Have you experienced a feeling of tingling in your forefoot or toes or the feeling of your sock being bunched up?
You make have a Neuroma.
A Neuroma is an injury of the interdigital nerve which involves a thickening of the tissue around one of the interdigital nerves causing it to become entrapped or impinged as it travels to the toes through the intermetatarsal space.
As the condition progresses the tissue becomes thicker and the nerve becomes more easily impinged, and therefore symptoms increase.
Research in 2007 supported the theory that the nerve is actually being compressed beneath the tip of the metatarsal head and the base of the toe and not under the transverse ligament as initially thought.
Neuromas can occur in any of the intermetatarsal spaces. A Mortons Neuroma occurs specifically between the 3rd and 4th metatarsal heads.
They can occur in isolation or with associated bursitis.
Treatment protocols include
- footwear modification. Wearing footwear with a wide toe box and minimal heel elevation can assist in alleviating symptoms and reducing pressure in the intermetatarsal space.
- Use of toe socks and toe spacers to open the intermetatarsal spaces
- Offloading padding - custom made u pads to reduce pressure on the affected metatarsal head
- addressing any tightness in the gastrocnemius muscle
- improving big toe strength and assisting in effective toeing off- therefore alleviating pressure to the lesser toes.
For runners:
- modification of midfoot or forefoot strike patterns to rear-foot strike
- decreasing stride length and increasing cadence can help in the short term.
Clinically a Neuroma can be identified by a Mulder's Click.
Radiographically they can be identified on an ultrasound and an MRI.
If you are experiencing forefoot pain, consult a foot health professional for proper assessment, diagnosis, and treatment.