Who does it affect?
Metatarsalgia is a very common
condition, often increasing in incidence with increasing age. Females
tend to be more often affected than males.
Why does it occur?
There are many factors that
contribute to the formation of the pain of metatarsalgia. Certain foot
shapes such high arched feet, or patients with excessively long
metatarsal bones, patients with claw or hammer toes, patients with
bunions, patients who wear high heeled shoes, being overweight can all
contribute to the formation of metatarsalgia.
Well-localised pain in the front
of the foot, can be usually felt in the sole and sometimes feeling like
'walking on pebbles'.
Full clinical examination would be
required. X-rays would be required to identify any associated risk
Non-operative treatment consists
of fitting patients into adaptive shoewear, physiotherapy, and
prescribed orthotic insoles.
Operative treatment is only
required if symptoms are interfering with daily activities and the
problem is not helped by the simple measures outlined above. Surgery is
performed to take the pressure off the metatarsal bones. The surgery can
be performed under general anaesthetic, regional anaesthetic (only the
leg is made numb), or in some circumstances a local anaesthesia (only
the specific part of the foot being operated on is made numb). There are
a number of different operations that can be used, dependent upon the
exact cause of the metatarsalgia. Sometimes wires may be used to
maintain surgically correct position and will be left sticking out of
the tips of the toes, usually for a period of about 4 weeks. No plaster
post-operatively would be required, patients would be able to fully
weight bear on the foot immediately after surgery.