These pages offer advice only. They are not a substitute for a proper consultation.

The Forefoot- Lesser Toes

Although far less important than the great toe, the lesser toes still provide some push-off, especially the second toe. As previously mentioned, a hammer toe commonly occurs with hallux valgus, leading to rubbing on the shoes and/or pressure on the end of the toe. The other lesser toes can also be affected. As the toe hammers, the plantar plate can fail.The plate can fail suddenly, causing increasing pain. It leads to a riding up and dislocation of the joint.

With or without a dislocation, a plunger effect occurs causing pain under the metatarsal head. This is due to pressure and can be likened to walking barefoot over a stone or pebble. This is called mechanical metatarsalgia.

Sometimes the overloading will only lead to inflammation with pain in the morning, associated with swelling. This inflammatory metatarsalgia can also be caused by more generalised conditions inflaming the joints and should be investigated with blood tests to exclude these diseases.

If the pain shoots down the toe and is worse when wearing tight shoes then this could be due to a swelling on the nerve between the metatarsals. This is neurogenic metatarsalgia and is caused by a Morton's Neuroma.