Toe pain, especially of the 2nd, 3rd and 4th toe can be quite common and have a few different sources of pain. The 2nd toe often has pain associated with a bunion or instability of the inside of the foot. A lot of patients have a foot structure that can overload the 2nd toe and cause mechanical pressures that eventually fatigue the joint. The 3rd and 4th toe are more likely to have an entrapped nerve. The anatomy in this location causes a compression issue where the nerve exists and can create problems for patients.

The 2nd toe or 2nd metatarsal phalangeal joint has a thickening called a plantar plate. This thickening acts like a cushion and helps protect the toe and joint when walking. If your foot structure places too much pressure on this joint, you can tear the plantar plate. One will often see the toe start to drift towards the 1st or inside of the foot. The pain is often like a neuroma, burning, tingling, and swelling. Often patients will require an MRI to confirm the tear. Once the tear is confirmed the plantar plate usually requires surgical repair. There are two methods one from the top of the toe and the other from the bottom. I often will decide which is appropriate for the patient based on any other foot pathology that may need to be addressed, like a bunion.

The 3rd and 4th MTPJ or 3rd interspace, the area between the 3rd and 4th toes is common spot for a Morton’s neuroma. The foot has two large nerves on the bottom the lateral and medial plantar nerves. These two nerves come together in the 3rd interspace and are often compressed between the metatarsal bones. This squeezing affect can result in burning to these two digits. A neuroma can be treated very effectively with alcohol injections. The alcohol injection series is 89% successful in eliminating nerve pain.

If you are suffering from burning, tingling, or swelling in your foot we can help. Give us a call at 425-391-8666 or make an appointment online.