Metatarsalgia is characterized by a pain and/or burning, and/or swelling on the ball of the fore foot. 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. Classically one or more of these metatarsal heads push down abnormally causing the tissues directly under the 2nd-4th metatarsal bones to start to hurt, burn, or swell. This most often takes place over a prolonged amount of time, of anywhere from months to years.
There are several reasons for this abnormal pressure, but the most common reason is due to the abnormal stress put on the fore foot by Morton’s Toe.
In Morton’s Toe 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 head of the 2nd metatarsal bone. This improper shifting of the weight from the 1st metatarsal bone 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 Toe is a Hereditary condition, that is to say you are born with a short 1st metatarsal.
I feel the problems seen in Metatarsalgia is mostly likely caused by a short 1st metatarsal bone that we see in Morton’s Toe and must be treated first.
Many times you can treat this yourself. In the office we treat Morton’s Toe by using using special padding and strappings, and Physical Therapy 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.