A Joplin’s neuroma is a damage to the nerve over the medial side of the first metatarsophalangeal joint.
A Joplin’s neuroma is a painful condition that occurs due to irritation or entrapment of the medial plantar digital nerve (also called the medial proper digital nerve of the hallux), specifically at the medial aspect of the great toe (big toe). It is named after Dr. David Joplin, who described it in relation to entrapment neuropathy. It affects the medial plantar proper digital nerve — a branch of the medial plantar nerve, itself coming from the tibial nerve.
Symptoms:
Medial side of the big toe, close to where the toe joins the foot with burning or tingling pain
Pain may be sharp, burning, or tingling — often described as “electric” or “pins and needles”.
It can be worsened by tight shoes, bunions (hallux valgus), or repetitive pressure.
Differential: Sesamoiditis; Hallux rigidus
Risk Factors:
Chronic pressure or trauma to the medial hallux area
Footwear (tight, narrow, high-heeled shoes)
Bunions or hallux valgus deformity
Flat feet or altered biomechanics
Overpronation during walking or running
Diagnosis:
Mostly clinical (via history + physical exam)
Tinel’s sign (tapping on the nerve reproduces tingling)
Ultrasound or MRI can help confirm if needed
Nerve conduction studies (rarely used)
Treatment Options:
Conservative:
Shoe modification: wide toe box, soft sole
Orthotics to offload pressure
NSAIDs for inflammation
Physical therapy: nerve gliding exercises
Corticosteroid injections in some cases
Surgical:
If conservative fails, neurectomy (removal of neuroma) may be considered