Pain developing over the ball of the foot (where the plantar metatarsal heads are) can cause a lot of problems with walking and activity. Walking up an incline puts added stress on this part of the foot, and we are seeing an increase of this problem as people are getting outside and hiking more. When this happens, we typically end up walking differently to try to keep pressure off of the painful spots, and then we end up with compensatory pain.
One of the problems with diagnosing this is that there are many different terms for this type of pain. Metatarsalgia, pre-dislocation syndrome, capsulitis and plantar plate tearing all can be used to describe pain that develops generally right behind the second toe. We think some people are set up for this genetically if they have a long second metatarsal that puts too much strain and pressure on that part of the foot.
We will sometimes see acute hammertoes develop if the plantar plate ligament tears more acutely, because the ligament is no longer stabilizing the toe and holding it straight. We also see many patients who think they have a neuroma, when they are really dealing with a problem from the second metatarsophalangeal joint. Neuromas will typically give pain that burns and tingles and goes into the 3rd and 4th toes, but less commonly affects the 2nd toe.
Treatment for this condition includes trying arch supports or custom orthotics, using metatarsal pads or bars, taping or splinting the toes in a plantarflexed position, wearing stiff soled shoes, cortisone or steroid injections, immobilzation in a CAM walker boot, and surgical repair.
If you have any foot and ankle pain, it is not normal and should be evaluated by one of our Colorado Springs expert podiatrists as soon as possible. Prevention can be really helpful in avoiding surgery for many conditions if conservative treatment is initiated before more long term damage has occurred. Our team and Foot and Ankle Institute of Colorado strives to treat you like one of our own family members and we are here to help. Call us at 719-488-4664 today!