(Interdigital Neuroma; Intermetatarsal Neuroma)
|Nerves of the Foot|
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- Wearing shoes that are too tight
- Wearing shoes that place the foot in an awkward position (eg, high heels)
- A foot that is mechanically unstable
- Repetitive trauma to the foot (such as from sports activities like tennis, basketball, and running)
- Trauma to the foot caused by an injury (such as a sprain or fracture)
- Sex: female
- Wearing narrow and/or high-heeled shoes
- Injuries to the foot
- Activities that cause repetitive trauma to the foot (such as sports-related activities)
- Burning, pain, tingling, and numbness often shooting into the toes
- Discomfort that is worse while walking
- Feeling of a lump between the toes
Symptoms are usually temporarily relieved when a person:
- Takes off their shoes
- Flexes their toes
- Rubs their feet
Physical exam of the foot, including:
- Checking for mechanical abnormalities in the foot
- Squeezing the side of the foot, doing so will usually cause pain when Morton's neuroma is present
Examination of your shoes to:
- Check for excess wear in parts of the shoe
- Check to see whether the shoes are too tight
- If the diagnosis is still in doubt, an x-ray may be done to rule out another cause of the pain (eg, fracture)
- An ultrasound may be used to visualize the neuroma
- Injections of local anesthetic can be used for diagnosis
Rehabilitation Measures to Reduce Nerve Irritation
- Switching to low-heeled, wide-toed shoes with good arch support
- Wearing padding in the shoes and/or between the toes
- Wearing shoe inserts to correct a mechanical abnormality of the foot
- Ultrasound, electrical stimulation, whirlpool and massage
Injection of Medication
- Avoid wearing tight and/or high-heeled shoes.
- Maintain or achieve ideal body weight.
- If you play sports, wear roomy, properly fitting athletic footwear.
American Podiatric Medical Association http://www.apma.org/
National Institute of Arthritis and Musculoskeletal and Skin Diseases http://www.niams.nih.gov/
Ontario Podiatric Medical Association http://www.opma.ca/
American College of Foot and Ankle Surgeons website. Available at: http://www.acfas.org/ . Accessed July 17, 2009.
Berkow R. The Merck Manual of Medical Information . New York, NY: Simon and Schuster; 2000.
Clinical Practice Guideline Forefoot Disorders Panel, Thomas JL, Blitch EL 4th, Chaney DM, et al. Diagnosis and treatment of forefoot disorders. Section 3. Morton's intermetatarsal neuroma. J Foot Ankle Surg . 2009;48(2):251-256.
Morton's neuroma. Mayo Clinic website. Available at: http://www.mayoclinic.com/health/mortons-neuroma/DS00468 . Updated June 2009. Accessed July 17, 2009.
Scardina RJ, Lee SM. Frontera: Essentials of Physical Medicine and Rehabilitation . Philadelphia, PA; Hanley and Belfus; 2002.
Thomson CE, Gibson JN, Martin D. Interventions for the treatment of Morton's neuroma. Cochrane Database of Systematic Reviews. 2004;(3):CD003118.
- Reviewer: Rimas Lukas, MD
- Review Date: 09/2012 -
- Update Date: 00/91/2012 -