Clinical Presentation & Protocol
Patient Usually Complains Of
Patient presents with localized pain in the right forefoot, specifically between the 3rd and 4th metatarsal heads. Describes symptoms as burning, tingling, and numbness radiating into the adjacent toes. Symptoms are exacerbated by narrow-toed footwear and prolonged weight-bearing, and relieved by rest and removal of shoes. Denies trauma, recent surgery, or systemic inflammatory symptoms.
Clinical Examination Findings
Right foot examination reveals tenderness upon palpation of the 3rd intermetatarsal space. Mulderโs click is positive upon lateral compression of the metatarsal heads. Sensation is diminished in the distribution of the common digital nerve. No erythema, edema, or deformity noted. Gait is antalgic, favoring the lateral aspect of the right foot.
Treatment Protocol
Conservative management initiated: recommendation for wider toe-box footwear, metatarsal pads to offload the intermetatarsal space, and activity modification. Consider corticosteroid injection into the 3rd intermetatarsal space if symptoms persist. Patient advised on NSAID use as needed for pain control.