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Condition/Disorder Synonyms

  • Intermetatarsal disorder

  • Morton's metatarsalgia

  • Plantar nerve lesion


  • 355.6 Lesion of plantar nerve

ICD-10-CM Codes

  • G57.6 Lesion of plantar nerve

  • G57.60 Lesion of plantar nerve, unspecified lower limb

Preferred Practice Pattern1

  • 4E: Impaired Joint Mobility, Motor Function, Muscle Performance, and Range of Motion Associated with Localized Inflammation

Key Features


  • Painful condition that affects the ball of the foot

  • Growth of scar tissue from chronic irritation of compression

  • Most common area is between the 3rd and 4th toes, but also can be in between the 2nd and 3rd 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”


  • Ladies wearing high heels

  • Rock climbers with repetitive forefoot pressure

Clinical Findings

Signs and Symptoms

  • Burning pain in the ball of the foot

  • Numbness and tingling in the toes, especially between the 3rd and 4th toes

  • Difficulty wearing/finding shoes, especially pointy ones

  • Limited motion of the MTP joint

Functional Implications

  • Pain with standing

  • Pain with ambulation at the toe

  • Inability to wear regular shoes

  • Need to wear larger shoes with a larger toe box

  • Alteration of gait pattern and mechanical issues of the forefoot

Possible Contributing Causes

  • Poor footwear: improper fit

    • Toe comes to a point (boots)

    • Narrow forefoot (high heels)

  • Certain sports

    • Repetitive trauma from high-impact activities, such as jogging or running

    • Those requiring tight shoes, such as snow skiing or rock climbing

  • Foot deformities: bunions, hammer toes, flat feet, excessive flexibility

Differential Diagnoses

  • Metatarsalgia

  • Metatarsal stress fracture

  • Capsulitis

  • Synovitis

  • Stress fracture

  • Tendinitis

  • Degenerative arthritis

  • Bursitis

  • Lumbar radiculopathy

  • Freiburg's disease: osteochondritis of the metatarsal head

Means of Confirmation or Diagnosis


  • X-ray

  • Diagnostic ultrasound

  • MRI

Diagnostic Procedures

  • Mulder's Sign (Pinch Test)2: Lateral squeezing of the forefoot with one hand and the opposite ...

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