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What is Metatarsalgia?

Morton's metatarsalgia is a very unpleasant syndrome, characterized by pain in the foot which makes normal walking difficult and sometimes impossible. The cause of this pain is neurological. Painful metatarsals consider a thickening of the small nerve which is located between the third and fourth leg finger, passing under the ligament which connects two bones in the foot. Although it was initially thought that pain is a consequence of a tumor and the inflammatory process, this theory has eventually been rejected. Nerve thickening simply develops as a response to irritation, trauma or a lot of pressure, and it is even 10 times more common in women than in men.


Symptoms of this condition primarily include pain and burning on the front and bottom of the foot or in the finger roots. The pain is mainly aggravated by physical activity, especially walking and running, and sometimes even by wearing shoes. Also, numbness of foot fingers and front of the foot and other unpleasant sensations in the toes also may occur. Pain will be definitely boosted by wearing tight shoes and shoes with high heels.


During the examination it is important to exclude a whole range of conditions that exhibit similar symptoms. These are: fatigue fracture, especially in athletes, arthritis, rheumatoid arthritis, gout and inflammatory conditions of tendons. Because of that, it is recommendable to do X-ray diagnosis, and if necessary, ultrasound examination. Additional magnetic resonance imaging to confirm the diagnosis is rarely needed. In particular, it is important to thoroughly examine the skin of the lower side of the foot to exclude calluses.


Treatment of this disease seems simple, but experience shows that it is not always effective. Literature usually recommends wearing special orthopedic insoles, comfortable shoes, taking analgesics, or directly injecting analgesics and corticosteroids (blockage) in the thickened nervous zone. If all this does not help, surgery that removes thickened nerve is applied. The results of this procedure may or may not be satisfying. Although the literature rarely or not at all mentions physiotherapy as an option in the treatment of this condition, experience shows the fact that this therapeutic method could be of great help in reducing or eliminating the pain caused by this unpleasant syndrome. There are two basic options. The first is based on the laser and ultrasound therapy. An ultrasound with its microvibrations and a laser with its thermal and photostimulative effect reduce the pain while moving. These treatments in combination with proprioceptive exercises can minimize or completely eliminate pain in most patients. The second option is the therapy of shock wave and it is effective on reducing the sensitivity of pain receptors by hyperstimulative analgesia. It should be combined with exercises, too. In addition to taking care about adequate footwear, as well as quality orthopedic insoles, metatarsalgia is an uncomfortable, but curable pain syndrome that doesn't have to impair the ability of performing daily and sports activities.

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