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De-Feet Metatarsalgia

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Some of my patients have described Metatarsalgia – forefoot pain – as sharp, shooting, pins and needles, dull, pebble-under-the-foot type pain  that returns even after a period of rest.

Metatarsals are the five long bones right behind your toes. Metatarsalgia is a general term that describes pain in the forefoot, typically under the ball or “knuckle
joints” of the foot.  Most metatarsal problems appear when something changes with how your feet work (foot care professionals call that biomechanics).   Some
of these problems may include:

  • Repetitive pressure on the ball of the foot from an activity
  • Claw or hammer toe deformities
  • Excess body weight which places additional stress on the feet in general
  • Thinning or forward shifting of the cushioning fat pads under the ball of the foot
  • Ill-fitted shoes which can place more pressure on the ball of the foot
  • Having a tight calf muscle
  • Diabetes and Arthritis (which are discussed elsewhere)

Usually Metatarsalgia can be treated conservatively. Depending on the cause, treatment options may include:

  • losing weight if overweight
  • modifying or avoiding the activity that causes the pain
  • Wearing properly fitted footwear, including low heels, with cushioning in the forefoot and plenty of toe room
  • Wearing a supportive sandal or shoes inside the home, especially on hard flooring
  • Applying ice to the inflamed metatarsals

If these options don’t improve the foot problem to your satisfaction, you can consult a Canadian Certified Pedorthist who may provide one or more of the following solutions:

  • Footwear advice, including what shoe features to look for to improve comfort and what shoe features to avoid
  • Orthopaedic footwear modifications, such as a forefoot rocker, to relieve the abnormal pressures at the ball of the foot
  • Custom or Prefabricated Foot Orthotics which allow metatarsals to function optimally without bearing excess weight
  • Many pedorthists have a background in another allied healthcare profession and can advise you on proper stretching techniques or will refer you to a healthcare professional who can

Not all foot pain requires medical intervention. However, if the pain persists contact a Canadian Certified Pedorthist directly or consult with your physician for a referral to a Canadian Certified Pedorthist.

Cheers to Happy, Healthy Feet!

Submitted by O’Llenecia Sauvé, M.Sc., C. Ped Tech (C), C. Ped (C) Mississauga,ON

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