Metatarsalgia

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Our feet are flexible structures of bones, joints, muscles, and soft tissues that let us stand upright and perform activities like walking, running, and jumping. In addition, the feet are divided into three sections, such as:

  • Forefoot – The forefoot contains the five phalanges (toes) and the five metatarsals (longer bones).
  • Midfoot – The midfoot is a pyramid-like collection of bones that form the arches of the feet. These include the three cuneiform bones, the cuboid bone, and the navicular bone.
  • Hindfoot – The hindfoot forms the heel and ankle. The talus bone supports the leg bones (tibia and fibula), forming the ankle. The calcaneus (heel bone) is the largest bone in the foot.

Muscles, tendons, and ligaments run along the surfaces of the feet, allowing the complex movements needed for motion and balance. The Achilles tendon connects the heel to the calf muscle and is essential for running, jumping, and standing on the toes.

Metatarsalgia (forefoot pain) is a common foot condition characterized by pain in the front of the foot. When the metatarsal bones are exposed to high levels of stress, they can become inflamed. This leads to symptoms such as sudden or gradually worsening pain in the front of the foot and burning, aching, shooting, tingling, or a numb sensation in the foot. Metatarsalgia is often associated with other foot conditions, including:

  • Morton’s neuroma – A neuroma is a thickening of nerve tissue that may develop in various parts of the body. The most common neuroma in the foot is Morton’s neuroma, which occurs between the third and fourth toes. It is sometimes referred to as an ‘intermetatarsal neuroma’. Intermetatarsal describes its location in the ball of the foot between the metatarsal bones.
  • Metatarsophalangeal synovitis (MTP) – MTP synovitis is a condition that causes pain in the forefoot and sometimes results in an overlapping of the toes. Patients may experience difficulty walking and wearing shoes as the foot becomes more and more inflamed.
  • Avascular necrosis (AVN) – Avascular necrosis (AVN) is a disease resulting in the death of bone cells. If the process involves the bones near a joint, it often leads to a collapse of the surface and subsequent arthritis due to an irregular joint surface.
  • Sesamoiditis – Sesamoiditis is a kind of tendonitis (inflammation of the tendons) that occurs in the ball of the foot. Because the tendons in the ball of the foot have tiny sesamoid bones embedded in them, these bones can become inflamed along with the tendons. The two pea-sized sesamoid bones sit under the big toe joint, where they provide leverage when the tendons load enough weight onto the ball of the foot.

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