Morton's neuralgia is a nerve entrapment between two metatarsals, usually between the third and the fourth metatarsal, sometimes also between the second and the third metatarsal. Most common in women aged between 25 and 40.
The pinching causes irritation of the nerve branch, sometimes resulting in thickening. Acute periods of pain in the forefoot with radiating to the toes, often described as sharp pains/pain cramps or the feeling of a cramp, are characteristic, usually occurring suddenly while walking or doing sports with shoes that are too narrow. Taking off the shoe and massaging the foot usually provides quick relief from the pain. Over time, the complaints can become chronic due to the development of a nerve thickening (neuroma).
The cause of the complaints can often be traced back to a deviation in the pattern of gait or an incorrect choice of shoe (shoes that are too narrow or the heels too high).
The podiatric treatment consists primarily of giving extensive shoe advice. Furthermore, if the cause is a deviated gait pattern, after extensive clinical and biomechanical examination with gait analysis, podiatric insoles can be used to adjust the gait pattern and reduce pain.
If the results of the podiatric insoles are insufficient, the podiatrist, in consultation with the general practitioner, will refer the patient for additional examination and follow-up with an orthopaedic foot surgeon. If necessary, after thorough additional examination, the surgeon will remove the Morton neurinoma surgically.