Neuroma is another common cause of forefoot pain. The pain will often be found in the interspace between the 3rd and 4th metatarsal heads. Common complaints are numbness, tingling, burning, shooting or radiating pain, along with a "rolled-up sock feeling" under that particular area of the foot. To diagnose a neuroma clinically, the practitioner should squeeze all of the metatarsal heads together while applying plantar and dorsal pressure. This technique called Mulder's sign mimics the pressure of the shoe. The first-line treatments are changing shoegear to a wider toe box, metatarsal pads (placed plantarly under the metatarsal necks to relieve the pressure), and injection therapy with corticosteroid. If those methods fail, surgical excision may be attempted (Singh, Ioli, & Chiodo, 2005; Thomas et al., 2009b).
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Cite this: Foot Care from A to Z - Medscape - Sep 01, 2010.