Metatarsalgia

1. [noun] metatarsalgia (Last edited: Wednesday, 4 October 2023, 10:37 PM) Metatarsalgia (met-uh-tahr-SAL-juh) is a condition in which the ball of your foot becomes painful and inflamed and characterized by pain and discomfort in the forefoot, specifically under the balls of the feet, usually beneath the 2nd and 3rd metatarsals. It is often associated with increased pressure on the metatarsal heads and the surrounding soft tissues. It is usually painful but not typically serious. Activities that can cause a flare up include sports that have running and jumping (high impact sport) particularly when done in poor shoes. Metatarsalgia Pain: typically begins as a dull, aching sensation in the affected area and may progress to a sharp, shooting pain. This condition is often exacerbated by activities that involve standing or walking for extended periods, high-impact sports, or wearing high-heeled shoes. Unlike Morton's Neuroma, Metatarsalgia does not typically present with a clicking or popping sensation, and there is no palpable mass or lump in the foot associated with this condition. Causes: Metatarsalgia can arise from a combination of factors, and while one single cause is possible, it's often a blend of several factors that contribute to this condition. These factors include: Intensive Physical Activity: Engaging in strenuous training or high-impact activities, such as distance running, can increase the risk of metatarsalgia. The front of the foot absorbs significant force during these activities, especially if your footwear is ill-fitting or worn. Foot Anatomy: The shape and structure of your feet can play a role in metatarsalgia. For instance, individuals with a high arch may exert additional pressure on the metatarsals. Also, having a second toe longer than the big toe can shift more weight onto the second metatarsal head. Foot Deformities: Wearing shoes that are too tight or high-heeled can potentially alter the natural shape of your foot. Conditions such as hammertoe (a downward-curling toe) and bunions (painful bumps at the base of the big toe) can contribute to metatarsalgia. Excess Body Weight: Since a significant portion of your body weight is transferred to the forefoot during movement, carrying excess pounds can increase pressure on the metatarsals. Weight loss may help alleviate or eliminate metatarsalgia symptoms. Footwear Choices: Inappropriate footwear, such as high heels that shift extra weight to the front of the foot, is a common cause of metatarsalgia in women. Shoes with a narrow toe box or athletic shoes lacking proper support and padding can also contribute to the condition. Stress Fractures: Small fractures in the metatarsals or toe bones can be painful and alter your weight distribution when walking or running. Morton's Neuroma: This noncancerous growth of fibrous tissue around a nerve typically occurs between the third and fourth metatarsal heads. It shares some symptoms with metatarsalgia and can contribute to metatarsal stress. Symptoms include: Sharp, burning or aching in the ball of the foot Pain that increase when you stand, run or flex your feet and improves with rest. More commonly when walking barefoot and on hard surfaces. Sharp, aching or burning pain in the ball of your foot — the part of the sole just behind your toes “Nerve” sensations/pain in toes (sharp or shooting pain, numbness and/or tingling Complaints of feeling of having a pebble in the shoe when you don’t You might develop it if you participate in activities that involve running and jumping. There are other causes as well, including foot deformities and shoes that are too tight or too loose. Treatment: Rest and Activity Modification: Giving your feet adequate rest and reducing or modifying activities that exacerbate metatarsalgia can be the initial step in managing the condition. Footwear Changes: Choosing shoes with proper arch support, cushioning, and a wider toe box can significantly help. Footwear modifications might involve switching to shoes that provide better shock absorption and reduce pressure on the forefoot. Metatarsal Pads: The use of metatarsal pads or orthotic inserts can redistribute weight and pressure away from the metatarsal heads, offering relief from discomfort. Physical Therapy: A physical therapist can guide you through exercises and stretches that strengthen foot muscles and improve biomechanics, which may reduce the strain on the metatarsals. Anti-Inflammatory Medications: Over-the-counter anti-inflammatory medications, as recommended by a healthcare provider, may temporarily alleviate pain and inflammation. In rare instances where conservative measures fail to provide relief, especially when metatarsalgia is complicated by conditions like hammertoe, surgical intervention may be considered. Surgical options can include procedures to realign the metatarsal bones, which should be discussed thoroughly with a healthcare professional. Not to be confused with Mortons Neuroma : Morton's Neuroma is characterized by thickened nerve tissue, pain between the 3rd and 4th toes, a numbing and tingling sensation progressing to discomfort, and the presence of a clicking sensation and a lump. Metatarsalgia , on the other hand, involves pain under the balls of the feet beneath the 2nd and 3rd metatarsals, starting as a dull ache and progressing to sharp pain, without the presence of a lump or clicking sensation

Source: https://www.mayoclinic.org/diseases-conditions/mortons-neuroma/diagnosis-treatment/drc-20351939