Metatarsalgia
Metatarsalgia is a broad diagnosis for a condition that describes pain around the head of the metatarsals, metatarsophalangeal joints and neighboring soft-tissue. Forces from physical activity applied on the forefoot can cause metatarsalgia. Most cases, around 90%, of metatarsalgia are biomechanically driven.
Symptoms
Pain and swelling around the metatarsal heads or fat pad of the forefoot
Increased pain during physical activity
Having varying overcompensating gaits
Causes
There are three types of metatarsalgia:
Primary Metatarsalgia: This type of metatarsalgia is caused by the anatomical relationships of the metatarsals to each other. In this case, as an example, having a pathological condition in the first metatarsal can cause metatarsalgia in the second metatarsal due to altered biomechanics.
Secondary Metatarsalgia: This type of metatarsalgia is caused by indirect mechanics. This type of metatarsalgia is driven by autoimmune disorders, neurological disorders and conditions like gout.
Iatrogenic Metatarsalgia: This type of metatarsalgia is caused by surgical correction for other pathologies that altered the biomechanics in the foot and caused metatarsalgia.
Diagnosis
To diagnose a patient with metatarsalgia, the clinician will need to observe the past medical history of the patient and also perform a biomechanical examination of the patient. A gait analysis is likely to be needed to correct pathological biomechanics. X-ray and other imaging studies may also be ordered.