What is a Stone Bruise?

Also referred to as Metatarsalgia, a stone bruise is a condition that affects the forefoot. This is the area between the toes and where the foot arcs. A stone bruise is characterized by pain and inflammation on the forefoot or the metatarsal, and more so between the phalanges. This condition occurs when two phalanges misalign and push against a nerve ending, therefore compressing it. It brings irritation to the surrounding nerves, causing them to be inflamed. A scar-tissue layer automatically forms around this area as the body seeks to protect these nerves.  

Causes of a stone bruise

1. Athletics lead to metatarsalgia due to feet overuse or injuries
2. Blunt trauma
3. People suffering from medical conditions such as pes cavus are more likely to suffer from metatarsalgia

Besides these causes, there are risk factors that contribute to this condition. They include:

• Obesity, which puts a significant strain on the feet
• Footwear: high heels add a lot of pressure on the forefoot
• Diabetes, which causes fluid accumulation in the foot as well as nerve irritation
• Age, where the pad that protects the foot thins out
• Arthritis
• Gout

How do I know I’m suffering from a stone bruise?

A stone bruise usually begins as an insignificant pain which, over time, becomes sharp and intense. A stone bruise is characterized by the following symptoms:

• Pain in the forefoot area that intensifies when you are on your feet
• Difficulty in walking, especially when bearing weight
• Tenderness around the forefoot
• Numbness or a tingling sensation on the toes

How is metatarsalgia diagnosed?

Numerous foot problems can imitate the symptoms of metatarsalgia. A podiatrist will analyze your lifestyle and activity level, and observe you as you walk. The podiatrist may also want to know details such as how the pain began, its frequency, your medical history, and your hobbies. An X-ray on the forefoot is done to confirm if the condition is metatarsalgia. In some cases, a blood test may be carried out in order to establish whether there are underlying causes such as diabetes or arthritis.

Metatarsalgia treatment

Home remedies that can help alleviate the symptoms of metatarsalgia include:

• Resting and avoiding any activity that will strain the feet. Walking around with a walking stick or crutches takes the pressure off your feet.
• Apply ice around that affected area at 20-minute intervals throughout the day.
• Compressing the forefoot with a bandage to reduce the inflammation and provide extra support.
• Elevating the foot to a level that’s above the heart helps reduce the swelling and relieves pain.
• Wearing flat, padded, spacious shoes helps significantly reduce the pressure on the forefoot
• Over-the-counter drugs may be used to relieve the pain

If the symptoms persist beyond 5 days, it's best to consult a podiatrist, who may prescribe anti-inflammatory drugs. He may also recommend the use of orthotic devices along with customized insoles. A change of footwear, especially for women who frequently wear high heels, may also be suggested. In extreme cases, a non-invasive procedure that realigns the metatarsal bones may be carried out. Steroid injections are also suggested as a last resort.