Sharp shooting pain into Forefoot & Toes when Walking

Morton’s Neuroma is a condition where people experience sharp shooting pain into the ball of foot when walking. Pins and needles can often accompany this pain and weight bearing activities such as standing and walking commonly bring about episodes of pain. The condition occurs when the plantar digital nerves that supply movement control and sensation to the muscles of the foot are compressed between the metatarsal heads of the 3rd and 4th toe. This compression between the metatarsal joint heads leads to the formation of a neuroma which is a point of nerve swelling. This neuroma is aggravated by weight bearing activities when the metatarsal heads are compressed to together causing impingement on the neuroma. Pain is described as sharp and sore pain.

People who have a history of wearing high heels or very flat shoes commonly suffer from Mortons Neuroma. Other conditions that are similar to Mortons Neuroma include a stress fracture of the 2nd and 3rd metatarsal head which can occur due to changes in running/walking frequency, intensity or indeed intensive walking with new footwear. Again tenderness and swelling are common symptoms of a foot stress fracture.

Signs & Symptoms of Morton’s Neuroma

• Collapse of the transverse Arch in Forefoot

• Sorre sharp pain in the ball of the foot when walking

• Clawing of the toes which indicates collapsed metatarsal heads with toes a curled position

• Pain can be triggered by squeezing the metatarsal heads together

Treatment & Managemenent of Morton’s Neuroma

My main objective with treatment is to reduce swelling around the metatarsal heads and this is achieved by focusing treatment on lifting the transverse arch in order to create greater space around the metatarsal heads thus relieve the compressed neuroma. Taping of the 3rd & 4th toes alongside inserting a dome pad underneath the aforementioned metatarsal bones will certainly help to lift the transverse and thus help relieve compression of the neuroma. Manual treatment to relieve the tight joint capsules of the individual toes coupled with graded manual release of the extensor tendons of the toes. The Patient should avoid wearing high heels or very flat shoes but instead wear shoes with a strong forefoot support.

Tomás Ryan is a Registered Physical Therapist with The Irish Association of Physical Therapy and is based in Thurles. Contact Number: 0504 26672 Email your queries to: tomaspryan@gmail.com