Morton’s Neuralgia is one of the most common causes of 3-4th toe pain in the ball of the foot(base of the toes). The pain is distinguished from other types of pain in this area because it causes shooting pain and numbness rather than the aching throbbing type of pain that results from the ball of the foot in muscle and bone pain. The pain also feet much better when you take off the shoe and massage the front of your foot in the area of tenderness; this area may feel as if though it contains a “pebble”.
Symptoms of Morton’s Neuralgia
- Burning .
- Sharp Pain.
- Shooting Pain.
- 80% of the time in the 3rd to 4th toes.
- 20% of the time between the 2nd and 3rd toes.
- Pain on weight bearing.
- “Clicking of the toes” in that area.
- Feeling of a “pebble” in that area.
Diagnosis of Morton’s Neuralgia
- Mulder’s Click Test.
- Rule out other obvious problems in the area like hammer toes or injuries.
- Sullivan’s sign = Splaying of the toes in the site of the neuroma.
- Xray and MRI to rule out other problems.
Differential Diagnosis of Morton’s Neuralgia
- Capsulitis – More of a sore and aching feeling in the joint of the toes.
- Metatarsalgia – Generalized pain in the ball of the foot.
- Hammer Toes – A crooked toe that presses against the shoe can cause nerve irritation that radiates.
- Swollen Painful Toe – The nerves in the toe can become irritated by this and radiate toward the foot.
- Foot Corn – A corn or callus can cause pain that radiates back toward the foot.
Predislocation Syndrome – A loose and “clicking” second toe joint can mimic morton’s neuralgia.
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