Forefoot pain – Morton’s neuroma.

Background

Without sounding like I’m falling to bits ! another common foot condition that caused me a lot of discomfort and lead me to develop a temporary limp was Morton’s neuroma/Intermetatarsal bursitis.

Symptoms

The discomfort was like a deep ache with sudden sharp electric shock sensation when I twisted on the foot to change direction. Some people often describe the feeling of the socks ruffled up under the foot or a pea inside their shoe when neither are visible.

Cause

I am sure there are plenty of good websites that give their explanation for Morton’s neuroma and give their reason and recommended treatment for the condition. Often this condition is explained as partly being due to the forefoot rolling inwards and trapping the nerves that run through the front of the foot – so to speak – and into the toes.

In my case and in the cases of many patients I have seen in NHS Biomechanics clinic and privately, I have found that in some folk the way the foot rolls ‘outward’ can be just as influential in the condition developing. Due to a damaged big to joint (I really am falling to bits !) from an earlier impact injury and confirmed on x-ray, I lack the necessary upward band at the big toe necessary during walking.

Treatment

The result is that I momentarily roll my foot outward during the propulsive phase of walking – it happens so quickly that it isn’t visible on slow motion video and is best visualized when I walk on my RsScan computer foot pressure plate. This outward roll of the forefoot, particularly when wearing a flexible boat style shoe, causes abnormal movement between the metatarsal heads at the ‘ball’ of the foot and an irritation to the protective fluid sac and nerve in between the joint heads.

Outcome

At one point I thought I would need to steroid inject the problem area just to get through a forthcoming holiday, however, by incorporating a metatarsal dome pad to my Left custom insole, the rotation of the forefoot and irritation of the soft tissue structures settled my discomfort immediately.