but in most cases it can bring instant relief.”