What is Metatarsalgia?

General pain in the ball of the foot at the metatarsal head is known as metatarsalgia. Deformity and discomfort can impair gait function and reduce the quality of life. It affects the metatarsals, which are the bones that link the ankle bones to the toes. They are a common source of pain since they bear your weight when you stand, walk, or run. Wearing unsupportive footwear, illnesses such as arthritis, and participating in high-impact activities can all contribute to metatarsalgia. It might be very uncomfortable and disrupt your regular activities, but it usually improves with very easy physiotherapy measures.

What causes metatarsalgia?

Metatarsalgia is commonly caused by increased pressure on the ball of the foot. The following are some of the most common causes of metatarsalgia:

• Poorly-fitting footwear – high-heeled or restrictive shoes can squeeze the ball of the foot into a limited space, increasing pressure on that area.
• high-impact activities – such as jogging or tennis, which place extra strain on the feet.
• Overtraining.
• Intermetatarsal bursitis.
• Tendinosis/tenosynovitis.
• Pes cavus or a high-arched foot.
• Excessive pronation of the foot.
• Clawing or hammer toes.
• A shortened Achilles tendon.
• Inappropriate footwear, particularly shoes with a limited toe box.
• overweight or obese.

SYMPTOMS OF METATARSALGIA:

Metatarsalgia tends to develop gradually over time. It can be felt in a small part of the foot or across its entire width. It is possible that one or both feet will be impacted.

• Metatarsalgia pain has been described as a sharp-shooting burning or painful sensation.
• Numbness or tingling in the toes
•  a sensation as if a little stone has become stuck beneath the foot
• Morning stiffness.
• Symptoms increase when you spend more time standing, running, or walking, particularly barefoot, and improve with rest.

DIAGNOSTIC PROCEDURE:

• History and physical examination.
• Investigations – X-rays can be used to determine the extent of joint deterioration.

TREATMENT AND PREVENTION OF METATARSALGIA:

• rest your feet – Put your feet up on a regular basis and avoid activities that aggravate the pain; Instead of sports that require a lot of running or jumping, choose low-impact hobbies like cycling or swimming.
• use an ice pack – Apply an ice pack to the affected area for around 20 minutes several times each day.
• change your footwear – Try flat shoes with plenty of room for your feet and a well-cushioned sole; replace any worn-out shoes as they may aggravate your condition.
• use shock-absorbing pads or customized insoles.
• maintain a healthy weight.

PHYSIOTHERAPY MANAGEMENT:

The following methods can typically help improve metatarsalgia and prevent it from returning:

Stretchings:

• Calf stretch (sitting and standing).
• Achilles stretching.
• Toe flexor stretch.

Strengthening:

• Toe towel-scrunches: Stand barefoot, one foot in front of the other on a towel. Keep the leg that is touching the towel slightly bent. Scrunch up the towel with your toes while keeping the rest of your foot on the ground. Three sets of 15 scrunch for each foot.
• Marble pickup exercise.
• Ankle band strengthening.
• Calf and toe raise.
• Single leg stance. Do 2-3 sets with 30-60 seconds hold.

Soft tissue mobilization:

Electrotherapeutic modalities:

• In the early stages of treatment, ultrasound or interferential therapy may be useful in reducing pain and inflammation.

Manual therapy is use to increase tissue mobility, range of motion, and pain relief.

Metatarsalgia taping:

Dry needling:

How Stretching & Exercise Help Metatarsalgia Pain

When it comes to treating metatarsal pain, regular exercise has numerous advantages. It is a necessary component of any effective therapy program. Among these advantages are:

• Increased blood flow to the foot and toes to aid in healing.
•  Reduced pain and swelling.
• Flexibility in the foot, ankle and lower body has improved.
• Improved strength and coordination for everyday activities.
• Gait mechanics and overall quality of life have improved.
• Excellent when combined with other treatment options.

MEDICAL MANAGEMENT:

• Orthotics.
• NSAIDS are routinely used to relieve mild to moderate pain. However, you must wear the proper footwear.
• If conservative therapies fail, surgery may be necessary. If there is inflammation (synovitis), a local corticosteroid/anesthetic combination injection may be beneficial.