Common name
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Forefoot pain
Who does it affect?
Metatarsalgia is a very common condition, often increasing in incidence with increasing age. Females tend to be more often affected than males.
Why does it occur?
There are many factors that contribute to the formation of the pain of metatarsalgia. Certain foot shapes such high arched feet, or patients with excessively long metatarsal bones, patients with claw or hammer toes, patients with bunions, patients who wear high heeled shoes, being overweight can all contribute to the formation of metatarsalgia.
Symptoms
Well-localised pain in the front of the foot, can be usually felt in the sole and sometimes feeling like ‘walking on pebbles’.
Investigations
Full clinical examination would be required. X-rays would be required to identify any associated risk factor.
Non-operative treatment
Non-operative treatment consists of fitting patients into adaptive shoewear, physiotherapy, and prescribed orthotic insoles.
Operative treatment
Operative treatment is only required if symptoms are interfering with daily activities and the problem is not helped by the simple measures outlined above. Surgery is performed to take the pressure off the metatarsal bones. The surgery can be performed under general anaesthetic, regional anaesthetic (only the leg is made numb), or in some circumstances a local anaesthesia (only the specific part of the foot being operated on is made numb). There are a number of different operations that can be used, dependent upon the exact cause of the metatarsalgia. Sometimes wires may be used to maintain surgically correct position and will be left sticking out of the tips of the toes, usually for a period of about 4 weeks. No plaster post-operatively would be required, patients would be able to fully weight bear on the foot immediately after surgery.