Metatarsal Pain – Causes, Treatment & Prevention

Metatarsal pain only includes pain that occurs in the area of ​​the metatarsal bones. The symptoms usually occur during physical exertion, for example when walking or rolling. Pain at rest is rare. The different forms of metatarsal pain also differ in that they are present when [[walking barefoot]] or the pain only occurs in shoes. The examining doctor subdivides the metatarsal pain based on the cause of the symptoms and then initiates a suitable therapy.

causes

Metatarsal pain when standing can be caused by nerve irritation or chronic nerve inflammation ( Morton’s neuroma ). The latter is a nerve compression syndrome of the plantar nerves. The complaints are often caused by flat feet/splayfoot. They can also result from the base joints of the toes. This often results from chronic overload.The diseases that can result from this include various forms of capsule injury or arthritis. A connective tissue weakness can be the cause of such arthrogenic complaints. Overloading caused by splayfoot can also lead to damage to the metatarsus. A splayfoot is a widening of the metatarsal bones. A change in the pressure conditions causes a load on the forefoot.

The possible consequences are inflammation in the metatarsal bones or irritation of the metatarsal heads and joints. These symptoms are often associated with misalignment of the big toe, resulting in difficulty standing and walking in the adjacent metatarsal bones. If loaded too early, fractures can also lead to persistent pain in the metatarsal.

Diseases

• nerve inflammation

• nerve compression syndrome

• Senkfuß

• splayfoot

• capsule injury

• Arthritis

• connective tissue weakness

When to the doctor?

If the pain in the metatarsal causes problems with locomotion, a doctor must be consulted. If the foot cannot be set up, rolled over or loaded with its own weight, there are illnesses or injuries that need to be treated. If the pain spreads over the entire foot or in the lower leg, a doctor must be consulted. There may be nerve damage that can spread down the leg.

If there are sensory disturbances in the foot, there may be problems with the circulation that need to be examined. In addition, there is a higher risk of accidents and injuries because the perception of the foot is impaired. If the pain in the metatarsal causes a bad posture of the pelvis or upper body, corrections must be made. There is a risk of permanent damage to the skeletal system if left untreated.

If the metatarsal pain occurs when wearing high-heeled shoes, the footwear must be changed. A visit to the doctor is not necessary in these cases, as it is sufficient to wear closed-toe shoes without heels or, if possible, to walk barefoot for a while. If there is swelling on the feet, skin changes occur or if the person concerned is very overweight, a doctor should be consulted.

diagnosis and course

In order to be able to diagnose metatarsal pain, an anamnesis (detailed doctor-patient discussion) is first required. In addition to the exact symptoms, questions are asked about the shoes and the resulting positions of the foot as well as possible previous illnesses, such as arthrosis or a previous fracture in the metatarsal area. Looking at the feet can also be helpful. This enables the doctor to identify any deformities.

In addition, the foot is scanned to detect calluses, for example. It is also often found that the fat pad underneath the foot, which has a protective effect, is narrower. If the diagnosis is still not certain, the doctor will request an X-ray of the foot. This is especially the case when there is a suspicion of a fracture in the metatarsal area. With the X-ray examination under load (while standing), it is also possible to determine the pressure distribution. As a supplement, high-resolution magnetic resonance imaging examinations help, in order to be able to differentiate the different triggers of pain in the metatarsal. Different causes of the complaints also have different courses and characteristic symptoms.

complications

Metatarsal pain can severely limit a patient’s life. Normal movements or strenuous physical work are no longer possible. Even physical activity can no longer be carried out in most cases with metatarsal pain. The pain is often so severe that standing and walking are no longer possible and the patient is dependent on a wheelchair or crutches and other walking aids.

Metatarsal pain is often caused by diabetes . In this case, treatment by a doctor is necessary. If the pain occurs after a heavy load or after an enduring sport, the foot definitely needs rest and relaxation. As a rule, the pain then disappears after a few days and does not lead to any further complications. Through the abuse of nicotine and alcoholnerves in the foot can be damaged, leading to metatarsal pain. Treatment can be either pain medication or surgery. In most cases, it leads to a positive course of the disease without further complications. However, painkillers should not be taken over a long period of time, as they can damage the stomach.

treatment and therapy

When treating metatarsal pain, first of all general therapeutic approaches are used. If these are not effective enough or if the symptoms become chronic, i.e. last longer than three to six months, pain clinics can offer further multimodal treatment concepts. Basically, the earlier the better. When treating metatarsal pain, it is important to alleviate the symptoms and avoid breaking out again in the future. Therefore, the patient must ensure, for example, that they wear suitable shoes.

Shoes that are too tight and high heels, for example, are unsuitable. With this method, the symptoms can often be improved in many patients. Insoles adapted to the shape of the foot offer additional support, for example in the context of a splayfoot. There are special metatarsal bandages with pads that relieve the metatarsal. Initially, local painkillers may be required to avoid improper gait resulting from the pain. It can also help to cool the affected area with ice for about 15 minutes several times a day. However, care must be taken to ensure that the ice is wrapped in a cloth. It must never come into direct contact with the skin.

An additional program to stabilize and train the foot muscles is also very important, because the loss of muscle function is often the cause of the symptoms. Furthermore, an ultrasound treatment under water and a gentle massage can relieve pain in the metatarsal. If the cause of metatarsal pain is a fracture, the patient will need surgery to heal it. The same sometimes applies to complaints that are far advanced. The middle bones are often shortened and the heads of the metatarsal bones are thus pulled further back. It is also possible to surgically free or remove an irritated or pinched nerve.

prevention

In order to prevent pain in the metatarsal, it is important to pay attention to suitable footwear. The shoes should have a good and springy sole. In addition, they must not be too tight. If you exercise regularly, it is advisable to use insoles that adapt to the corresponding shape of the foot. In women, high-heeled shoes are often the cause of the symptoms. The same applies to sandals without a sole profile. Obesity is also considered to be a cause of metatarsal pain. So it’s important to lower it to take the load off your feet.

If the symptoms result from an injury, physical exercise or strenuous activities should not be started too early. The metatarsus must be given sufficient rest. In general, high-impact sports that put tension on the feet should be avoided. Swimming and cycling, for example, are more foot-friendly. In addition, the feet should be relieved of the body weight as often as possible, i.e. put up or supported. This also makes it possible to prevent pain in the metatarsal.