Clinical Presentation & Protocol
Patient Usually Complains Of
Patient presents with chronic, burning, or sharp pain in the forefoot, specifically localized to the intermetatarsal space (typically 3rd-4th). Symptoms exacerbated by narrow footwear and weight-bearing; relieved by rest and removal of shoes. Reports sensation of "walking on a pebble."
Clinical Examination Findings
Patient is in no acute distress. Ambulates with a cautious gait, favoring the lateral aspect of the affected foot to avoid pressure on the metatarsal heads.
Treatment Protocol
Conservative management initiated: wide-toe box footwear, metatarsal pads/orthotics, and activity modification. Consider corticosteroid injection if refractory. Surgical neurectomy discussed as a secondary option.