Pain on the ball of foot: Morton's Neuroma

Dear Ask The Doctor:  I have a foot question i have had very severe pain in the ball of my foot for about a month and a half more serious early in the morning and late at night not sure if i can go to my regular doctor or not what can i do to help it? 

Dear Patient:  According with your description is most likely that you have a Morton's Neuroma, which is not a true neuroma, produces pain in the distribution of the interdigital nerve secondary to repetitive irritation of the nerve. The most frequent location is between the third and fourth metatarsals (third webspace) but it can develop between the second and third metatarsals (second webspace) as you described. The most common presenting complaints include pain, which is sharp and burning, and it may be associated with cramping. Morton's neuroma is known to develop as a result of chronic nerve stress and irritation, particularly with excessive toe dorsiflexion (toe upward) with activities such as prolonged walking, running, squatting.The conservative treatment involves footwear modifications: soft-soled shoes with a wide toe box and low heel. The next step is altering the alignment and elevation of the metatarsal heads which is achieved by wearing a plantar pad. This prevents more compression and irritation of the digital nerve. Also a physical therapy program can be beneficial and may include: local cold packs, ultrasound, deep tissue massage, and stretching exercises. The coticoesteroids local injection is another treatment option. And if all of the above results unsuccessful, surgery might be considered.

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