Foot & Toe Pain
There are several foot and toe pain problems including: Freiberg’s disease, Morton’s neuroma, plantar plate problems, sesamoiditis and tarsal tunnel syndrome.
If they are diagnosed early, many of these painful conditions can be treated non-surgically, returning patients to their normal way of life as soon as possible.
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Freiberg’s disease
This unusual condition occurs when the second metatarsal bone becomes deformed. Most often found in young women, it normally happens during rapid growth at puberty. The bone’s shape has been likened to ‘a square peg trying to fit into a round socket’.
Freiberg’s disease
Causes of Freiberg’s disease are:
- A lack of blood supply to the bone’s tip, frequently at puberty
- Repetitive strain on the bone that prevents normal development
Symptoms normally manifest themselves in the teenage years or early 20s, including:
- Forefoot stiffness, swelling and pain, often close to the second metatarsal bone, which is exacerbated by wearing high heels
- Pain beneath the ball of the foot
- Some sufferers may walk with a limp
Your consultant will invite you to explain your symptoms in detail at your first meeting and will then normally perform X-rays, MRI scans, and, in some cases, bone scans to pinpoint any areas of bone damage.
Taking plenty of rest, wearing special medical shoes to minimise pressure on the toe and taking anti-inflammatory painkillers as directed by your doctor, may prove effective. Depending on the severity of the condition, your consultant may recommend surgery to clean up the joint to ease the pain. During surgery the deformed bone may be straightened to improve the joint’s effectiveness.
Morton’s neuroma
Morton’s neuroma, also known as Morton’s metatarsalgia, occurs when a nerve in the foot becomes irritated and extremely painful. It is normally found in the nerve between the third and fourth toes, but the second and third toes can be afflicted too. It may involve a single foot or both feet.
Morton’s neuroma
Morton’s neuroma can occur when the nerve gets trapped between the ends of the foot’s metatarsal bones, causing inflammation.
Middle-aged women suffer it more than most, and narrow footwear or high heels could be contributing factors.
Greater pressure on the toes when playing sport or running.
· Discomfort and a numb feeling between the toes
· Extreme pain in the ball of the foot, as if a stone is digging into the foot
· Walking exacerbates the pain, particularly if your shoes do not fit properly
· Pain may travel along the foot or move up the leg. Going barefoot may improve this
Morton’s neuroma can be problematic to diagnose because the swollen nerve isn’t visible under the skin. Your consultant will advise you on the most suitable course of treatment at your first meeting, once you have discussed your symptoms with him or her.
Surgery is by no means a foregone conclusion for people suffering with Morton’s neuroma. Frequently, a change in footwear, taking pain relief under medical advice, getting plenty of rest, maintaining a healthy body weight, and a personalised course of physiotherapy is sufficient to ease the pain. Steroid injections to minimise the inflammation may be offered. However if the injection is not placed in exactly the correct location it may lead to damage to the ligaments of the toes and discolouration of the overlying skin. In extremely painful cases, your consultant may opt to perform Morton’s neuroma surgery to cut away part of the nerve or to get rid of tissue that is placing pressure on the nerve.
