Metatarsophalangeal Joint Pain

Metatarsophalangeal Joint Pain

Metatarsophalangeal Joint Pain refers to joint pain occuring from the metatarsal for an unknown reason. This is usually used because it is not essential to diagnose exactly what is causing the pain, because as long as you elminate a few options, treatment for metatarsal joint pain is usually always the same.

Metatarsal joint pain usually occurs at the prominent part of the forefoot where the toes connect to the metatarsal bones. The most common site of metatarsal joint pain is the second metatarsal but it can spread over to the third, fourth and fifth toes as well. The most common causes of metatarsal joint pain are detailed below.


Metatarsophalangeal Joint Pain

Complete Ball of the Foot Pain Guide


Symptoms of Metatarsophalangeal Joint Pain

  • Pain in the forefoot that is worse with weight bearing.
  • Pain usually begins the longer you are on your feet vs some conditions that get better the more you walk.
  • If you move the toe up and down to its extreme range of motion, it should usually hurt more.
  • If you push on the foot from the bottom, see if a metatarsal is longer or somehow more prominent than the other metatarsal heads.


Most Common Causes of Metatarsal Joint Pain

  • A flat foot which spreads out the forefoot as well as putting more pressure on it
  • Over pronation of the foot.
  • A previously broken, bent or rigid big toe joint that then relies on the other four joints to carry a greater load.
  • Tight footwear- make sure you use a brannock device to properly measure your shoe size.
  • Capsulitis.
  • Bursitis.
  • Long 2nd toe.
  • Short 1st toe.
  • Previous fractures that may have healed improperly and lead to osteoarthritis.
  • Morton’s neuroma or Morton’s Neuralgia.


Home Treatment of Metatarsophalangeal Joint Pain

    • Taping: Low Dye Taping is a taping technique that can recreate the foot arch and can be attempted to maintain supination rather than pronation.
    • Splinting: An offloading pad can be made for your forefoot that has a second toe cutout that is amazing for relieving pain.
    • Ice: This is not just about pain! It will decrease the inflammation and the time needed to heal the forefoot. Put ice in a bag (wrapped with cloth) and apply it for 15-20 minutes until the area starts to become numb. This decreases the effect of inflammatory cells and at the same time boosts the rebound blood flow to the area after the ice is removed.
    • Elevation: Recline in a chair and elevate our foot while watching tv. Like the Ice principle, it flushes the inflammatory cells out of the area and is very important immediately after running or standing for a long time.
    • Pain medication: Ibuprofen or other anti-inflammatories. The goal is to continue it regularly for 1-2 weeks not for pain but to raise anti-inflammation enzyme levels in your blood so that the area has a chance to heal. This is not just for pain!
    • Tight Calf Muscles – Stretching your calves is essential and the cheapest possible cure. This may be the single most important component of reducing pain due to overpronation!
    • Use a Brannock device to properly measure your shoe size: It is essential to measure the foot length, the arch length and the foot width. It is possible that you have longer toes or longer metarsals that require a wider Toe box than you think you need.
    • Combine icing, elevation, non-weight bearing and pain medication gives you the best chance at healing as quickly as possible.
    • Corticosteroid injection at the podiatrist office is highly recommended as it is shown to slightly decrease pain, but greatly increase motion and time of recovery.

What can a podiatrist do for Metatarsophalangeal Joint Pain?

  • X-rays, MRI’s or Ultrasound scans can be used to look inside the foot to view any damage.
  • Blood tests may be taken to diagnose any underlying medical causes such as diabetes or gout.
  • A podiatrist may assess your foot position and gait (walking pattern).
  • If necessary custom orthotics (insoles) can be made.
  • A doctor may inject a corticosteroid injection into the foot.

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