Metatarsalgia (forefoot pain) / sesamoiditis / fat pad atrophy
Metatarsalgia is a general term used to describe inflammation under the ball of the foot. Metatarsalgia is often located under the 2nd, 3rd, and 4th metatarsal heads, or more isolated at the first metatarsal head (sesamoiditis).
This can be exacerbated by a poor foot structure i.e. a dropped metatarsal head or a collapsing arch. The onset is usually due to excessive pressure over a long period of time i.e. regular use of high heels, tight fitting footwear, poor running shoes or activities with particularly high impact such as jumping. Also as we get older, the fat pad in our foot tends to thin out, decreasing the natural cushioning in the foot and making us much more susceptible to pain in the ball-of-the-foot.
Treatment is determined by clinical diagnosis and often depends on the structural and biomechanical causes to the problem. Common treatments available include change of footwear, additional padding to footwear and/or foot orthoses. All treatments are aimed a reducing pain and protecting the vulnerable structures affected.
Morton's Neuroma is swelling and/or an inflammation of a nerve, usually at the ball of the foot between the 3rd and 4th toes.
Abnormal function of the foot or poor footwear (i.e. tight or high heels) causes the metatarsal bones to compress the metatarsal nerve, causing symptoms such as sharp pain, burning, cramping and numbness in the forefoot. Diagnosis is usually made through clinical examination and/or ultrasound of the affected area.
Symptoms are most prevalent during or after you have been placing significant pressure on the forefoot area i.e. walking or running.
Treatment involves allowing the metatarsals to spread, reducing any compression of the nerve. This is often obtained through footwear selection and an orthotic designed with a metatarsal pad. When the neuroma is advanced in its size and symptoms cannot be alleviated through conservative methods, a surgical opinion may be required.