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Differential diagnosis for Morton's neuroma

Morton's neuroma is a common condition of the forefoot, but not all forefoot pain is Morton's neuroma. This article explores the differential diagnosis of Morton's neuroma.

If it’s not Morton’s neuroma, then what could it be?

Differential diagnosis for Morton’s neuroma

Differential for forefoot pain

The vast majority of referrals that I get from primary care for evaluation of forefoot pain are referred for a suspected Morton’s neuroma.  Interestingly, not many of these referrals actually have Morton’s neuroma.  So if it’s not Morton’s neuroma, what could the source of the pain be?  Let’s take a look at the differential diagnosis for Morton’s neuroma.

First, we have to qualify this patient and rule out a history of lumbar pain or peripheral vascular disease.  Referred pain from lumbar disc disease and critical limb ischemia (poor circulation) can also contribute to forefoot pain.  But in this case, we’re referring to a young and otherwise healthy individual.  And the pain that we’re referring to does not involve the great toe joint.  We’re talking pain behind the 2-5th toes.

Other than Morton’s neuroma, what foot conditions can be the source of forefoot pain?  Here’s a list of possible problems.

By far, the most common problem that I see in the office that causes forefoot pain is capsulitis.  Capsulitis will usually be found in the ball of the foot under the second toe.  The symptoms of capsulitis increase when going barefoot and are relieved with the use of a shoe.

The other conditions listed should be ruled out when evaluating forefoot pain.  Be sure to follow the link for more information on each condition.


Dr. Jeffrey Oster
Jeffrey A. Oster, DPM

Medical Advisor

Updated 12/24/19

Leave your comment
11/27/2018 1:40 PM
My wife complains that she feel as if she has a pebble in her shoe . What would you suggest as we would love to go dancing over the Holidays.
11/29/2018 11:24 PM
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First, go to our condition page on <a href="">Mortons Neuroma.</a> Once you're convinced that your wife's condition is consistent with that which is discussed in the article, there are associated products at the conclusion of the article.<br>
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Happy holiday and take that girl out dancing now will ya?<br>
<a href="/jeffrey_a_oster_dpm_cv">Jeffrey A. Oster, DPM</a><br>
Medical Director<br>