Technical Bulletin
Morton's Metarasalgia (Morton's Digital Neuralgia)
Steven Subotnick, MS, DPM
Introduction
Morton's Digital Neuralgia, or neuroma, is described as pain in the ball of the foot at the junction of adjacent toes to the ball, which is usually sharp and may alternate with periods of comfort or dull pain. Associated with sharp shooting pain into the planar aspects of adjacent toes, there may be periods of numbness. More commonly, pain is referred into the medial aspect of the fourth toe and lateral aspect of the third toe. This is referred to as the third interspace. There also may be a neuroma present in the second interspace with shooting pain into adjacent aspects of the second and third toes. Really, a neuroma can be associated with an inflamed sesamoid in the first interspace. Very rarely a neuroma can be present in the fourth interspace. Neuromas usually are present in one interspace only, but may be present in adjacent interspaces; more commonly the second or third. They are more prevalent among female than male patients who are comfortable in loose-fitting footwear such as slippers or sandals, but experience acute discomfort after standing or walking some time in close fitting shoes or boots. Generally, the foot appears normal in appearance.
