Forefoot Pain

“These two toes go numb.” “My toes are burning.” “I have to take my shoes off under the table.” If this is you, if you find yourself describing your foot pain symptoms this way you may be dealing with an interdigital nerve entrapment or a mortons neuroma.

Mortons Neuroma can effect any of the toes, however it commonly presents itself in the 3rd and 4th toes.

MortonneuromaWith time and pressure the arch that spans across the ball of the foot, (the transverse metatarsal arch) can drop down. When this happens the space between the metatarsal heads decreases and you can get friction and rubbing on the nerves that pass through this space. This can cause numbness, tingling or even burning sensations. Narrow shoes will aggravate this and if you find this pain decreases or stops when you remove your shoes you are most likely dealing with an interdigital nerve entrapment.

If you allow this friction on the nerve to continue over a long period of time, the nerve will develop a fibrous mass around it to protect it. This is what is referred to as a mortons neuroma and can be very painful, sometimes requiring surgery.

If you feel that these symptoms pertain to you here are a few tests you can do at home. If any of these are positive you should contact your local pedorthist to see if their services are right for you.

    1. Mulder’s Click Test: Massage out the ball of the foot, wiggle the toes a little and move the metatarsal heads up and down. Now, with both hands, squeeze around the ball of the foot. If this is painful or your feel a click or a pop this could be indicative of a nerve entrapment.
    2. If you find that you only get pain in certain shoes, take a closer look at those shoes. Are they narrower than the ones that don’t cause you pain? If they are this can also be indicative of a nerve entrapment.
    3. When you have pain and remove your shoes does the pain subside? If yes this is also indicative of a nerve entrapment.

*Keep in mind that a nerve entrapment can be present even if you had negative results to the above three tests.*

How Do We Treat a Nerve Entrapment?

Well, a better question is how do YOU treat a nerve entrapment. Responsibility has to be placed on the patient to ensure they are wearing shoes with a wide forefoot. In nerve entrapment patients the test is easy, If the shoe hurts, its too narrow!

What a pedorthist can do for you is to create a footbed for your shoes that incorporates a metatarsal arch support that will lift up in behind the ball of the foot and try to recreate the transverse arch allowing space again for the nerves to comfortably pass.

If you would like someone to assess if pedorthic services are right for your symptoms, contact Pedorthics In Motion.

Call us for more information (416) 887-4109