It is the compression of a nerve located between the heads of the metatarsals (most often between the 3th and the 4th metatarsals). The pains are brutal, sharp like burns or electric shock radiating down the foot and to the ends of the toes and oblige to stop walking and remove the shoe.
At the beginning stage, discomfort only appears in certain shoes and the pain can sometimes disappear spontaneously. After several months of development, the pains become almost daily with or without shoes.
It is above all an adaptation of the shoes and the wearing of soles that helps relieve the symptoms. The infiltrations are sometimes effective. If treatment by infiltration or insoles (worn for at least 3 months) fails, surgery may be proposed.
Surgical procedures and techniques
There are 2 types of intervention: either the resection of the neuroma (the painful nerve is cut and removed), or the treatment of nerve compression (the ligaments and the heads of the metatarsals are cut to give room to the compressed nerve).
Immediate full support is permitted. There is postoperative edema for about 3 months requiring restraint (cohesive bands, compression socks).