Metatarsalgia is defined as pain in the ball of the fore-foot which is felt when walking and putting weight on the foot.
Pressure is usually distributed across the metatarsals, with the first and fifth metatarsals taking a larger share of the pressure. Metatarsalgia is caused by excessive pressure on the head of one or several metatarsals.
Metatarsalgia condition
The skin where the excessive pressure is concentrated may thicken and form a callus. Being more a consequence than the cause, only treating the callus is futile and it will probably come back. Treatment should instead aim to reestablish normal weight distribution in the foot.
This essentially involves wearing an insole which will take weight off the callused area. Being overweight places more pressure on your metatarsals, therefore losing weight may also help.
Metatarsalgia surgery
If these measures are unsuccessful or if wearing a support is too restrictive for the patient, a surgery called distal metatarsal minimally invasive osteotomy (DMMO) can be considered. This procedure consists of shortening the metatarsal(s) involved in order to reduce and even out the pressure. It involves making one or several small incisions and can be performed under general or local anaesthetic. No screws or pins are used in this surgery and it can be carried out as an outpatient procedure.
Walking after undergoing this surgery is possible and even encouraged as this allows you to naturally “adjust” the position of the metatarsals by distributing the pressure using your weighting. However, you will need to wear a special shoe for three to four weeks and use a pair of crutches for the first few days, therefore, you will need to rest and take time off work. Pain medication, keeping your foot elevated and applying ice packs to the area will keep the postoperative pain and oedemaSwelling of the foot. to a minimum. That said, even if these precautions are taken, this type of procedure does frequently cause oedema for two to three months. Finally, regular follow-up consultations will be arranged for you.