An individual with metatarsalgia experiences pain and inflammation in the ball of the foot, usually near the toes. Although it can affect anyone, it is more common in people who run, jump, or wear high heels, which put a lot of pressure on the forefoot. Despite the fact that metatarsalgia can interfere with daily activities and reduce quality of life, it can be treated with proper footwear, rest, ice, medication, and physical therapy. The underlying cause of the pain may require surgery in some cases.
Causes of Metatarsalgia
There are various factors that can cause metatarsalgia, such as:
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Forefoot overuse or injury: A repetitive or excessive amount of pressure on the forefoot can result in inflammation, swelling, or damage to the ball of the foot's tissues, bones, or joints. A sprain, fracture, or bruise can cause this, as can activities involving running, jumping, or changing directions.
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Deformities of the foot can cause abnormal pressure or friction on the forefoot, such as hammertoes, bunions, high arches, flat feet, or long second toes.
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An ill-fitting shoe can cause discomfort or injury to the foot if it is too tight, too loose, too narrow, or too high. In too tight shoes, the toes can be squeezed and blood flow is reduced. In too loose shoes, the foot may slide and rub against the shoe. In too narrow shoes, nerves and blood vessels can be compressed. In too high shoes, the body weight is moved to the front of the foot, which increases the stress on the metatarsals.
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There are other medical conditions that can cause metatarsalgia, including diabetes, gout, arthritis, osteoporosis, and nerve damage.
Symptoms of Metatarsalgia
A common symptom of metatarsalgia is pain in the ball of the foot near the toes. When walking, standing, or wearing shoes, the pain may be sharp, burning, aching, or throbbing, and when resting or removing shoes, it may be better. Metatarsalgia may also cause pain in the toes or arch of the foot. Other symptoms include:
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Affected area is swollen or red
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Toe tingling or numbness
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Having trouble moving or bending your toes
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Foot calluses or corns
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The feeling of having a pebble in your shoe
Diagnosis of Metatarsalgia
The doctor will look for any signs of inflammation, injury, or deformity on the foot, as well as any activities that may have caused or worsened the pain in order to diagnose metatarsalgia. To rule out other possible causes of the pain, the doctor may also perform some tests.
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A foot X-ray is taken to check for fractures, arthritis, or bone spurs
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Inflammation, swelling, or damage to the soft tissues of the foot, such as tendons, ligaments, or bursae, can be detected with ultrasound
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The purpose of an MRI is to get a detailed picture of the structures and tissues in the foot and detect any abnormalities, such as tumors, cysts, and neuromas.
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Infections, inflammations, and metabolic disorders, such as diabetes or gout, can be detected by blood tests
Treatment of Metatarsalgia
Treatment options for metatarsalgia depend on the cause, the severity, and the duration of the pain. These include:
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Most cases of metatarsalgia are treated conservatively. This involves:
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Avoiding activities that aggravate the pain and resting the foot
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Several times a day, apply ice to the affected area for 15 to 20 minutes to reduce swelling and inflammation
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Pain relievers, such as ibuprofen or acetaminophen, can be taken over-the-counter
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It is important to wear supportive shoes that fit well, have enough room for the toes, and have a low heel height
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Using shoe inserts, pads, or orthotics to cushion the forefoot and evenly distribute pressure
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Strengthening and improving the flexibility of the foot with gentle stretches and exercises
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Treatment with medicine: This is used when conservative treatment fails or the pain is caused by a specific condition that must be addressed. It may include:
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Corticosteroid injections: To reduce inflammation and pain in the foot. However, they should be used with caution, as they may cause infections, bleeding, or nerve damage.
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Exercises and stretches can improve the function and mobility of the foot and prevent further injuries through physical therapy.
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A medication is used to treat the underlying condition that may be causing the pain, such as diabetes, gout, or arthritis.
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Surgery is usually reserved for severe or persistent cases of metatarsalgia that do not respond to other treatments, such as hammertoes, bunions, bone spurs, or neuromas.
Prevention of Metatarsalgia
Some simple steps can be taken to prevent or minimize metatarsalgia, such as:
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Eating a balanced diet and maintaining a healthy weight
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Shoes that fit well and are appropriate for the activity should be worn
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Regularly replacing worn-out shoes or shoe inserts
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Limiting or avoiding high-impact or repetitive activities that put pressure on the forefoot
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Exercise warm-ups and cool-downs
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In case of foot pain or problems, seek medical attention immediately
