Morton's neuroma
The nerves to the toes pass between the forefoot bones (metatarsals) and can be pinched there, especially if the shoes are too tight. The nerve develops a thickening and pinches even more. Eventually there is a small nodule called a neuroma on the nerve. Despite the sound of its name, it has nothing to do with tumours. The pain, a type of metatarsalgia, often has a tingling character and goes into the toes, foot or even the shin. There is sometimes a clicking sensation when walking as the neuroma pops between the metatarsal heads.
With most causes of metatarsalgia, such as metatarsal overload, people like to wear a nicely cushioned shoe and dislike walking barefeet on hard floors because of the painful - walking on pebbles feeling they experience.
With a Morton's neuroma however most people actually like to to be barefoot because that allows their feet to spread. Wearing anything constrictive makes a Morton's neuroma pain worse.
The diagnosis is sometimes clear, but scans or injections can help clarify it. Indeed, a steroid injection can settle enough of the thickening to solve the problem but the pain often returns, especially with large neuromas. Other treatments include taking care to choose broad enough footwear (feet do spread over the years) and orthotic insoles to improve the foot posture. If the diagnosis is a confident one and the above treatments have not helped, the neuroma can be removed surgically, with a high satisfaction rate.