What could be causing your forefoot pain?

Anything that causes compression or irritation of the nerve can lead to the development of a neuroma.  Certain biomechanical factors including the presence of bunions, hammer toes or flatfeet can cause increased irritation to the area. Pronation of the foot may cause the heads of the metatarsal bones to rotate slightly, thereby pinching the nerve running between the metatarsal heads. This increased pressure or pinching causes the nerve sheath to enlarge which can lead to worsening pain over time, if not addressed.

The two most common causes we see for the development of a Morton’s Neuroma are wearing shoes that have a narrow toe box or high-heeled shoes.  Other potential causes are activities that involve repetitive irritation to the ball of the foot, such as running or court sports. An injury or other type of trauma to the area may also lead to a neuroma.

A common question we might get asked is, “will the neuroma ever go away or shrink in size?” Neuroma’s will never 100% ‘disappear’, however there are ways to reduce the size of the neuroma.  Here are a few of the different types of treatment we might use. 

• New footwear with a wider toe box 
• Offloading the area with custom foot orthotics and a metatarsal dome 
• Intrinsic muscle strengthening
• Massage and dry needling 
• Consideration for a cortisone injection if symptoms persist