– Metatarsalgia is defined as pain beneath the metatarsal head or shaft.
– It may be due to trauma , inflammation.
– When an excessive proportion of body weight is taken up the forefoot , pain occurs over the plantar aspect of foot.
– It is common in presence of ,
√ Pes cavus
√ Pes plantaris
√ Muscular weakness
√ Wearing high heels
√ Plantar aponeurosis tightness
– Tarsus is made up of 7 tarsals and are arranged in 2 rows.
√ Proximal row :
– Talus above
– calcaneus below.
√ Distal row :
– 4 tarsals lying side by side.
– From medial to lateral : these are medial cuneiform, the intermediate cuneiform, lateral cuneiform, and the cuboid.
– The navicular bone is interposed between talus and 3 cuneiforms.
• The tarsal bones are much larger as well as stronger than carpal bones .
Because they have to support as well as distribute body weight
Each tarsal bones is roughly Cuboidal in shape , having 6 surfaces.
✓ Static Metatarsalgia : found in developmental anamolies like hallux valgus
✓ Relaxation Metatarsalgia : Flexion of MTP joints by interosseous muscle – extend toes – draw the Metatarsals together
✓ Compression Metatarsalgia : Due to foot wear and can lead to neuritis
✓ Fracture of 2 nd metatarsal bone : common cause of chronic mid foot pain.
• Clinical features
– Pain : beneath the metatarsal heads
– Pain increases due to compression of foot .
– Atrophy of interosseous muscle
1) Intrinsic muscle exercise , well designed shoes , strapping is changed at an interval of one week , pad is used to support inner sole and oblique osteotomy of metatarsal necks.
2) Painful stage : Hot packs , contrast bath , TENS and Ultrasound
3) Swelling : Cryotherapy with legs in elevation
4) Speedy ankle toe movements : reduces edema and improves blood circulation
5) Faradism under pressure
6) Gradual re-education of walking.