There are many causes of forefoot pain, however Morton’s Interdigital Neuroma is one of the most commonly seen. Morton’s Neuroma is best described as an irritation or compression of the nerve most commonly between the 3rd and 4th metatarsal bones in the foot.Book A Consultation
Forefoot pain associated with a Morton’s Neuroma is often difficult to describe and ill-defined. It generally presents as a burning or shooting pain which often radiates into the toes. Periods of weight-bearing, particularly running up on the toes or wearing high-heels tends to intensify the pain, as does wearing occlusive or tight-fitting footwear. Many patients who present with Morton’s Neuroma will also describe feelings of pins and needles which can often be re-produced when the forefoot is squeezed.
Morton’s Neuroma generally occurs as a result of an unstable forefoot where there is a lot of movement between the bones of the forefoot causing compression on the nerve. This can lead to scar formation and enlargement of the nerve ending exacerbating the problem.
The first thing you should do if you believe you may have forefoot pain is remove your shoes and stop activities which cause an increase in your symptoms. Management is often as simple as no longer wearing a particularly constrictive pair of shoes which bring on the pain. If this does not provide any relief we recommend a consultation with a Podiatrist.
Diagnosis is usually made based on a clinical examination and possibly an Ultrasound to identify any abnormality in the space between the metatarsals. Various forms of padding or orthotic devices may be supplied by a Podiatrist to separate the metatarsals, reducing the pressure on the nerve, whilst controlling and correcting abnormal biomechanics. In many cases injections of local anesthetic or cortisone can significantly reduce the symptoms associated with a Morton’s Neuroma. Massage, stretching and acupuncture may also be helpful for forefoot pain relief.