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METATARSALGIA

Metatarsalgia is a generalized, not a specific, diagnosis. It refers to forefoot pain that can be caused by a number of underlying causes. Most, but not all, of the causes of forefoot pain relate to the soft tissues. For those that are objectively observable, such as with bone injury or toe length, the solution to becoming more comfortable and more functioning are similar to that of soft tissue dysfunction – take pressure of the front part of the foot while providing support and optimal foot motion.

Other names or similar foot conditions:

• Metatarsal strain
• Ball of the foot pain

Symptoms:

• Burning or cramping pain associated with weight bearing and relieved with rest
•  Callusing on the ball of the foot
• Tenderness with palpation of the ball of the foot

Signs to look for:

• Callusing on forefoot
• Morton’s Toe/Foot Syndrome
• Loss of forefoot fat pad

Possible Causes:

• Loss of forefoot fat pad
• Arthritis
• Morton’s Toe/Foot Syndrome
•  Short toes (Brachymetatarsia Sesamoiditis)
•  Traumatic injury

Goals:

• Obtain diagnosis
• Take pressure off forefoot
• Restore optimal foot motion
• Move foot forward with as little lateral movement as possible

Solutions:

Arch Supports:

• Bio-Orthotics Winstep or Sundance exercising support with metatarsal lift

• Lower and thinner arch support with longitudinal and metatarsal support, such as the Bio-Orthotics Journey or Silhouette, for use when shoes cannot accommodate the Winstep or Sundance exercising support

• Extra depth shoes with firm heel counter, connecting shanks, and rocker soles
• For exercise, wear shoes with titanium springs
• MBT physiological shoe
• Negative heel shoe
• Go barefoot on a minimal basis only

Other:

• Use ball of foot gel pad if the arch supports do not provide enough relief (in conjunction with arch supports – not independent of them)

Activities:

• Where cause is from traumatic injury, refrain from weight bearing recreational activities until symptoms recede
• Rotate weight bearing exercises, such as walking or jogging, with non-weight bearing exercising, such as swimming or bicycling
• Regular callus filing with pumice device