Metatarsalgia

Last updated
Metatarsalgia
Other namesStone bruise
Specialty Orthopedics

Metatarsalgia, literally metatarsal pain and colloquially known as a stone bruise, is any painful foot condition affecting the metatarsal region of the foot. This is a common problem that can affect the joints and bones of the metatarsals.

Contents

Metatarsalgia is most often localized to the first metatarsal head – the ball of the foot just behind the big toe. There are two small sesamoid bones under the first metatarsal head. The next most frequent site of metatarsal head pain is under the second metatarsal. This can be due to either too short a first metatarsal bone or to "hypermobility of the first ray" – metatarsal bone and medial cuneiform bone behind it – both of which result in excess pressure being transmitted into the second metatarsal head.

Symptoms

Metatarsalgia is characterized by a sharp pain in the ball of the foot.

Causes

One cause of metatarsalgia is Morton's neuroma. When toes are squeezed together too often and for too long, the nerve that runs between the toes can swell and get thicker. This swelling can make it painful when walking on that foot. High-heeled, tight, or narrow shoes can make pain worse. This is common in runners, particularly of long distance. The ball of the foot takes a lot of weight over the years and if running on pavement or running in ill-fitting running shoes, the odds of developing Morton's neuroma increase. Changing to shoes that give the toes more room can help.

Diagnosis

Diagnosis is often done by patient self report.[ citation needed ]

If a patient feels pain in the ball of the foot a podiatrist is the best source for a diagnosis. A podiatrist is a trained expert who can offer treatment options.[ citation needed ]

Treatment

The most common treatments are: [1]

Removing excess callouses may be helpful. In extreme cases, injection or surgery may be indicated. [2]

Related Research Articles

<span class="mw-page-title-main">Foot</span> Anatomical structure found in vertebrates

The foot is an anatomical structure found in many vertebrates. It is the terminal portion of a limb which bears weight and allows locomotion. In many animals with feet, the foot is a separate organ at the terminal part of the leg made up of one or more segments or bones, generally including claws and/or nails.

<span class="mw-page-title-main">Toe</span> Digit of a foot

Toes are the digits of the foot of a tetrapod. Animal species such as cats that walk on their toes are described as being digitigrade. Humans, and other animals that walk on the soles of their feet, are described as being plantigrade; unguligrade animals are those that walk on hooves at the tips of their toes.

<span class="mw-page-title-main">Bunion</span> Deformity characterized by lateral deviation of the big toe

A bunion, also known as hallux valgus, is a deformity of the joint connecting the big toe to the foot. The big toe often bends towards the other toes and the joint becomes red and painful. The onset of bunions is typically gradual. Complications may include bursitis or arthritis.

<span class="mw-page-title-main">Callus</span> Thickened and hardened area of skin

A callus is an area of thickened and sometimes hardened skin that forms as a response to repeated friction, pressure, or other irritation. Since repeated contact is required, calluses are most often found on the feet and hands, but they may occur anywhere on the skin. Some degree of callus, such as on the bottom of the foot, is normal.

<span class="mw-page-title-main">Pes cavus</span> Medical condition

Pes cavus, also known as high arch, is a human foot type in which the sole of the foot is distinctly hollow when bearing weight. That is, there is a fixed plantar flexion of the foot. A high arch is the opposite of a flat foot and is somewhat less common.

<span class="mw-page-title-main">Plantar fascia</span> Aponeurosis of the sole of the foot

The plantar fascia or plantar aponeurosis is the thick connective tissue aponeurosis which supports the arch on the bottom of the foot. Recent studies suggest that the plantar fascia is actually an aponeurosis rather than true fascia. It runs from the tuberosity of the calcaneus forward to the heads of the metatarsal bones.

<span class="mw-page-title-main">Diseases of the foot</span>

Diseases of the foot generally are not limited, that is they are related to or manifest elsewhere in the body. However, the foot is often the first place some of these diseases or a sign or symptom of others appear. This is because of the foot's distance from the central circulation, the heart and its constant exposure to pressures from the ground and the weight of the body.

<span class="mw-page-title-main">Flat feet</span> Deformity in which the foot arches contact the ground

Flat feet, also called pes planus or fallen arches, is a postural deformity in which the arches of the foot collapse, with the entire sole of the foot coming into complete or near-complete contact with the ground. Sometimes children are born with flat feet (congenital). There is a functional relationship between the structure of the arch of the foot and the biomechanics of the lower leg. The arch provides an elastic, springy connection between the forefoot and the hind foot so that a majority of the forces incurred during weight bearing on the foot can be dissipated before the force reaches the long bones of the leg and thigh.

<span class="mw-page-title-main">Ingrown nail</span> Medical condition

An ingrown nail, also known as onychocryptosis from Greek: ὄνυξ 'nail' and κρυπτός 'hidden', is a common form of nail disease. It is an often painful condition in which the nail grows so that it cuts into one or both sides of the paronychium or nail bed. While ingrown nails can occur in the nails of both the hands and the feet, they occur most commonly with the toenails, and for the most part are only problematic and painful on the big toe.

<span class="mw-page-title-main">Chondromalacia patellae</span> Medical condition

Chondromalacia patellae is an inflammation of the underside of the patella and softening of the cartilage.

<span class="mw-page-title-main">Ball (foot)</span> Ball of the foot

The ball of the foot is the padded portion of the sole between the toes and the arch, underneath the heads of the metatarsal bones.

<span class="mw-page-title-main">Morton's neuroma</span> Benign neuroma of an intermetatarsal plantar nerve

Morton's neuroma is a benign neuroma of an intermetatarsal plantar nerve, most commonly of the second and third intermetatarsal spaces, which results in the entrapment of the affected nerve. The main symptoms are pain and/or numbness, sometimes relieved by ceasing to wear footwear with tight toe boxes and high heels. The condition is named after Thomas George Morton, though it was first correctly described by a chiropodist named Durlacher.

<span class="mw-page-title-main">Subungual hematoma</span> Medical condition

A subungual hematoma is a collection of blood (hematoma) underneath a toenail or fingernail. It can be extremely painful for an injury of its size, although otherwise it is not a serious medical condition.

<span class="mw-page-title-main">Morton's toe</span> Type of brachymetatarsia affecting the big toe

Morton's toe is the condition of having a first metatarsal bone that is shorter than the second metatarsal. It is a type of brachymetatarsia. This condition is the result of a premature closing of the first metatarsal's growth plate, resulting in a short big toe, giving the second toe the appearance of being long compared to the first toe.

<span class="mw-page-title-main">Hallux rigidus</span> Medical condition

Hallux rigidus or stiff big toe is degenerative arthritis and stiffness due to bone spurs that affects the metatarsophalangeal joints (MTP) at the base of the hallux.

Mulder's sign is a physical exam finding associated with Morton's neuroma, which may be elicited while the patient is in the supine position on the examination table. The pain of the neuroma, as well as a click, can be produced by squeezing the two metatarsal heads together with one hand, while concomitantly putting pressure on the interdigital space with the other hand. With this technique, the pain of the Morton's neuroma will be localized strictly to the plantar surface of the involved interspace, with paresthesias radiating into the affected toes.

<span class="mw-page-title-main">March fracture</span> Medical condition

March fracture is the fracture of the distal third of one of the metatarsals occurring because of recurrent stress. It is more common in soldiers, but also occurs in hikers, organists, and people whose duties entail much standing. March fractures most commonly occur in the second and third metatarsal bones of the foot. It is a common cause of foot pain, especially when people suddenly increase their activities.

<span class="mw-page-title-main">Cuboid syndrome</span> Medical condition

Cuboid syndrome or cuboid subluxation describes a condition that results from subtle injury to the calcaneocuboid joint and ligaments in the vicinity of the cuboid bone, one of seven tarsal bones of the human foot.

Running injuries affect about half of runners annually. The frequencies of various RRI depend on the type of running, such as speed and mileage. Some injuries are acute, caused by sudden overstress, such as side stitch, strains, and sprains. Many of the common injuries that affect runners are chronic, developing over longer periods as the result of overuse. Common overuse injuries include shin splints, stress fractures, Achilles tendinitis, Iliotibial band syndrome, Patellofemoral pain, and plantar fasciitis.

<span class="mw-page-title-main">Toe box</span> Part of a shoe

The toe box is the section of footwear that surrounds the toes on closed-toe shoes. Toe boxes that are too tight can cause injuries and foot deformities, whereas wider toe boxes may be used to treat or prevent common foot conditions such as Morton's neuroma. Toe boxes come in a variety of shapes and styles of construction, some of which are a matter of fashion, and some of which are designed for specialized functions.

References

  1. "Metatarsalgia - Diagnosis and treatment - Mayo Clinic". www.mayoclinic.org.
  2. "Metatarsalgia Management and Treatment". Cleveland Clinic.