What causes swollen nerve between toes?
It's quite hard to ignore any changes or injuries in the foot especially because you need both feet to move around.
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Your foot consist of many small bones, including five long bones found next to one another. In between these long bones are nerves which pass on into each toe.
Performing certain activities – prolonged periods of running, walking etc - places continuous pressure in certain areas of the foot where the nerves are located.
When the applied pressure is constant and too much for the nerve and the surrounding tissues to overcome, the result is swelling of the nerve and surrounding tissues resulting in a condition known as Interdigital Neuroma.
The swelling usually occurs between the third and fourth long bones in the foot and usually has a frequent occurrence in women than in men. The condition usually affects one foot but may also affect both feet at the same time.
What are the causes?
The cause of the condition cannot be easily determined. However, the risk factors include repeated damage to the nerve in the foot.
The repeated irritation to the nerve, results in the formation of scars which may thicken to form a swelling (neuroma).
The repeated irritation of the nerve in the foot occurs each time your foot gets into contact with the ground when you walk or run consistently over a prolonged period of time.
In this case, there is constant rubbing of the bones in the foot with the nerve resulting in scarring and subsequent swelling of the nerve in the foot.
The wearing of high heels, narrow-fitting or tight fitting shoes may predispose you to having this condition. Some individuals who engage in sporting activities such as running, subject their feet to repeated trauma which may cause the condition to occur.
Individuals with varied foot abnormalities such as flat feet, high foot arches etc. may cause the nerves around the toes to be stretched out and rub against other surrounding tissues resulting in the development of the condition.
It may also occur in individuals who have problems in their forefoot as this promotes extreme movements in between the long bones of the foot. Some individuals may also develop the condition as a result of stepping on sharp items, damage to the foot or the presence of swollen bursa (fluid-filled cavity) in the foot close to the nerves around the third and fourth long bones.
In such instances the nerve is compressed and the condition ensues.
What does it feel like?
Individuals may usually complain of pain beneath the foot and two affected toes. The pain is described as burning, sharp or unbearable. Pain may also be felt and increases in areas where you bear weight in your foot – ball of the foot.
Some individuals may complain of a painful catching sensation when walking and may feel pointed pain or discomfort which seems to move into the toes especially the third and fourth toes.
You may experience a swelling or an odd sensation in between the toes. You may also have numbness and tingling sensation in your toes. Some individuals feel that a small stone might be beneath their foot when they walk.
Pain may increase when you walk on hard surfaces or continue to wear high heels or tight shoes or when you press the ball of your affected foot. Some individuals may also notice the swelling of the affected foot.
How is it diagnosed?
The physiotherapist performs a thorough examination on your affected foot. The examination includes a physical assessment to identify the limitations in the foot, including reduced movement or otherwise, area of pain, presence or absence of swelling etc.
Specific tests are also performed to rule out other suspected conditions. The history of your condition is also taken into consideration because it assists in ascertaining how the condition could have developed.
Other investigations such as X-rays, MRI, or an ultrasound may be conducted to rule out other conditions and confirm diagnosis. These investigations will also assist in identifying the severity of the condition.
The writer is a Senior Physiotherapist at the 37 Military Hospital, [email protected]