Glomus Tumours of the Foot

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Expert Patient Guide  ·  London

Glomus Tumours of the Foot

A comprehensive patient guide by Mr Matthew Welck, Consultant Orthopaedic Foot & Ankle Surgeon, Royal National Orthopaedic Hospital (RNOH) Stanmore and UCL — London and North London, UK.

At a Glance: Glomus Tumours of the Foot

ConditionA small, benign (non-cancerous) tumour arising from the glomus body — most often found under a toenail.
How CommonRare in the foot. The vast majority of glomus tumours occur in the hand.
Typical PatientAdults aged 30–50, with a slight female predominance.
Classic SymptomsSevere pinpoint pain, exquisite point tenderness, and sensitivity to cold.
Often Mistaken ForIngrown toenail, Morton’s neuroma or gout — so diagnosis is frequently delayed, sometimes for years.
DiagnosisClinical examination and MRI (the key test). X-rays are usually normal.
TreatmentComplete (marginal) surgical excision — usually a day-case procedure.
OutcomeComplete symptom relief and cure in the great majority; recurrence is uncommon.
SpecialistMr Matthew Welck — Consultant Foot & Ankle Surgeon, RNOH Stanmore & UCL, London.

Contents

  1. What Is a Glomus Tumour?
  2. How Common Is It in the Foot?
  3. What Causes a Glomus Tumour?
  4. What Are the Symptoms?
  5. Investigations
  6. Non-Surgical Management
  7. Surgical Treatment
  8. Why Choose Mr Welck?
  9. Frequently Asked Questions
  10. Book a Consultation

01

What Is a Glomus Tumour?

A glomus tumour is a small, benign (non-cancerous) growth that develops from the glomus body — a tiny natural structure in the skin that helps to regulate blood flow and temperature. Because these structures are especially concentrated under the nails, glomus tumours most commonly form in the fingertips, and much less often in the toes.

Although they are harmless in the sense that they are not cancer and do not spread, glomus tumours are notorious for causing severe pain that is out of all proportion to their tiny size. In the foot they usually sit under a toenail (a “subungual” position), most often on the great toe. The good news is that, once correctly identified, a glomus tumour can be removed with a straightforward operation that reliably relieves the pain.

Why specialist review matters: Because these tumours are uncommon in the foot and mimic more everyday problems, specialist assessment by a Consultant Foot & Ankle Surgeon — such as Mr Matthew Welck in London — gives you the best chance of a prompt, accurate diagnosis and a lasting cure.

02

How Common Is It in the Foot?

Glomus tumours are rare in the foot. The great majority occur in the hand, and even large published series of foot cases contain only a handful of patients. They typically affect adults between 30 and 50 years of age, with a slight female predominance.

When they do occur in the foot, they are most often found under a toenail, most commonly on the big toe. Because they are both rare and easily confused with common conditions, delayed diagnosis is very common — many patients live with the pain for years, and some for decades, before the true cause is found. It is not unusual for a patient to have seen several clinicians, and sometimes to have undergone unsuccessful minor nail surgery, before the tumour is identified.

03

What Causes a Glomus Tumour?

A glomus tumour is caused by an overgrowth (hyperplasia) of the glomus body. The precise trigger is not fully understood, and in most people no clear cause is found. A few patients recall previous injury to the area, but for the majority the tumour simply develops on its own.

Key points that reassure patients:

  • It is not cancer — glomus tumours are benign and do not spread to other parts of the body.
  • Malignant change is extremely rare — reported in well under 1% of cases.
  • Occasionally there is more than one — a small proportion of people have multiple tumours, which is one reason an MRI is valuable before surgery.
  • It is not caused by anything you have done and is not related to footwear or activity.

04

What Are the Symptoms?

Glomus tumours classically produce a distinctive triad of symptoms that, once recognised, strongly points to the diagnosis:

  • Severe, pinpoint pain — often coming in bursts (paroxysmal), sometimes spontaneously, and frequently disturbing sleep.
  • Point tenderness — exquisite, sharp pain when one precise spot is pressed, for example with a pen tip.
  • Cold hypersensitivity — a dramatic flare of pain on exposure to cold, such as cold water or an ice cube on the toe.

Other common features include a bluish or reddish discolouration under the nail, changes in nail shape, and pain that limits walking or wearing enclosed shoes. Simple bedside tests — pressing on the spot, and applying cold — are often highly suggestive and can be performed in the clinic.

05

Investigations

Diagnosis begins with a careful history and examination, looking specifically for the classic triad above. Imaging is then used to confirm the diagnosis, pinpoint the tumour and plan surgery:

  • MRI scan — the key test. A glomus tumour appears as a small, well-defined mass, typically dark on T1-weighted images, bright on T2-weighted images, and strongly enhancing after contrast. MRI is highly sensitive and is the single most useful investigation.
  • X-rays — usually normal, and often obtained to exclude other problems. Occasionally a longstanding tumour causes a small area of erosion (scalloping) in the underlying bone, but a normal X-ray does not rule out a glomus tumour.
  • Ultrasound — can detect and localise some tumours and assess blood flow, and is sometimes used alongside MRI.

Mr Welck’s practice offers rapid access to high-quality MRI and, where relevant, advanced imaging including weight-bearing CT (WBCT), supporting accurate diagnosis of both common and unusual foot and ankle conditions.

06

Non-Surgical Management

It is important to be honest about this: there is no medicine, injection or insole that will make a glomus tumour disappear. Painkillers, anti-inflammatories and protective footwear may take the edge off symptoms, and avoiding cold exposure can reduce flare-ups, but these are temporary measures only.

The most important first step is not treatment but the correct diagnosis. Because glomus tumours are so often mistaken for an ingrown toenail, patients sometimes undergo repeated nail procedures that do not help — the pain persists because the underlying tumour is still present. If you have ongoing, severe, pinpoint toe pain that has not responded to conventional treatment, it is worth seeking specialist review to confirm what is actually causing it.

07

Surgical Treatment

The definitive treatment for a glomus tumour is complete (marginal) surgical excision — precise removal of the whole tumour. Guided by the MRI and clinical examination, the surgeon locates the tumour and removes it in its entirety.

The Operation

For the common subungual tumour, the nail is carefully lifted (and usually replaced or allowed to regrow) so the tumour can be reached and excised; for tumours in the pulp of the toe, a small direct or side incision is used. It is typically a day-case procedure, performed under local, regional or general anaesthetic depending on your circumstances. The tissue removed is sent to the laboratory to confirm the diagnosis.

Recovery

Relief of the characteristic pain is often immediate and dramatic. The wound is dressed and kept clean while it heals; if the nail was lifted, it regrows gradually over several months. Most patients return to comfortable walking quickly and to sport and full activity as the toe settles, following the individual advice given by the surgical team.

Will It Come Back?

Recurrence is uncommon. When it does happen it usually reflects either incomplete removal or a second, previously undetected tumour — which is exactly why a good-quality preoperative MRI, mapping the lesion and checking for more than one, is so valuable.

08

Why Choose Mr Welck?

Mr Matthew Welck is a Consultant Orthopaedic Foot & Ankle Surgeon at the Royal National Orthopaedic Hospital (RNOH) Stanmore — one of the UK’s leading tertiary orthopaedic centres — and Honorary Associate Clinical Professor at UCL.

His practice is dedicated exclusively to disorders of the foot and ankle. Alongside specialist interests in total ankle replacement, complex foot and ankle reconstruction, revision surgery and sports injuries, he has extensive experience in diagnosing and treating unusual and easily-missed conditions such as glomus tumours, where an accurate diagnosis makes all the difference.

He has authored over 50 peer-reviewed publications, holds double fellowship training including international experience, and is a pioneer of weight-bearing CT and 3D-printed patient-specific instrumentation. Patients are seen across London and North London, with rapid access to MRI, WBCT and multidisciplinary care. Every option is discussed openly and an individualised plan is agreed together through shared decision making.

09

Frequently Asked Questions

Is a glomus tumour cancer?

No. A glomus tumour is a benign (non-cancerous) growth. It does not spread to other parts of the body, and malignant change is extremely rare (well under 1% of cases).

Why is such a tiny tumour so painful?

The glomus body helps control blood flow and is packed with nerve endings. Even a very small tumour in this tissue can therefore cause severe, pinpoint pain, marked tenderness and dramatic sensitivity to cold.

Why does it so often take years to diagnose?

Glomus tumours are rare in the foot and their symptoms overlap with common problems such as an ingrown toenail or Morton’s neuroma. As a result they are frequently overlooked, and some patients undergo unsuccessful minor procedures before the true cause is found.

What is the best test for a glomus tumour?

MRI is the key investigation — it reliably shows a small, well-defined mass, usually under the nail. X-rays are often normal, so a normal X-ray does not exclude the diagnosis.

Will surgery cure it?

Yes. Complete (marginal) excision cures the great majority of patients, and relief of the characteristic pain is often immediate.

Can it come back after surgery?

Recurrence is uncommon and usually reflects either incomplete removal or a second, undetected tumour. A preoperative MRI reduces this risk by mapping the lesion and checking for more than one.

Will I lose my toenail?

For a tumour under the nail, the nail is carefully lifted during surgery and is usually replaced or allowed to regrow. Any temporary nail changes settle as the nail grows back over several months.

How soon can I walk and return to sport?

Most patients walk comfortably soon after this day-case procedure and return to sport and full activity as the toe heals, guided by the individual advice of the surgical team.

Where can I see Mr Matthew Welck for a glomus tumour in London or North London?

Mr Welck consults across London and North London. NHS patients are seen at the Royal National Orthopaedic Hospital (RNOH) Stanmore. Private appointments can be booked on 07547 395270 or by emailing secretary@matthewwelck.com.

10

Book a Consultation

If you have ongoing, severe or pinpoint toe pain — particularly pain that flares with cold and has not settled with usual treatment — specialist assessment can make a real difference and give you a clear answer.

Book a private or NHS consultation with Mr Matthew Welck, Consultant Foot & Ankle Surgeon. Early expert review gives you an accurate diagnosis and the widest range of treatment options.

This page is for information only. It does not replace personalised medical advice. Always consult a qualified specialist for diagnosis and treatment.

Written by: Matthew Welck | Consultant Orthopaedic Foot & Ankle Surgeon London — last updated September 2026

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