The disorder primarily affects women and typically occurs between the third and fourth toes, causing a sensation similar to walking with a pebble stuck in your shoe. A sudden, sharp pain can make even simple walking difficult. One of the most common triggers is footwear. Shoes that are too tight, with a pointed toe, or excessively high heels force the foot into unnatural positions and increase pressure on the metatarsal nerves.
It’s no coincidence that many patients find relief simply by changing their habits: choosing softer shoes, with a wider sole and low heel, can significantly reduce the discomfort . In some situations, however, these precautions aren’t enough, and more targeted treatments are necessary.
The underlying cause of the problem is a nerve irritated by repeated trauma or constant pressure. The doctor diagnoses the condition through a physical examination, often supplemented by X-rays—helpful in ruling out fractures—or ultrasound and MRI scans, which allow visualization of the thickening of the nerve.
Once the problem is identified, the treatment strategy varies based on the severity of the symptoms. In milder cases, treatment is conservative: specific insoles, metatarsal pads, and a change of footwear are the first steps. If the problem persists, corticosteroid injections may be used to reduce inflammation. In more resistant cases, surgery becomes necessary. Prevention remains essential: comfortable shoes, avoiding high heels, and activities that compress the forefoot can reduce the risk of developing this condition.
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