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Morton's metatarsalgia is a condition associated with a painful neuroma* on
the digital nerve causing pain in the foot. It is a condition that occurs most
frequently in women (F:M 4:1) aged 40-50.
The neuroma occurs at the level of the metatarsal necks. The common digital
nerve to the third/fourth metatarsal spaces is most often affected, although
other interspaces can be involved.
The condition is characterised by sharp intermittent pain that shoots into
the toes. However the pain is only felt when the patient wears shoes. There
is localized tenderness over the site of the neuroma. There may diminished sensation
in the affected cleft. The patient will be very clear about relief of pain being
achieved by removing the shoe and manipulating the foot (1).
X-rays are not useful, except to rule out other causes.
If there is no relief from symptomatic padding then the neuroma may be excised
(note that this results in the toe being permanently numb, but pain is alleviated
(1)). Note that some would use cortisone injections as a treatment option for
this condition (1).
* technically this condition is not a true neuroma , as a degenerative rather
than a proliferative process is involved (1).
Reference:
- Rheumatic Disease in Practice (September 2001). The therapeutic scope of
modern podiatry. Issue number 6, Arthritis Research Campaign
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