Millions of Americans live with chronic pain in their backs, hips, legs and feet. Many self-medicate with ibuprofen or other analgesics… or they undergo batteries of expensive tests to identify the underlying problem.
Do this first: Take off your socks and look at your toes. If the second toe is even slightly longer than the big toe, you might have Morton’s toe, a condition that disrupts normal alignment and can cause pain throughout the body, particularly in the back, legs and feet.
The condition is named after Dudley J. Morton, MD, of Yale Medical School, who first wrote about it causing foot problems. Janet Travell, MD — White House physician to Presidents Kennedy and Johnson — took the concept further by explaining that Morton’s toe could cause pain all over the body.
It’s estimated that up to 15% of Americans have Morton’s toe. Among those with chronic musculoskeletal pain, the prevalence might be as high as 80%. People are born with Morton’s toe, but it usually takes decades of accumulated stress and the age-related loss of tissue elasticity to start producing symptoms.
When we walk and our feet push off from the ground, the big toe typically touches before the other toes. For a fraction of a second, it absorbs virtually all of the body’s weight. Then as the foot rolls forward, some of the pressure is shifted to the adjoining, weaker toes.
In patients with Morton’s toe, the first metatarsal bone (in the big toe) is abnormally short and the longer second metatarsal bone typically touches the ground first and absorbs most of the body’s weight. The second metatarsal bone isn’t strong enough for this much pressure. To compensate, the foot overpronates — it rolls in the direction of the big toe to support the excess weight.
Overpronation makes the foot unstable. It also prevents the big toe from pushing your weight upward. This means that other muscles and joints have to compensate.
The result: Decades of abnormal stress that can disrupt your posture and potentially damage joints throughout the body, causing pain.
The simple, inexpensive remedy for Morton’s toe is a toe pad. It will act like a shim under the first metatarsal bone and cause the big toe to meet the ground a fraction of a second sooner. This will prevent overpronation and help keep the foot stable. It often relieves symptoms within a few weeks — and sometimes right away.
Exception: Because a toe pad changes the body’s alignment, some people experience a temporary increase in pain. This usually diminishes within a few days.
Once the pain goes away, you still will need to wear a toe pad every day, just as someone with sight problems needs to wear glasses or contact lenses every day. To make a toe pad…
Buy a package of inexpensive foam shoe inserts. I have found that Dr. Scholl’s Molefoam is a good product for making a toe pad (one pack provides six to eight toe pads). Just about any product will work — even no-name brands available at most pharmacies and discount stores, usually for less than $2.
Cut out a rectangle about one-inch wide and two-and-a-half inches long. That’s about the size of a stick of chewing gum or a Band-Aid. Put it over the first metatarsal head, the bulge on the bottom of the foot that is below the point where the big toe joins the foot. Position the pad so that the longer dimension runs lengthwise with the foot. If the insole doesn’t have an adhesive backing, tape it to the foot with duct tape, electrical tape or even Scotch tape. It does not have to look pretty.
You can take the toe pad off at night and put it back on the foot in the morning. One toe pad usually lasts two to four days.
Helpful: If you don’t have a foam insert, a quarter can work. Anything that adds thickness to the first metatarsal head will help restore proper alignment.
If a toe pad doesn’t eliminate the pain right away, you might want to apply heat. Rest your feet on a heating pad or soak them in warm water for about 15 minutes, once or twice a day.
If after two to three weeks you still have pain, see your physician.
