Case Study
Gender: Female
Age: 56
Presenting Complaint:
Pain in the right forefoot. Patient reported pain is at its worst when pressure is applied between her 2/3rd ID space, particularly when she is driving and her foot is up on the gas pedal. Patient reported she has become more active recently and noticed the pain soon after activity. Pain was described as tingling/burning and is worse with friction. The patient is awaiting an MRI to investigate the area.
Treatment:
Hands-on assessment alongside thorough history take was conducted. A positive Mulders click test was found and thus a mortons neuroma was suspected. Differentials such as plantar plate/bursitis/fracture were also investigated. However, mortons neuroma was most likely after assessment, particularly with the presentation of HAV bilaterally.
The patient was educated on the role of footwear and the importance of wide-fitting toe and deep toe box. Short-term management included an insertion of a metatarsal dome to splay the digits and alleviate the stress and friction.
Long-term patient will be reviewed following results of MRI scan and options for long-term orthosis will be considered.
