DEFINITION

– 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

ANATOMY

– 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.

• Types

✓ 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

– Tenderness

• Treatment

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.

THANK YOU

BY PHYSIOFEEDS.