There are several foot and toe pain problems including: Freiberg’s disease, Morton’s neuroma, plantar plate problems, sesamoiditis and tarsal tunnel syndrome. If they are diagnosed early, many of these painful conditions can be treated non-surgically, returning patients to their normal way of life as soon as possible.

Morton’s neuroma is one of the most common. A nerve between the toes — usually the third and fourth — becomes thickened and irritated, producing burning, tingling or the sensation of a pebble underfoot. Many settle with roomier footwear, an orthotic and an image-guided injection; a small number need the nerve addressed surgically.

Plantar plate problems and sesamoiditis cause pain in the ball of the foot — the first from a strained or torn ligament under a lesser toe, the second from irritation of the two small bones beneath the big toe. Freiberg’s disease affects the head of a metatarsal in younger patients, and tarsal tunnel syndrome is a nerve compression at the inside of the ankle that sends tingling into the sole.

What these share is that they are very treatable once correctly identified, and frequently mistaken for one another. Most respond to footwear advice, orthotics, activity modification and targeted injections; surgery is reserved for the cases that do not. The first step is always a clear diagnosis, often with the help of ultrasound or MRI.