 Metatarsalgia is characterized
by a pain and/or burning, and/or
swelling on the ball of the fore foot.
Classically one or more of the
metatarsal bones, and the tissues,
muscles, bursa, and capsules directly
under the metatarsal bones in the
fore foot area, start to burn, hurt
or swell. This is normally due to
abnormal pressure, over a
prolonged amount of time,
anywhere from months to
years.
There are several reasons for
this abnormal pressure, including
high heel shoes, Arthritis, and hard
walking surfaces, but the most
common reason is due to what's
known as Morton's Syndrome.
There are five metatarsal bones
in our feet. The very end of these
bones in the fore foot area is
called the "head" of the metatarsal
bones. This is what our toe bones
are attached to.
In Morton's Syndrome
the first metatarsal bone,
this is the one that the
big toe bone is attached to,
is unnaturally short. Hence
resulting in a short 1st toe,
or the more classically longer
2nd toe, what is know as
"Morton Toe". Because of
this shortness, the 1st
metatarsal bone can not
support all of the weight
Mother Nature intended it
to support. This excessive
weight has to go somewhere
and in the vast majority of
the time it is shifted onto the
2nd metatarsal.
This atypical
shifting is what causes all of
the pain, swelling and burning
in Metatarsalgia, but may also
be the cause of a Callus
being formed under the
metatarsal heads. Morton's
Syndrome is a Hereditary
condition, that is to say you
are born with a short 1st
metatarsal. About 1/3 of
the population has this.
Treatment
The simplest thing to do to start
with is to change your shoes. If
your problem is caused by the
constant wearing of high heels,
it is a good bet that the odd
pressure put on your fore foot is
contributing to your discomfort.
If high heels is not the problem,
then you can assume the
problem is mostly likely caused
by a short 1st metatarsal bone
that we see in Morton's Syndrome.
At this time professional care is
indicated. In our clinic this problem
is approached on 2 levels. The first
one being to get you out of the pain
you came in with. Be it Arthritis,
Bursitis, capsulitis
and/or myositis (muscle pain), we
use Physical Therapy
and padding and strappings,
to get you out of pain.
Once this is accomplished,
we will fabricate an Orthotic
to rebalance the fore foot and to
accommodate for the short 1st
metatarsal bone. We have found
that by using this treatment protocol,
surgery is rarely if ever needed.
 Back
|