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Others describe a feeling akin to having a pebble in the shoe or walking on razor blades. Burning, numbness, and paresthesia may also be experienced. [9] The symptoms progress over time, often beginning as a tingling sensation in the ball of the foot. [10] Morton's neuroma lesions have been found using MRI in patients without symptoms. [11]
One cause of metatarsalgia is Morton's neuroma. When toes are squeezed together too often and for too long, the nerve that runs between the toes can swell and get thicker. This swelling can make it painful when walking on that foot. High-heeled, tight, or narrow shoes can make pain worse. This is common in runners, particularly of long distance.
Wearing overly tight shoes, high-heeled shoes, family history, rheumatoid arthritis [2] [3] Diagnostic method: Based on symptoms, X-rays [2] Differential diagnosis: Osteoarthritis, Freiberg's disease, hallux rigidus, Morton's neuroma [4] Treatment: Proper shoes, orthotics, NSAIDs, surgery [2] Frequency ~23% of adults [1
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Mulder's sign is a physical exam finding associated with Morton's neuroma, which may be elicited while the patient is in the supine position on the examination table. The pain of the neuroma, as well as a click, can be produced by squeezing the two metatarsal heads together with one hand, while concomitantly putting pressure on the interdigital space with the other hand.
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