Metatarsalgia is a condition affecting the joints between the metatarsal bones and phalanges more often in the second, third or forth toes.  In normal gait we push off from the big toe.  If there is a dysfunction of the big toe we change the way we walk putting more force through the ball of the foot around the second, third and forth toes leading to overstrain of the structures.  The condition is caused by

• First toe dysfunction: shortness, mal-alignment, excessive rigidity or flexibility
• A high arched foot (pes cavus)
• Rigid mid-foot joints
• Over pronation of the foot
• High impact activities (running, jumping and dancing)
• Trauma
• Tight extensor tendons of the toes

Symptoms

• Pain in the forefoot usually of gradual onset
• Pain is aggravated by weight bearing.
• Pain and tenderness aggravated by pressing on the ball of the foot.
• Pain aggravated by extending toes (bending toes up)
• Excess skin or calluses under the foot due to excess pressure.
• Swelling under ball of foot

What you can do

• Padding to protect the foot and re-distribute weight on the foot.
• A gel type shock absorbing and cushioning insole can be worn.
• Footwear with a wide toe box can help.
• Take anti-inflammatory medication (speak to doctor or pharmacist first)

What we can do

• Treatment to modify big toe mobility and alignment
• Mobilisation of joints to improve movement of midfoot
• Massage to reduce tension in extensor muscles on top of foot

Further Treatment options

• Corticosteroid injection into the foot to reduce inflammation.
• X-rays can indicate the amount of degeneration or wear and tear in the joint.

Tags: Foot Pain, Pain around toes