FOREFOOT PAIN | METATARSALGIA

Forefoot pain (Metatarsalgia) is a common overuse injury that brings pain and inflammation into the ball of the foot. It is most common in high impact athlete's such as runners, and tennis, football, soccer and baseball players. The young are not the only ones affected.  As we age, the fat pad under the forefoot flattens over time increasing stresses to the bony forefoot area which may contribute to pain and pathology.  Metatarsalgia is a "catch all term" for any pain in the forefoot area and not a diagnostic term.

It is important to visit a Chiropodist to determine the true cause of the forefoot pain. The problem may lie in the epidermis such corns and calluses or may be located in deeper synovial tissue (capsulitis, intermetatarsal bursitis) and even may be osseous in nature (sesamoid fracture, march fracture of the 2nd metatarsal head). 

TREATMENT

The primary focus of treatment is restoration of normal biomechanics and relief of pressure in the symptomatic area. Additionally, it is important to control the inflammation in the area with rest, ice, anti-inflammatories and therapeutic modalities. At the Royal City Foot Clinic, we will perform a biomechanical assessment to determine the cause of the pathology. The treatment plan will be developed based on the diagnosis. As stated above, if the cause of the pain is due to corns/callus in the skin the treatment will instantly resolve the pain. However, if we suspect a stress fracture imaging and an aircast to immobilize the area may be required. Ultimately, without a thorough biomechanical assessment and appropriate treatment plan cannot be established. 

WITHOUT TREATMENT

Without treatment the forefoot pain will persist and may aggravate over time. Metatarsalgia is usually treated with conservative treatment options such as proper footwear and orthotics. The prognosis for metatarsalgia is good. However, with delay in treatment, it may take longer to treat and decrease quality of life. It may be difficult to complete daily tasks and lead to abnormal gait compensation.