The foot has 28 bones. Five of them called the metatarsals extend from the base of the toes to the ankle. Metarsa in the first part of the word metatarsalgia refers to these. The suffix algia, commonly used in medicine to denote pain is derived from algos, the Greek word for pain. Thus, the literal definition of metatarsalgia is metatarsal pain, but the podiatric definition of metatarsalgia is inflammation and pain occurring in the ball of the foot. This is not a dichotomy since the ball of the foot is the fleshy portion between the arch and the base of the five metatarsal bones.
Metatarsalgia has many causes. Some, like high arches or an abnormally long second toe, are structural. Others, like bunions and hammertoes, are caused by ill-fitting shoes or high heels, while conditions like osteoarthritis, rheumatoid arthritis, obesity, and gout can be contributing factors. But a large portion of the patients treated by podiatrists experience metatarsalgia as an unfortunate by-product of running or other high-impact sports. Others are engaged in work that requires them to stand much of the day and who tend to place their weight on the ball of the foot.
Sharp or burning pain that intensifies when walking, running, flexing the foot, or even standing is the foremost complaint of people suffering from metatarsalgia. And it's not uncommon for the area to become inflamed and display bruising or swelling. Other symptoms that may appear over time include numbness, tingling, or a persistent sensation as if walking with a pebble in one's shoe. The pain can intensify when walking barefoot on hard surfaces and improve upon resting.
After listening to the patent's description of his discomfort, the doctor will ask relevant questions, examine his foot, and observe his gait. He may also take x-rays to rule out a stress fracture that could cause similar pain, and in some cases he may order an ultrasound to rule out a Morton's neuroma. Other than this clinical observation, there is no definitive way to diagnose metatarsalgia.
Initial treatment consists of recommending ways to ameliorate the condition such as soaking the foot to soften pressure- causing calluses before using a pumice stone to remove them; placing a metatarsal pad or arch support insert in the affected foot's shoe; restricting footwear to athletic shoes or ones with a rocker sole for the immediate time being; and in the future wearing only shoes with sturdy soles, low heels and wide toe boxes; and giving up walking barefoot on bare wood floors or paved sidewalks and paths
Should none of these work, the doctor may recommend injection of an anesthetic or nerve blocker to relieve the pain or corrective surgery to address any underlying structural abnormalities.
Failing to treat metatarsalgia can result in compensatory limping, which in turn can lead to lower hip or back pain. If you are experiencing several of these symptoms, call Sweeney Foot & Ankle today!