Metatarsal pain

introduction

The five metatarsal bones (ossa metatarsalia) connect the tarsus with the toes and are numbered 1-5 from inside to outside in medical parlance. Pain in the metatarsal bones can have a wide variety of causes, the consultation with a doctor (anamnesis), a clinical examination, the quality and exact location of the pain or an imaging procedure can help clarify this.

Illustration metatarsal pain

Illustration metatarsal pain

Pain
in the metatarsal bones

  1. Metatarsal I -
    Os metatarsi I
  2. Metatarsal V -
    Os metatarsi V.
  3. Phalanx -
    Phalanx proximalis
  4. Inner sphenoid bone -
    Medial cuneiform bone
  5. Middle sphenoid bone -
    Os cuneiform intermedium
  6. Scaphoid bone - Navicular bone
  7. External sphenoid bone -
    Os cuneiform laterale
  8. Lead on the 5th
    metatarsal bones -
    Ossismatic tuberosity
    tarsalis quinti
  9. Cuboid bone - Os cuboideum
    I-I - metatarsophalangeal joints -
    Articulationes
    metatarsophalangeae
    II-II - tarsus metatarsal
    Joints -
    Articulationes
    tarsometatarsales
    Possible causes:
    A - broken bone (Fracture)
    B. - Morton's neuralgia
    (Compression of the nerves)
    C. - hallux valgus


You can find an overview of all Dr-Gumpert images at: medical illustrations

Metatarsal pain caused by trauma

Pain is not uncommon Metatarsal bone caused by trauma, that means they are created by a Damage to the structures of Metatarsus through direct or indirect violence. This can be the case, for example, from falling on the foot heavy objects or by a Sports injury, as well as by a Twist of the foot.

Kick depending on how the accident happened different injury patterns all of which are accompanied by metatarsal pain. For one, can Band structures tear or compress will and small vessels burstso that it becomes a Bleeding into the tissue (Bruise = hematoma) comes from what often Pain and a swelling result. Furthermore, the Bone directly compressed become or breakresulting in increased pain in the area of ​​the Metatarsus especially when occurring, as well as swelling and bruising.

The course of the accident gives that doctor already important information about the type of injury. Then he becomes the foot look closely and look for signs of injury like bruises, Swelling or Misalignments respect, think highly of. If you experience severe pain when you subsequently palpate the metatarsus or if the bones can slide against each other, this is a sign of one fracture. If there is a suspicion of a broken bone, it will be X-ray made of the foot. If the suspicion is confirmed, in the case of complicated fractures, a CT be made to accurately capture the extent of the injury and the therapy to be able to plan exactly. In the event of injuries to Soft tissue (Tendons, Ribbons, etc.), in rare cases it may be necessary to use a MRI image to make. The therapy depends on the injury pattern and consists of simple ones Ligament or tendon injuries, such as Upsets or Bruises mostly off Cool, Elevate and Relieve, sometimes the patient wears one for a few days / weeks Orthosis.
More about this topic can be found: Tendonitis in the metatarsus

So can simple fractures conservative be treated by the foot in plaster will and after approx. 6-8 weeks may be fully charged again.

Is the fracture on the other hand postponed or are several metatarsals affected, so is a surgical procedure necessary. The metatarsals are thereby over Wires (so-called Kirschner wires) with each other fixed and the foot may only be used for the following weeks partially loaded until after about 2 to 3 months of the fracture is completely healed.

A special form of the Fracture the metatarsal is that Stress fracture, not as a result of sudden violence, but after prolonged heavy exposure occurs. This can be the case with, for example Competitive athletes like runners, so the common term “march fracture” is also appropriate.
Marching fractures are a form of the one Fatigue fracture in the metatarsus.
More about this topic can be found: Fatigue fracture in the metatarsus

Misalignments

Various misalignments of the Foot bones can cause Metatarsal pain be. Women in particular often suffer from one hallux valgus, one Deviation of the first metatarsal, which one Tarsus and big toe connects. A surgery is seldom necessary to prevent the onset of pain however the choice is yours correct footwear (by no means too small, pointed or high shoes) of great importance. Most often the hallux valgus as an expression of splayfoot, but just like all others Misaligned feet (Flat foot, Arches foot, Arched feet, Buckle foot) can be changed by a Pressure load in the foot and the following Irritation of nerves, tendons and ligaments cause pain in the metatarsus. Often this can already be done by an orthopedist prescribed insoles and suitable footwear Provide relief.

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Athletes (joggers, soccer players, etc.) are particularly often affected by diseases of the foot. In some cases, the cause of the foot discomfort cannot be identified at first.
Therefore, the treatment of the foot (e.g. Achilles tendonitis, heel spurs, etc.) requires a lot of experience.
I focus on a wide variety of foot diseases.
The aim of every treatment is treatment without surgery with a complete recovery of performance.

Which therapy achieves the best results in the long term can only be determined after looking at all of the information (Examination, X-ray, ultrasound, MRI, etc.) be assessed.

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    60311 Frankfurt am Main

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Further information about myself can be found at Dr. Nicolas Gumpert

Joint disease

The osteoarthritis is a degenerative changes in joints and attacks frequently large joints as the knee or the hip, but not infrequently are smaller joints like that Big toe joint (between the first metatarsal bone and the first joint of the big toe). One then speaks of one Hallux rigiduswho become a painful restriction of movement and subsequently to one changed rolling of the foot when walking leads.

Morton's neuralgia

Morton's neuralgia(Neuralgia = nerve pain) or Morton's neuroma mostly affects people with splayfoot and most often occurs between the third and fourth metatarsal on. The splayfoot position leads to Compression of the nerves running between the metatarsals, Which reactively thicken and remodel connective tissue (Overgrowth of nerve tissue = neuroma). This manifests itself as suddenly shooting in Nerve pain in the metatarsus. Morton's neuralgia is initially diagnosed in the Ultrasonic and then in MRI of the foot. Often it is sufficient as therapy to correct the splayfoot deformity in order to do so to relieve compressed nerves. If this therapeutic approach is unsuccessful, the neuroma can be surgically removedThe aim should be to preserve the nerve.

Metatarsal pain when running

Occurrence of pain in the metatarsal area while running on, this can be a sign of an overload of the structures in the form of smaller ones Torn ligaments, Upsets or even Fatigue fracture in the metatarsus be. Especially with people who, for example, recently used the to jog this is often observed and can be a sign that you have started too fast too much of yourself required Has. The wrong footwear can also lead to considerable pain if this causes the Compressive and impact forces be unfavorably distributed on the foot.
Especially when the load increases quickly while running or the running volume, e.g. When preparing for a marathon is very high, you have to go to one Metatarsal fatigue fracture think.
We have specially written a topic for this purpose: Fatigue fracture in the metatarsus

Pain in the back of the foot can also be caused by walking. Sharp pain is often seen in conjunction with swelling and redness on the back of the foot.
You can find out the cause and treatment options under this topic: Pain in the back of the foot