Metatarsalgia

What is metatarsalgia?

Metatarsalgia is pain in the forefoot region caused by compression of the nerves located between the metatarsal bones of the feet. The injury can also appear by the overload of the head of the metatarsals. In any case, they cause pain that intensifies when walking or supporting this area of the foot.

Types of metatarsalgia?

  • Mechanical: due to excess pressure of the metatarsal heads on the ground.
  • Compressive: due to compression of the nerves that run between the metatarsal bones (Morton’s neuroma).
  • Inflammatory: pain when pressing on the joint between the metatarsals and the toes.

Symptoms of metatarsalgia

The patient usually feels significant pain in the forefoot, usually in the plantar region, sometimes mistaken for arthritis or plantar fasciitis, but it can also occur in the dorsal region of the foot. Symptoms of metatarsalgia may include:

  • Severe, continuous, intense pain just behind the toes.
  • Pain that gets worse when you stand, run, bend your foot or walk, especially barefoot on a hard surface, and gets better when you rest.
  • Sharp or stabbing pain, numbness or tingling in the toes.
  • Feeling of having a stone in your shoe.

Symptoms worsen when walking and at the end of a day’s work while standing, improving with rest. Due to the intense pain felt by the patient, he/she tries to walk away from the pain, supporting the weight on the good foot, and this compensation in the long term may cause other symptoms to appear, such as hip or back pain.

What are the causes of metatarsalgia?

The metatarsalgia can be caused by:

  • Wearing improper, narrow, narrow-heeled, narrow-toed shoes
  • Overweight
  • Aging, due to loss of plantar fat.
  • Excessive or inadequate sports practice
  • Foot disorders: pes cavus, claw toes, bunions or hammer toes.
  • Systemic diseases:
Read Now 👉  Rheumatic Fever

o Diabetes: can cause ulceration of the foot.
o Rheumatic diseases: gout, arthritis or osteoarthritis.
o Vascular diseases
o Infections: such as septic arthritis

Diagnostic tests for metatarsalgia

To make a correct diagnosis of metatarsalgia a thorough clinical examination is usually performed and the patient’s medical history, symptoms and signs are reviewed.
Instrumental tests that may be performed are:

  • X-rays
  • If the podiatrist suspects the presence of a Morton’s neuroma, he/she will prescribe an ultrasound or MRI to see the soft tissues.
  • The baropodometer, to check plantar pressures.

Prognosis of the disease

The metatarsalgia does not check gravity, but certain disability when not being able to walk adequately and if it is not treated it could lead to the metatarsal phalangeal dislocation, bunions, toes in claw, etc.

Can it be prevented?

To prevent metatarsalgia, it is recommended that people who practice sports stretch their feet well before and after exercise. Especially if we refer to a practice of high impact.
In addition, it is recommended to use footwear with sufficient width for the toes and with a good balance between cushioning and stability. Massage is also indicated for our suffering feet.

Treatments for metatarsalgia

The treatment for metatarsalgia will depend on the type of pain, and always from less to more, from the application of ice and massage with anti-inflammatory cream, physical therapy such as ultrasound and infiltrations. Sometimes we will indicate the administration of oral anti-inflammatory drugs, change or reduce the sport activity avoiding turns and impacts of the foot on the ground and to use correct footwear.
Surgery is only used in the most severe cases.

Which specialist treats it?

The Podiatrist, together with the Traumatologist and Physiotherapist, are the specialists indicated to treat this ailment.