Morton Neurom
Morton’s neuroma is basically a nerve disorder that is responsible for the sensation of sensation in the underside of the foot and toes. These nerves run between the bones of the metatarsus and pass through a very narrow gap in the area of the bone ends, through which they run. This gap is narrowed further by overloading the foot or by a splayfoot, for example, which is present from the beginning.
The bones then begin to squeeze the nerve a little bit and slide along it. This leads to nerve irritation at the corresponding location and also to the formation of a shell of firm connective tissue around the nerve. This sheath in turn, however, ensures that the nerve has even less space and is therefore constricted and squeezed even more quickly.
Typical signs of Morton Neuromas are a slight tingling sensation or a disturbed sensation on the underside of the foot. When walking, the person affected feels an unpleasant shooting pain the more they roll their foot. This pain can also be provoked by grasping the two long sides of the foot and compressing it. This also compresses the metatarsal bones so that the damaged nerve is also compressed. In the majority of cases, the nerve between the third and fourth toe is affected by Morton’s neuroma.
Arthrosis in the metatarsus as a cause of pain
Metatarsal arthrosis is one of the rarer forms of joint arthrosis and is generally observed more frequently in women than in men. Like any other form of arthrosis, the cartilaginous joint surfaces of the bones are damaged. Overloading the joints – whether due to a foot malposition or too much body weight – increases the wear and tear on the cartilage of the joints until it is finally largely worn out.
The body compensates by forming small bone attachments (osteophytes) at the edge of the joint to better distribute the pressure on the joint. However, since these are not as stable as the original bone and are partly scraped off again by movement, a permanent latent inflammation develops in the affected joints. Those affected usually complain of pain in the area of the metatarsus, which is particularly strong when rolling, i.e. when the foot is bent.
However, this pain seems to be most likely to be localized on the back of the foot, i.e. the upper side of the foot. Depending on how far the arthrosis has already progressed, the “bone attachments” described above can also be felt when feeling the joints. However, they are visible at the latest when the foot is X-rayed.
Furthermore, the affected area of the metatarsus appears warmer than the rest of the foot, and the patient tries to adopt a compensatory, gentle position with his feet in order to minimize the load on the metatarsus. Pain in the metatarsophalangeal joint of the toe can have many different causes. However, pain in the big toe joint is a typical symptom of a gout attack, which is why this aspect will be discussed in more detail.
Gout pain typically occurs during the cold season, as uric acid crystallizes more easily into small lumps in the cold. These in turn rub inside the joint and cause pain when the foot is moved or rolled. A typical indication is therefore that the pain decreases when the foot is warmed.
Another possibility that could cause pain in the metatarsophalangeal joint of the toe would be a fracture of a toe bone. This often affects the little toe or possibly the fourth toe. Pinched in a door or clumsily caught on an edge, this force can cause a fracture. The patient feels severe pain during the acute incident and also afterwards, and a hematoma develops at the affected area.
