Interossei of the Foot: Pain Pattern and Treatment
The interossei are the small muscles between the long bones of the foot, four on the top side that spread the toes and three on the sole side that draw them in. They steady the toes at push-off. Their documented pattern is pain along one toe, top and bottom, from the ball of the foot to the tip, and an ache between the metatarsals above it. When one toe hurts and the toe itself is normal, this is the muscle to check. They relate to the deep foot muscles page.
Attachments and action
Origin: Dorsal interossei: the adjacent sides of the metatarsals, two heads each. Plantar interossei: the inner sides of the third, fourth, and fifth metatarsals.
Insertion: The bases of the proximal phalanges of the toes and the extensor expansions.
Action: Dorsal interossei spread the toes; plantar interossei draw the outer three toes toward the second; both flex the toes at the base and steady them during push-off.
Where the pain is felt: Along one toe, on the top and the bottom, from its base to the tip, and on the sole over that toe's metatarsal. Cramping in the forefoot.
Common causes: Shoes narrow at the toes; a hammer toe or claw toe that keeps the muscle working; gripping the ground with the toes for balance; running in minimal shoes; a long period in a boot or cast; a bunion that changes how the toes load.
Patients say: "One toe hurts and the doctor found nothing wrong with the toe." "My forefoot cramps in bed." An ache between two metatarsals on the top of my foot. "The second toe aches along its whole length."
When to get evaluated: Pain along one toe after a stub or a fall, with bruising or a crooked toe, needs an X-ray first. Burning between the third and fourth toes with a click when the forefoot is squeezed points to a Morton neuroma and needs a podiatric assessment. A hot, red toe with fever needs medical evaluation.
How this muscle is examined and treated
Examination presses between the metatarsals from the top and from the sole for the point that reproduces the pain along the toe, tests toe spreading and toe flexion, and checks the toe joints and the web spaces to separate this from a fracture or a neuroma. Needling here addresses the muscles between the metatarsals from the top of the foot. Assessment and treatment happen in the same visit.
Related conditions
Ankle & Foot PainChronic Pain PatternsSports & Performance Injuries
This page is educational. It describes muscle referral patterns commonly associated with pain; it does not diagnose your condition. Individual patterns vary. For evaluation of your specific pain, see a licensed clinician. Seek immediate medical care for emergencies. Eugene Baek, L.Ac. · New Jersey License 25MZ00080600