Interdigital Neuroma (Morton’s Neuroma)

Description:

An interdigital neuroma is a swelling of the nerve and scar tissue arising from the compression of an interdigital nerve. This most often occurs between the 3^rd and 4^th metatarsals. Pain generally radiates towards the toes and is intensifies with forefoot weightbearing and in shoes with insufficient forefoot width.

Signs & Symptoms:

• Localized tenderness between the 3^rd and 4^th (or 2^nd and 3^rd) metatarsals with pain that radiates down the involved toes,
• Aching and burning sensation,
• Highly sensitive to pressure either under the foot or from squeezing,
• Pins and needles (paresthesia) in the toes, and
• Increased pain and discomfort during forefoot weightbearing and in narrow fitting shoes.

Causes:

• Swelling of the interdigital nerve that is impinged by the metatarsals,
• Excessive pronation, and
• Improper footwear, i.e. narrow fitting shoes or high heel shoes.

Preventative Measures:

• Ensure proper shoe fit and design, and
• Custom foot orthoses to address anatomical and biomechanical issues.

Management:

• Ice
• Intrinsic foot muscle strengthening,
• Custom foot orthoses and appropriate shoe prescription, and
• Corticosteroid and local analgesic injections.