Morton’s neuroma is a condition affecting a nerve in the ball of the foot, causing significant discomfort. It involves the thickening and irritation of nerve tissue, typically occurring between the third and fourth toes. Symptoms include sharp, burning pain, tingling, or numbness, often feeling like standing on a pebble. Metatarsal pads offer a common, non-surgical approach to managing this pain by altering the foot’s structure. Correct placement is the most important factor for achieving pain relief.
Understanding the Location of Morton’s Neuroma
Morton’s neuroma primarily affects the interdigital nerve running between the metatarsal bones in the forefoot. The irritation most frequently occurs in the third intermetatarsal space, situated between the third and fourth metatarsal heads. These heads form the ball of the foot, which bears the weight when standing or walking. Pain is felt directly under the ball of the foot, often described as a stabbing or burning sensation. Compression, such as from narrow shoes, squeezes the metatarsal heads together, entrapping the thickened nerve and causing painful symptoms. The metatarsal pad must be placed behind the area of pain to be effective.
The Mechanism of Metatarsal Pad Relief
The goal of using a metatarsal pad is to change the foot’s biomechanics, not to cushion the painful area directly. The pad supports the transverse arch, the slight curve running across the ball of the foot. By providing support just behind the metatarsal heads, the pad gently lifts and spreads these bones apart. This separation alleviates pressure on the irritated interdigital nerve, creating more space for the nerve and reducing irritation. The pad also helps to redistribute weight away from the painful nerve site.
Precise Placement Instructions
The correct positioning of the metatarsal pad is necessary to ensure it provides the required lift and separation. The pad must be placed immediately behind the metatarsal heads, proximal to the ball of the foot and the area of pain. Placing the pad directly under the painful spot is a common error that increases pressure on the neuroma.
To find the correct location, identify the bony ridge of the metatarsal heads by feeling for the prominent area on the sole of your foot just before the toes. The pad’s center, specifically its highest point, should be positioned in the soft tissue pocket about 1/2 to 3/4 inch (1 to 2 centimeters) behind this ridge.
To help mark the spot, you can press your foot onto the shoe insole to see where the ball of your foot naturally lands. The pad should then be adhered to the insole so that its front edge sits just behind the marked line where the metatarsal heads rest.
The pad must be centered width-wise so that its peak aligns with the space between the affected metatarsal bones, typically the third and fourth. The goal is for the pad to press into the sole just behind the weight-bearing area, which helps to reestablish the foot’s natural arch structure. Once the pad is partially secured to the insole, place the insole back into the shoe and stand up to test the pressure. You should feel the pad pressing into the arch of your foot, not directly under the ball of the foot.
Adjusting and Fine-Tuning Pad Position
The initial placement may not be perfect, and fine-tuning is often necessary to find the optimal position. If the pad feels uncomfortable, particularly if it feels like you are standing on a hard object, it is likely positioned too far forward or is too large. Conversely, if you feel no noticeable pressure or relief, the pad may be too far back or too small to effectively lift the metatarsal arch.
Small adjustments are key, and repositioning the pad by a few millimeters forward, backward, or slightly sideways can make a significant difference in comfort and efficacy. If the pad is adhesive, only partially secure it initially to allow for trial-and-error adjustments. Pay attention to the direction of the neuroma pain, and rotate the pad slightly so its highest cushioning aligns with the interspace of the affected nerve.
If persistent pain or discomfort remains after several careful adjustments, or if the symptoms worsen, consult a podiatrist, as metatarsal pads may not be sufficient for more advanced cases.