By Rehan Iqbal
If you are experiencing pain in the ball of your foot, at the base of your second and third toes, you may have developed metatarsalgia. This is pain in the metatarsal bones of the foot. Interestingly, this is not a condition in its own right. Rather, it is a symptom of other foot problems. In this article, we will discuss metatarsalgia and provide good advice to help you deal with it. Read on to learn more.
How Do You Know You Have Metatarsalgia?
Incorrect diagnosis is quite common with metatarsalgia. For example, many people confuse this condition with one that is quite similar, Morton’s Neuroma. This is inflammation of the nerves in the area of the metatarsals. It actually causes metatarsalgia.
If you feel pain at the base of your second and third toes, suspect metatarsalgia. Many people say that, at first, they believe they have a wrinkled sock or a rock in their shoe. Some people say the pain is an ache that gets worse when they stand or walk (especially on very hard surfaces). Some feel a sharp pain, and some feel a burning sensation in the toes.
What Cause the Pain?
This pain occurs because the fatty tissue that is meant to absorb shock to the forefoot may have shifted so that it no longer protects the bones that bear weight in the ball of the foot. This causes more trauma to the bones and may cause calluses to build up to protect the bones.
If excessive loading of the affected area continues, the problem will only worsen and will eventually become a chronic injury. This can lead to complications such as swollen joints, toes that are not able to bend and protruding knuckles on the tops of the toes. If left untreated, metatarsalgia can cause toes to “claw”. The development of these complications can cause a misdiagnosis in that the metatarsalgia is overlooked.
It’s a good idea for your diagnostician to get an ink imprint of the sole of your foot as this can literally give a clear picture of the distribution of weight across the sole of your foot. Dark imprints at the second and third metatarsal bones indicate excessive weight bearing in that area.
What Causes This Problem?
Physical oddities of the feet can cause metatarsalgia. For example if either the second or the third metatarsal is very long in comparison to the fourth metatarsal, you may be predisposed to this condition. Sometimes the metatarsophalangeal (MTP) joints may be dislocated or just partly out of joint.
There are a number of conditions that are associated with metatarsalgia. Among them are:
All of these conditions can cause you to put too much weight on your forefoot. This leads to wear and tear and pain in the ball of the foot. Luckily, this painful symptom can usually be treated successfully without resorting to surgery.
How Do You Treat Metatarsalgia In The Long Term?
There are lots of good ways to treat this problem without surgery. Once the underlying cause has been identified and addressed, you can find a great deal of relief from metatarsalgia pain with these simple treatments:
When Surgery Is Necessary
Every once in a while, non-surgical methods simply do not work to resolve this problem. When this happens, your doctor may recommend one of several procedures that are commonly performed to deal with metatarsalgia.
There are some procedures that are done on their own to focus specifically on this problem. Others are done in combination with procedures intended to deal with the underlying cause of the problem (e.g. bunions or other foot deformities.)
Symptoms of the problem, such as claw toe, may also be simultaneously surgically addressed. When toe deformities are taken care of, the plantar fat pad can also be shifted so that it once again protects the metatarsal heads.
If the MTP joint at the base of the affected toe is inflamed and swollen, your surgeon may decide to perform a synovectomy (removal of the synovial lining).
If your problem is caused by excessively long metatarsal heads, your surgeon may decide to shorten one or both of them using a procedure called Well osteotomy. Shortening these bones can change the loading characteristics of metatarsal heads to provide relief to the forefoot.
If calf muscles have not responded to stretching and strengthening exercises, your surgeon may perform a “Strayer procedure” to provide more flexibility to this muscle through surgery.
Are There Any Complications With These Surgical Procedures?
Post surgical complications for these procedures are similar to those associated with all surgical procedures. You may experience:
Complications That are Specific to Surgical Treatment of Metatarsalgia Include...
Good Health And Good Footwear Help Your Avoid Metatarsalgia
The best way to deal with metatarsalgia is to avoid having it develop in the first place. It’s important to maintain a healthy weight to avoid putting excessive stress on your feet. Follow a regular schedule of light-to-moderate exercise to ensure better circulation throughout your body.
Avoid high heels and shoes with narrow or pointy toes. Wear good quality shoes that are correctly fitted. They should have a roomy toe box and provide proper cushioning, arch support and alignment for your feet. Non-slip soles help you avoid all manner of foot injuries.
Don’t underestimate the value of good socks. Invest in padded socks that will stay in place and provide extra protection and cushioning for the metatarsal bones. Use over the counter shoe inserts as needed for comfort.
This article is an information resource. Do not consider this as professional or Doctor’s advise.
