The pain is often reproduced by palpation of the intermetatarsal space. Often a large neuroma can be palpated through the skin. Decreased sharp sensation of adjacent toes is frequently found. The important goal of treatment is to eliminate pain. Patient education such as instruction on proper fitting shoes is helpful.
Steroid injections can provide temporary comfort.
Physical therapy and orthotics are often used for conservative treatment. This usually will not result in total anesthesia of the toes because there is sensation overlap from other nerve branches. There will be spots of total numbness, and deep sensation is not affected. This surgical procedure is most commonly performed under local anesthesia. After surgery most patients resume normal activity in 6 to 10 weeks but immediate walking is permitted.