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Anterior Metatarsalgia, Sports Medicine

Dominic Jacobelli, MD and Kenneth Bielak, MD, FACSM, FAAFP, CAQSM Reviewed 04/2019
 


BASICS

DESCRIPTION

  • Pain in the plantar aspect of the metatarsal (MT) heads

  • Metatarsalgia can be thought of as a symptom rather than a specific disease.

  • Primary metatarsalgia develops from intrinsic facto...

DIAGNOSIS

HISTORY

  • Pain over the plantar surface of the MT heads, typically described as walking with a “pebble in the shoe”

  • Pain is typically gradual and chronic in onset rather than acute.

  • Pain is worse...

TREATMENT

  • Acute:

    • Ice and rest with activity modification

    • Well-cushioned, correctly fitted athletic shoes 1[C]

    • Analgesics such as acetaminophen or nonsteroidal anti-inflammatory drugs (NSAIDs)

    • Calluses sho...

ONGOING CARE

PATIENT EDUCATION

  • Instruct patient about wearing proper shoes and gradual return to activity.

  • Cross training until symptoms subside

COMPLICATIONS

  • Back, knee, and hip pain owing to compensator...

REFERENCES

1
Espinosa N, Maceira E, Myerson MS. Current concept review: metatarsalgia. Foot Ankle Int.  2008;29(8):871–879.
2
Hockenbury RT. Forefoot problems in athletes. Med Sci Sports Exerc. ...

ADDITIONAL READING

  • Baker CL, Flandry F, Henderson JM, eds. Reactive synovitis of the foot—metatarsalgia. In: The Hughston Clinic Sports Medicine Field Manual. Baltimore, MD: Williams & Wilkins; ...

CLINICAL PEARLS

  • Pain of the plantar surface of the forefoot, usually over the MT heads

  • May be caused by abnormal pressure distribution over the plantar surface of the MT heads

  • Common in athletes involve...

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