04/11/2020
Metatarsalgias :
Metatarsalgia is a general term for pain in the area of the metatarsophalangeal joints.
This is often seen in clinical practice, the deformity and pain can deteriorate gait function and decrease quality of life.
Most of the time metarsalgia appears on a hollow foot. On this type of foot, the metatarsals are vertical towards the ground and cause more pressure.
Most common causes include:
- Interdigital nerve pain (Morton neuroma)
- Metatarsophalangeal joint pain
- Sesamoiditis
- Submetatarsal head fat pad atrophy typically associated with aging
Metatarsalgies are often accompanied by excessive callus formation over a bony protrusion, with severe pain and pressure sensitivity around the callus.
Treatments :
- Orthotics :
Shock absorbing insoles with metatarsal pads may help redistribute and relieve pressure from the noninflamed joints.
With excess subtalar eversion or when the feet are highly arched, an orthotic that corrects these abnormal alignments should be prescribed.
- Right shoes ! It’s advisable to have suitable and cushioning shoes.
NO HEELS ! 👠
- Physiotherapy : stretches, strengthening, ice, rest
- Electrotherapeutic modalities such as ultrasound or interferential therapy may be of assistance to reduce pain and inflammation in the beginning stages of treatment.
- Surgery may be needed if conservative therapies are ineffective. If inflammation (synovitis) is present, injection of a local corticosteroid/anesthetic mixture may be useful followed by taping few weeks to bring some comfort
- NSAIDS are most commonly used for the relief of mild to moderate pain.
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