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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.
Morton's neuroma is a benign neuroma of an intermetatarsal plantar nerve, most commonly of the second and third intermetatarsal spaces (between the second/third and third/fourth metatarsal heads; the first is of the big toe), which results in the entrapment of the affected nerve.
Symptoms may be treated by wearing wider shoes to relieve pressure, or the patient can wear padding around the toes. Surgery is also an option, if the pain and discomfort cannot be treated, or for cosmetic reasons. In this procedure, the short metatarsal is typically cut and a piece of bone is grafted between the two ends.
Asymptomatic anatomical variations in feet generally do not need treatment. [10] Conservative treatment for foot pain with Morton's toe may involve exercises [ 11 ] or placing a flexible pad under the first toe and metatarsal; [ 4 ] an early version of the latter treatment was once patented by Dudley Joy Morton. [ 12 ]
The third line of treatment, if shockwave therapy is not effective after around 8 weeks, is using customised foot orthoses which can offer short-term relief from pain. [23] [24] Affected people use further different treatments for plantar fasciitis but many have little evidence to support their use and are not adequately studied. [4]
Physical examination: Assessment of pain, swelling, and range of motion in the affected foot. Radiography: X-rays may reveal flattening, sclerosis, or fragmentation of the metatarsal head. Magnetic Resonance Imaging (MRI): Provides detailed images of soft tissue and bone changes, particularly useful in early stages of the disease.
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Treatment of flat feet may also be appropriate if there is associated foot or lower-leg pain, or if the condition affects the knees or the lower back. Treatment may include foot gymnastics or other exercises as recommended by a podiatrist or physical therapist. In cases of severe flat feet, orthoses should be used through a gradual process to ...