What To Do When You Have A Pain Between Fourth And Fifth Toes?
Whether you are a new or seasoned runner, experiencing a pain between the fourth and fifth toes may not seem too serious. The good news is you are the right-the pain is definitely not life-threatening.
However, what you may not realize is how the initially irritating pain can greatly affect your running in the future. So what is causing the pain you are experiencing? How can it be treated? Can I continue running with the condition? We'll answer all these questions in this article.
The pain that is usually felt between the fourth and fifth toes is referred to medically as a Morton’s Neuroma. It is caused by nerve tissue growing to form a benign lump between the toes. This thickening of the tissue is often caused by constant squeezing of the common plantar digital nerve for extended periods of time. (1)
The thickening of the nerve forms a lump that causes a pain, tingling, and numbness between the toes and in the ball of the foot. The sensation is often described by sufferers as similar to having a stone in your shoe. (2)
2. General Symptoms
To help you determine whether your pain is caused by Morton’s Neuroma, examine yourself for these symptoms: (3)
Two of the reasons why this is the case is because women tend to wear pointed, narrow shoes which compress the foot and increase pressure. (4)
High heeled shoes are titled which puts pressure on the nerve between the toes and makes it prone to more stress. When it comes to athletes, Morton’s Neuroma can be triggered for the following reasons: (5)
In addition to women and athletes being at higher risk, deformities of the feet including flat feet, bunions and hammer toes can cause the ligament to press the nerve. It has also been found that running with improper form can trigger the condition since you are putting extra pressure on the foot.
4. Diagnosis of Morton’s Neuroma
Lateral squeeze test
Since Morton’s Neuroma has no visible signs, diagnosis needs to be made by a qualified physician. A useful test is called the lateral squeeze test.
This Morton’s Neuroma test is performed with the index and thumb finger on the painful space in between the toes. The forefoot is compressed with the other hand by squeezing together metatarsal heads.
Imaging tests are also useful for diagnosing the condition.
5. Treatment of Neuroma
As the condition progresses, walking will become more and more difficult so running is out of the question at this stage. Treatment of Morton’s is classified into two-conservative treatment and operative treatment.
One of the first things you should do is wear wide, comfortable shoes with wide toe boxes. When selecting shoes for running make sure that they are low-heeled. These are the best running shoes for Morton’s Neuroma. Also, consider adding a metatarsal pad or a custom orthotic. These pads are a great way to relieve pressure.
Non-steroidal anti-inflammatory medications can be purchased without prescription to help control the inflammation. They can also help with the pain. Medications include aspirin, ibuprofen and the like. Although these will not permanently treat the condition, they may make walking more bearable.
Physical thereby including massage, and electrical stimulation is also used although the efficacy has not been confirmed.
Intermetatarsal corticosteroid and local anesthetic injection is another conservative treatment method. This provides short-term relief but no long-term benefits can be expected.
Operative treatment has been said to be the only way to permanently get rid of Morton’s Neuroma. Surgical methods include interdigital nerve excision, isolated intermetatarsal ligament division, metatarsal shortening osteotomy and isolated interdigital nerve excision.
During surgery, the patient is usually given regional anesthesia with sedation and a thigh or ankle tourniquet is used to limit the bleeding.
Although surgery can remove the neuroma, the complications that occur afterward make it a difficult treatment option. For example, keloid formation from wound healing may result. A recurrent neuroma is another possible complication.
6. Easy Prevention Methods
Morton’s Neuroma can be easily prevented if you follow these steps:
Experiencing pain between fourth and fifth toes may have long-term effects on your running routine. Despite this, with early diagnosis, you will be able to prevent the condition from getting worse. The moment you feel a numb sensation in your feet, consult a physician to confirm the diagnosis.
If you have flat feet, wear high heels regularly, or engage in a sport that requires tight shoes, you are at higher risk of developing a neuroma.
When deciding which treatment method to follow, keep in mind the pros and cons of both conservative and surgical treatment methods. Conservative methods may make the condition bearable but they cannot cure it. Surgical methods, on the other hand, have the potential to completely remove the lump but complications may occur.
Prevention is the best cure when it comes to Morton’s Neuroma. Always opt for wide toe boxes, limit the time you wear high heeled shoes and use padded shoes.