Morton’s toe sciatica describes a buttocks and leg pain syndrome that is theorized to be related to the demonstration of the second toe being longer than the first. This condition is alternately called Morton’s foot, Morton’s Syndrome, Royal toe, Greek foot or hallicusbradymetatarsalgia.
Morton’s toe is a very controversial theory of pain, since the symptoms blamed on it are wildly diverse and wide-ranging throughout the anatomy. Most diagnoses are made by physical therapists or sports medicine doctors who have focused much of their careers on diagnosing and treating this particular form of foot irregularity. However, there remains much debate about the validity of the Morton’s foot diagnosis and a significant percentage of all healthcare providers believe this theory of pain to be completely baseless and illogical.
This dissertation examines the idea that pseudo-sciatica can be the direct result of Morton’s toe conditions. We will explore how this is possible and what types of symptoms might occur. We will also examine the contrasting viewpoint that states unequivocally that Morton’s toe is a completely incidental and innocuous structural abnormality.
Many foot specialists focus on conditions where the second toe is skeletally longer than the first. Morton’s toe is known for being a common cause of foot pain, since the weight of the body rests on a different area of the foot than is organically engineered for this purpose. Body weight is supposed to rest predominately on the bones of the first toe, but in cases of Morton’s foot, the weight pressures the bones of the second toe. Calluses and general discomfort are common results of this condition. Some patients also demonstrate excessive mobility in the bony joint of the large toe metatarsals.
The primary factor that might lead to sciatica pain, as well as other wider-ranging symptoms than simply foot pain, is the development of over-pronation of the foot in response to this added stress. This excessive pronation causes flat-footedness, abnormal posture and irregular ambulation. We have already written much about the topic of flat-footed sciatica and foot pronation sciatica, so please explore those essays for the exact mechanisms through which symptoms can be generated.
We have seen many cases where foot pronation can indeed be responsible for enacting various anatomical changes, including misalignments in joint components in the ankle, knee and hip, pelvic tilting, leg length differentials and spinal curvature changes. We have also seen evidence that when the foot pronation is resolved, these issues also tend to correct themselves organically over time.
It is certainly possible that changes to posture and anatomical functionality can create the ideal circumstances for sciatica and pseudo-sciatica to occur. In some very dramatic over-pronation profiles, the Morton’s toe might be causative, while in virtually all other cases, the toe condition might be contributory to a variable degree ranging from minor to moderate.
As we have noted in other writings on the subject, changes in posture and gait associated with excessive regular pronation of the foot can alter many tissues in the body and contribute to spinally-enacted sciatica due to nerve root compression, as well as pseudo-sciatica caused by piriformis, sacroiliac and local compression of the sciatic nerve. However, far more often we see joint pain syndromes resulting from Morton’s toe including hip, knee and ankle joint symptoms that are not related to the sciatic nerve.
Many doctors and therapists doubt that most Morton’s toe conditions will generate enough anatomical change to create sciatica, although most concede that severe cases of foot over-pronation might have mild contributory effects to certain spinal and nonspinal pain syndromes. These skeptical doctors cite the body’s amazing ability to compensate for anatomical irregularity and usually do so without any ill effects.
The argument here is one of the classic debates of modern medical history: Structure versus function and their mutually inter-related effects on each other. This is the same debate we often see in regards to different leg lengths and atlas/axis misalignments, as well as a host of structural irregularities that might be "different", but are not universally deemed as being pathological.
We see both sides of the coin on this issue, since our own extensive experience has proven that patients can suffer exacerbated sciatica-type pain due to foot over-pronation. We see proof of this when foot posture correction efforts resolve widespread symptoms, including sciatica, over time. However, we also see many people who have Morton’s toe and demonstrate marked foot pronation, yet have no pain at all and are actually incredibly healthy and active.
Therefore, we make the judgment that Morton’s toe (and subsequent severe foot pronation) might be a contributory factor to sciatica in some patients, while most cases are likely to be incidental nonfactors to sciatica that may exist. This latter statistic has also been proven in countless patients, since Morton’s foot irregularity affects a very significant percentage of the population that ranges upwards of 20% in some geographic regions of the world.