Forefoot Pain by David Webby
The most common pains in the feet are usually associated with the heel or the arch, but at time the ball of the feet can develop acute symptoms.
Symptoms could include intense or aching pain. It could also be sharp pain with numbness or pins and needles.
The term ‘Metatarsalgia’ is sometimes used to describe pain associated with the forefoot. This can refer to simple, sometimes complex pain, and can refer to bruising around the Metatarsal heads.
Pain that is not specifically diagnosed requires further examination and assessment to determine the possible causes and resulting condition.
Common conditions include:
Capsulitis – inflammation of the soft tissue capsule or cartilage of the joint
Plantar plate tears– rupture of the transverse ligament across the Metatarsals resulting in the toes to become splayed, sometimes painful.
Neuromas– Irritation of the nerve that runs between the Metatarsals, causing thickening. Can cause burning sharp pain, and pins and needles in toes.
Metatarsal fractures– Forces to the Metatarsal bones can result in stress fractures to the 2nd, 3rd or 4th Metatarsal shafts. Can be very painful to walk.
Sesamoiditis– Inflammation of the small bones under the first Met head. Sometimes these bones can fracture if there has been severe forces applied.
Distal planter fasciitis– Inflammation of the planter fascia towards the toes.
Plantar fasciitis is mainly associated with heel pain, but inflammation of the long band of tissue that connects the heel and the Metatarsals can also occur at the Metatarsal end, depending on the stage of gait during which those excessive forces occur.
Sometimes we see micro-tears along the planter fascia ligament resulting in lumps in the band of tissue, which we call fibrotomas.
Osteoarthritis / Inflammation – Any malalignment of the joints can cause Osteoarthritis or beginnings of inflammation/degeneration of the cartilage.
Gout – An excessive amount of Uric acid in the blood (but not always), can cause destruction of the joint margins, resulting in destruction of the joint.
Often associated with intense pain, swelling, and redness.
Affects mainly the big toe joint, sometimes smaller toes, and the ankle.
Hallux Limitus/Rigidis – Osteoarthritis of the 1stMPJ (Big toe joint), which results in the dorsal degeneration and bone lipping of the upper joint margin/articular surface, resulting in jamming/reduced range of motion of the joint. (normally the big toe can dorsiflex up to 65 degrees. Jamming of the joint can cause significant reduction in range of motion, and can finally become fused.
Bunions – Depending on foot shape, gait, and shoes, bunions can develop out of their normal alignment due to abnormal; forces on the joint.
Osteoarthritis can develop if joint margins are irritated resulting in a build-up of bone over the prominence. This may or may not cause joint pain, but can be irritated by shoe pressure.
Bursitis – A fluid sac may develop between the skin and the bone over bony prominences, in order to protect the bone. There are naturally occurring Bursa’s all over the body, but they can become inflamed if frictional forces are excessive.
Other skin conditions – Corns and calluses can cause extra pressure on nerves over bony prominences, thus cause pain. Corns can also be found between toes, and can break down and ulcerate. Warts often also irritate nerves in the surrounding tissue so painful with pressure. Ingrown toe nails can also be very painful and difficult to fix, particularly if there is pressure on nerves in the sulci, or if there is q spicule of nail.
What can we do for you:
It is important not to second guess these issues but have a professional assessment and treatment plan. Treatment plan is based on the diagnosis, so the Podiatrist may include Xrays or Ultrasounds with the initial assessment to determine the condition, in order to implement the appropriate treatment plan.
Podiatrist are trained professionals in assessing and treatment of feet and lower limbs.
Ring 6229 9844 to make an appointment, or go to online bookings on this website.