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Orthopaedics 360

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Metatarsalgia is an umbrella term that is used to describe ball of foot pain. Many different conditions can result in pain in this location. The metatarsals are long bones in the foot that are designed to allow an even weight distribution during walking. When this balance is disrupted, overload occurs, resulting in ball of foot pain.

 

 

What conditions cause ball of foot pain

 

Metatarsalgia can be classified as primary or secondary metatarsalgia.

Primary Metatarsalgia

Ball of foot pain occurs in this situation due to altered biomechanics of the 1st metatarsal. Excessive weight transfer occurs through the lesser metatarsals (smaller toes) resulting in overload pain.

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Examples include Bunion deformity and Great toe arthritis (1st MTP joint)

 

Secondary Metatarsalgia 

This group includes specific conditions that can affect this region of the foot resulting in pain.

 

Secondary Causes of Metatarsalgia

Mortons Neuroma

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A morton’s neuroma is a painful condition that affects the ball of your foot. It is a painful enlargement / thickening of the nerve that supplies sensation to the skin between your toes. Most commonly these occur in the 2nd and 3rd webspaces of the foot. Classically people describe the sensation of walking with a pebble in their shoe. Nerve irritation can cause a tingling sensation, numbness, or burning.

MTP Joint Bursitis

A bursa is a ‘sac like’ structure that is found in many locations in the body. When the bursa becomes inflamed, this results in bursitis. Bursal inflammation between the metatarsals can result in ball of foot pain.

Freiberg’s Disease

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This is an uncommon condition that results in collapse of the joint surface of the 2nd metatarsal head. Pain, swelling, and stiffness occur. Freiberg’s disease most commonly affects young / middle aged females.

Stress Fracture

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Stress fractures occur during periods of overload or a recent change in activities (i.e taking up long distance running) . The most common site of a stress fracture in the foot is the metatarsal bones. Stress fractures have poor healing potential if high work loads are maintained.

 

 

Bunions

Myths Exposed

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Making the Diagnosis

A detailed assessment is required

Dr Smith will conduct a thorough history to determine what is the likely cause for your ball of foot pain. As outlined above, there are many causes that need to be considered, and each of these has a different treatment plan. A detailed examination of your foot will assess for the exact location of your tenderness, determine the likelihood of you having a neuroma, and assess whether the function of your great toe is contributing to your pain.

Plain weight bearing xrays are performed to check for arthritis, stress fractures, Freiberg’s disease, and the relationship of your metatarsals (foot bones).

Once a diagnosis is confirmed, a treatment plan is initiated.

 

Want to know why your feet hurt?

Come in for an assessment with our foot and ankle surgeon

Been told you have a neuroma?

Day Surgery neuroma excision

Metatarsalgia Treatment

Generic treatment options for ball of foot pain include offloading orthoses, pre-metatarsal pads, and stretching exercises. If ongoing pain is an issue, then further intervention may be required. Targeted ultrasound guided steroid injections also play a role.

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Is your ball of foot pain continuing to bother you ?

Difficulty walking

Pain under your foot

Feels like your walking on stones

Disclaimer: Please note that this is general advice only - for more information, please consult your regular doctor, or obtain a referral to see a specialist orthopaedic surgeon. 

Orthopaedics 360

Orthopaedics 360

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Southern Specialist Centre

Orthopaedics 360

P: (08) 7099 0188

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Health @ Hindmarsh

Orthopaedics 360

P: (08) 7099 0188

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Rugby Union SA partnership

Orthopaedics 360 are proud to be partnered with Rugby Union SA. With one of the most active sporting clubs in South Australia, we have acknowledged the growing need for customised care for the growing and established athletes.

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