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Metatarsalgia vs Morton’s Neuroma: How to Tell the Difference

While both conditions have similar symptoms, you can differentiate Morton's neuroma and metatarsalgia based on the location and type of pain.

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By Babafemi Adebajo
Joel Taylor
Edited by Joel Taylor

Published January 26, 2022.

Though a common occurrence, pain in the ball of the foot is still a nuisance, especially when the cause is unknown. Two of the most common causes of pain in the ball of the foot are metatarsalgia and Morton’s neuroma. Both conditions affect the metatarsal heads and are similar in presentation, making them hard to differentiate.

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Morton’s Neuroma Pain vs. Metatarsalgia Pain

While it may be hard to differentiate between Morton’s neuroma and metatarsalgia pain, it is not impossible. Here are three areas to consider when trying to identify the real cause of your pain:

  1. Location of pain While Morton’s neuroma usually affects the tissue around the plantar digital nerve between the 3rd and 4th toes, metartarsalgia pain occurs under the balls of the feet beneath the 2nd and 3rd metatarsals.
  2. Type of pain Morton’s neuroma starts as a numbing and tingling sensation which worsens to become uncomfortable and painful. On the other hand, metatarsalgia often begins as a dull, aching pain that progresses to a sharp shooting pain.
  3. Clicking sensation More often than not, Morton's neuroma presents with a mass and a clicking sensation around the third and fourth metatarsals. There’s no such lump with metatarsalgia, though it may still feel like you're walking on marbles.

When to Address the Symptoms

Whichever it is, the key to recovery is prompt intervention. Both conditions start small, but you shouldn't wait until the symptoms escalate before seeking medical attention.

The first line of action is to determine the cause of the pain and the severity. Only then will it be possible to choose a treatment approach. You can expect this to include:

  • Rest
  • Activity modification
  • Ice
  • Non-steroidal anti-inflammatory drugs (NSAIDs)
  • Exercise
  • Massage
  • Prescription of braces
  • Splints
  • Orthotics

Only when all these fail to bring improvement does surgery become an option.