The Marlow Podiatry Clinic

A neuroma is an enlarged fibrous nerve in the front of the foot in-between the metatarsal bones (inter-metatarsal space). The neuroma in the diagram is positioned in the third - fourth inter-metatarsal space.

Neuromas are more common in females but can affect anyone. Frequently they are found in the third - fourth inter-metatarsal space (50-70% of patients) with the second-third inter-metatarsal space being the next most common site.  

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Most patients complain of a sharp shooting pain affecting the front of their foot that radiates towards their toes. Some patients experience numbness, tingling and often describe a sensation of “walking on a stone”.

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Symptoms can be initiated or made worse by wearing footwear with a narrow toe box or increased heel height, walking or driving for extended periods of time and high impact activities.

Resting and removing aggravating footwear can often alleviate symptoms.

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An abnormally shaped toe can rub against adjacent toes or be irritated by your footwear.  Symptoms include soreness between the toes, over the prominent joint or at the tip of the toe.  Hard skin or corns may form and there may be associated damage to the toenail

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The exact cause may be unknown but may be due to one or more of the following:

• Poorly fitting or unsupportive shoes

• High or low arched foot type

• Previous injury such as a fracture

• Increased length of toe in comparison to adjacent toes

• Older age

• Medical conditions such as diabetes or rheumatoid arthritis

• Genetics – it may run in families

The plantar fascia is a band of thick tissue that runs along the sole of the foot.  Plantar fasciitis is a common condition that occurs when the plantar fascia becomes inflamed and irritated near where it attaches to the heel bone. Often there is a tenderness beneath the heel which can radiate into the arch of the foot.

This condition accounts for 11% to 15% of all foot symptoms referred to Foot and Ankle departments.

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Most common symptoms:

• Stiffness 

• Variable pain worse at the end of the day 

• Tenderness – Often beneath the heel bone, which can radiate into the arch of the foot.

Metatarsalgia is the term used to pain affecting the ball of the foot; however it is not a diagnosis.  The cause is varied and can include overuse injuries, fracture, trapped nerve, joint pain and skin lesions.  The symptoms can include pain, swelling and inflammation. The problem is often worse in thin sole or high-heel shoes and aggravated by standing for long periods or lengthy walks.