Forefoot pain
Ankle pain Bunions Corns and bursa Forefoot pain Heel pain Hip & back pain Knee pain Mid foot pain Shin pain Toe nail conditions Toe problems Verrucae

Forefoot pain

Forefoot pain (often referred to as metatarsalgia), can have many causes. The key is to make an accurate diagnosis and to ascertain the cause for the condition. The Centre uses different techniques including orthotic therapy, mobilisation, rehabilitation, injection therapy and surgery. Kinetic analysis (pressure/force analysis) is one of the key investigations used at the Centre to determine the cause for metatarsalgia. This system is also extremely useful in ensuring that treatment has been effective in normalising forefoot pressures.

Causes for metatarsalgia include:

  1. Morton's neuroma: A condition where the nerve becomes impinged and thickened. If the nerve has not enlarged too much, then non-surgical treatment can be effective. In cases where the nerve is large, injection therapy or surgery may be required. For more information on Morton's neuroma, see our sister site.
  2. Plantar Plate / Flexor Tendon Inflamation: This is probably the most common cause for forefoot pain. Here the metatarsal heads have become over loaded due to foot instability and overload. Non-surgical treatment is generally effective unless the condition has become very chronic.
  3. Stress fractures: These are often seen at the centre and must be diagnosed and managed quickly to avoid a "complete fracture" which can have far more serious consequences. The problem is generally caused by metatarsal overload due to the foot not functioning normally and a full biomechanical assessment is therefore important.

Another common injury seen at the Centre is called Freiberg's Infarction. Here the metatarsal head begins to break down due to compromised circulation. This in turn is caused by a previous injury (commonly a stubbed toe). The Centre offers various treatments ranging from orthoses and specific operations.

Focal pressure and force is the main cause for forefoot pain. Our centre uses advanced systems to measure the individual loading time and magnitude on joints and bones of the foot.

F-Scan image of Metatarsalgia

Treatment focuses on achieving normal loading through footwear change, orthotic therapy and rehabilitation. In chronic cases, surgery is sometimes required to re align bones in the feet.

View our blog posts about arthritis.

Advanced cryosurgery is available for Morton's neuroma

Advanced cryosurgery is available for Morton's neuroma and other conditions

Forefoot pain diagnosis

Diagnostic images of forefoot pain

This patient suffers from forefoot pain and has torn tissue at the base of her toe, called the plantar plate. Only surgery can correct this type of deformity although symptoms can be helped with orthoses.

Foot with plantar plate injury