Metatarsalgia

What is Metatarsalgia?

Metatarsalgia is a bit of an umbrella term used to cover any forefoot pain. More specifically, it is an inflammatory condition which occurs in the joints between the metatarsal bones and phalanges (phalanx bones), more often in the second, third or forth MTP joints.

Metatarsalgia most commonly occurs in the joints of the 2nd, 3rd, and 4th toes, although it can occur in any of them and is frequently in more than one. The symptoms with this can range from mild to severe and there may be many causes for the condition such as arthritis or even poorly fitted footwear.

Symptoms of Metatarsalgia

• Pain in the forefoot which is worse when weight bearing.
• Pain is usually of gradual onset.
• Pain and tenderness when pressing in on the joint.
• Passive flexion of the toe (bending the toes down) can stimulate pain.
• There may be excessive skin or calluses under the foot due to excess pressure.

Causes of Metatarsalgia

• A high or rigid arched foot (pes cavus) may increase the likelihood of metatarsalgia.
• Over pronation of the foot.
• A shortened first metatarsal causing excess pressure to go through the second metatarsal (morton's foot).
• Tight extensor tendons of the toes.
• Poorly fitting footwear.
• Conditions such as hammer toe or bunions.
• Age - older people are more susceptible.
• Stress fractures of the metatarsals.
• Repetitive high impact such as running.
• Arthritis.
• Diabetes.
• Morton's neuroma.
• Gout.

Treatment

What can you to do treat metatarsalgia?

• NSAID's such as ibuprofen (non steroidal anti inflammatory drugs) may reduce pain and inflammation. Always speak to your Doctor first.
• Use padding to protect the foot and re-distribute weight on the foot.
• Use a gel type shock absorbing and cushioning insole can be worn.
• Wear flat, spacious shoes.
• Stretch your calf muscles regularly throughout the day.

What can a professional do?

• X-rays, MRI's or Ultrasound scans can be used to look inside the foot to view any damage.
• Blood tests may be taken to diagnose any underlying medical causes such as diabetes or gout.
• A podiatrist may assess your foot position and gait (walking pattern).
• If necessary custom orthotics (insoles) can be made.
• A doctor may inject a corticosteroid injection into the foot.