Differential Diagnosis for Forefoot Plantar Nerve Pain
Single Most Likely Diagnosis
- Morton's Neuroma: This condition is characterized by the thickening of the tissue around the nerves leading to the toes, causing pain, numbness, and tingling in the forefoot, particularly between the toes. It is a common cause of forefoot pain and is often related to footwear, activity level, and foot mechanics.
Other Likely Diagnoses
- Plantar Fasciitis: Inflammation of the plantar fascia, a band of tissue supporting the arch of the foot, can cause pain in the heel and forefoot, especially with weight-bearing activities. While it primarily affects the heel, the pain can radiate to the forefoot.
- Metatarsalgia: This condition involves pain and inflammation in the ball of the foot, which can be due to various factors including poor foot mechanics, overuse, or footwear issues. It can cause significant discomfort in the forefoot area.
- Intermetatarsal Bursitis: Inflammation of the bursae between the metatarsal bones can cause pain in the forefoot, similar to Morton's neuroma but often more diffuse.
Do Not Miss Diagnoses
- Deep Vein Thrombosis (DVT): Although less common, DVT can present with pain in the foot, including the forefoot, and is a medical emergency due to the risk of pulmonary embolism. It's crucial to consider this diagnosis, especially in patients with risk factors for DVT.
- Infection (e.g., Cellulitis, Abscess): Infections in the foot can cause significant pain, redness, and swelling. Early diagnosis and treatment are essential to prevent serious complications.
- Tumor: Both benign and malignant tumors can occur in the foot and cause pain. While rare, missing a diagnosis of a tumor could have serious consequences.
Rare Diagnoses
- Tarsal Tunnel Syndrome: This is a rare condition that involves compression of the posterior tibial nerve as it travels through the tarsal tunnel on the inner side of the ankle, which can cause pain, numbness, and tingling in the foot, including the forefoot.
- Complex Regional Pain Syndrome (CRPS): A chronic pain condition that can affect the foot, characterized by intense burning or aching, along with swelling, redness, and sensitivity. It is rare but can be debilitating.
- Neurological Disorders (e.g., Peripheral Neuropathy): Certain neurological conditions can cause pain, numbness, and tingling in the feet, including the forefoot. These conditions are often systemic and require a comprehensive evaluation.