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Metatarsalgia: symptoms, causes and pain relief tips

Table of contents

 

Symptoms of metatarsalgia

Causes of metatarsalgia

Risk factors for metatarsalgia

Treatment of metatarsalgia

Medical treatment

Surgical treatment

Resuming activity

Complications

Prevention of metatarsalgia

 

Metatarsalgia is a common injury often caused by walking or standing for long periods. It is pain and inflammation in the sole of the foot due to excessive pressure on the heads of the metatarsals. It is often considered a symptom of other conditions, rather than a specific disease.

As with any foot condition, there are many treatment options before considering surgery. And we recommend that you seek professional advice if you suffer from this type of condition. Claw toe can cause this kind of pain.

 

Symptoms of metatarsalgia

The main symptom of metatarsalgia is pain at the end of one or more metatarsal bones. The metatarsals are the bones in the sole of the foot, closest to the toes.

 

The pain can be sharp or burning.

 

The discomfort is usually worse when running and there may be a tingling sensation or numbness in the toes.

 

High-impact athletes who also have an inflammatory condition such as bursitis often have more widespread pain in the arch and midfoot.

 

Most often the pain occurs over a period of months, rather than suddenly.

Douleur métatarsalgie

 

Location of metatarsalgia

 

Causes of metatarsalgia

The pain of metatarsalgia is caused by excessive pressure on the front of the foot, especially on the metatarsals. It is often the result of multiple impacts during sports. It may be due to a pathology in your bones or muscles that affects the way pressure is distributed on the feet, for example:

  • A short first metatarsal bone or a long second metatarsal bone
  • Prominent metatarsal heads in a round forefoot
  • Weakness of the toe flexor muscles
  • Claw or hammer toe deformity
  • Short Achilles tendon

Other causes of metatarsalgia include

  • A valgus foot
  • Wearing narrow shoes in the forefoot (a shoe of the right width for your foot will relieve pain quickly)
  • Being overweight
  • Stress fracture of the toes or metatarsals
  • Bunion, which causes the first metatarsal to be out of joint

A condition known as Morton's neuroma also causes metatarsalgia-like symptoms. Extra tissue builds up around a nerve, usually between the third and fourth toes. The irritated and inflamed nerve causes pain.  Morton's neuroma can also cause numbness in the toes in addition to pain in the forefoot.

 

Risk factors for metatarsalgia

Forefoot injuries, including metatarsalgia, are common in athletes who participate in sports that involve regular and repeated running or jumping. While track and field runners are most at risk, other athletes, including tennis, football and basketball players, often injure their forefoot.

 

Other factors that increase the risk of metatarsal pain include

  • Having a sunken foot or a flat foot
  • Wearing high heels
  • Certain diseases that cause joint inflammation, such as osteoarthritis, rheumatoid arthritis and gout
  • Age, as the plantar pad covering the sole of the foot thins over time

Treatment of metatarsalgia

There are several options for the treatment of metatarsalgia.

 


 

Selection foot care products

 


 

Medical treatment

To relieve the pain of metatarsalgia, your doctor or other health care professional may advise you to

  • Avoid high impact activities for a while and support your injured foot when you can
  • Ice the injured foot by rolling it on a frozen water bottle
  • Use a pressure bandage
  • Wear a pair of custom-made orthopaedic insoles
  • Do gentle stretching and strengthening exercises
  • If you have a callus under the forefoot, you can consult a podiatrist to scrape and remove it
  • Choose a shoe suitable for metatarsalgia

Surgical treatment

As a last resort, surgery may be considered to address bony problems or to free a pinched nerve.

Following a thorough clinical examination, the surgeon will decide which surgical protocol is best for you:

  • Shortening osteotomy in case of a too long metatarsal
  • Treatment of the bunion responsible for metatarsalgia
  • Tendon lengthening in case of metatarsalgia due to a short Achilles tendon

Resuming activity

Once the pain is gone, you can increase stretching and strengthening exercises and gradually resume normal activity.  Initially, resume with a low-impact sport, such as swimming.

 

Complications

Metatarsalgia can lead to other problems if left untreated.

To avoid pain and relieve pressure on the painful area of the foot, you may change the way you walk and stand, and this can cause pain elsewhere in the foot, ankle, knee and down to the back or hips.

Finally, a stress fracture can occur if analgesic walking continues for a long period of time.

 

Prevention of metatarsalgia

Taking care of your feet can help you avoid metatarsalgia:

  • Wear shoes that fit your feet
  • Do not wear high heels
  • Use cushioning pads or other foot orthotics recommended by your doctor
  • Have custom-made insoles made for you
  • Prevent horn build-up by seeing a podiatrist regularly
  • Pay attention to your weight
  • Gradually increase the intensity of your physical activity
  • Always stretch and warm up before exercising

Sources

 

Has-sante.fr

Chirurgie-pied-cheville.fr


Author : Philippe Vesin - Pedorthist