+++
CONDITION/DISORDER SYNONYMS
++
Intermetatarsal disorder
Morton metatarsalgia
Plantar nerve lesion
++
++
+++
PREFERRED PRACTICE PATTERN
++
++
PATIENT PRESENTATION
A 42-year-old female presents with a severe pain in the ball of her right foot that radiates into her second and third toes. She states the pain started about 1 week ago. She describes the pain as being sharp and burning in nature. She does not recall a specific injury but does state that she started barefoot running 6 weeks ago and eliminated her heel strike. She also goes to dance classes for the past 4 weeks. She feels better with a hard soled shoe on but cannot wear her dress shoes, especially heels. Upon palpation there is a thickening of the tissue between toes 2 and 3 right. Tenderness is present in the same region. There is hypomobility of the MTP toes 2 and 3 right and a positive pinch test. The patient’s radiograph, which was ordered by the referring physician, is negative for any fractures.
++
Painful condition that affects the ball of the foot
Growth of scar tissue from chronic irritation of compression
Most common area is between the third and fourth toes, but also can be in between the second and third toes
Involves a thickening of the tissues (neuroma) around one of the intermetatarsal plantar nerves
Branches from the medial and lateral plantar nerves
May alter mechanics during the push-off phase of gait
+++
Essentials of Diagnosis
++
Can be an independent diagnosis and not associated with a disease process
Characterized by numbness, burning, and pain
Sometimes relieved by removing shoes
No visible deformity
Higher risk for individuals with bunions and flat feet
++
+++
General Considerations
++
Feeling like you are stepping on something like a pebble
A burning pain in the ball of the foot that radiates to the toes
Tingling or numbness in the toes
Titled a neuroma, but is not a tumor formation as “oma”
++
++