What is Metatarsalgia? 

It is a common overuse injury in which there is DISCOMFORT and inflammation of the ball of the foot (first metatarsal head) and may include other metatarsals heads also. It is common in those that participate in high impact sports such as jumping, track and field, baseball, soccer and tennis.

Factors that may influence its appearance.

The following factors can contribute to excessive localized pressure over the forefoot:

• High level of activity

• Prominent metatarsal heads

• Tight toe extensors (muscles)

• Weak toe flexors (muscles)

• Hammertoe deformity

• Hypermobile first foot bone

• Tight Achilles tendon

• Excessive pronation (side-to-side movement of the foot when walking or running)

• Ill-fitting footwear

Some anatomical conditions may predispose individuals to forefoot problems. They include:

• A high arch

• A short first metatarsal bone or a long second metatarsal bone is often seen in people with a Morton toe; the normal forefoot balance is disturbed, resulting in the shift of an increased amount of weight to the second metatarsal.

• Hammertoe deformity

Any or all of the above musculoskeletal problems may contribute to forefoot trauma in athletes.

What are the symptoms?

Discomfort in the ball of the foot (first metatarsal) or other metatarsals aggravated by walking or running. Patient may also describe the feeling of like walking on marbles or pebbles. 

What treatment work best? 

After the correct diagnosis is made and after you have tried all the common modalities of treatments such as ice, rest, physical therapy, orthotics etc., and before any surgery is considered, you owe it to yourself to try Proliferative therapy. This modality of therapy is very benign and the results are very good.  In a retrospective study done by Dr. Hauser, of 19 patients treated with Hackett-Hemwall hypertonic dextrose proliferative therapy, all 100% had improvements of their pain and stiffness. Eighty-four percent experienced 50% or more pain relief. Dextrose Proliferative therapy helped the patients make large improvements in walking and exercise ability, as well as produced decreased levels of anxiety and depression. One-hundred percent of patients said Proliferative therapy changed their lives for the better. This article was published in the Journal of proliferative therapy.