Course Description:

Metatarsalgia refers to pain experienced on the plantar surface of the forefoot in or around the region of the metatarsophalangeal (MTP) joints. Tenderness, burning, and aching may be described by patients with metatarsalgia, especially during prolonged weight-bearing, running, or jumping activities. There are a number of causes of metatarsalgia, including nerve impingement, fat pad degeneration, excessive pronation, and MTP joint instability. The primary mechanisms in metatarsalgia are mechanical overload and chronic stress on the metatarsal heads of the forefoot, which leads eventually to wear and breakdown. Poorly fitting footwear, excessive participation in lower extremity impact activities, foot deformities, gastrocnemius tightness, and obesity have all been implicated as contributing factors. Conservative management, typically involving the prescription of orthotics/metatarsal pads, activity modification, and footwear education, is the treatment of choice. Surgery is considered in only the most recalcitrant of cases.