[Metatarsalgia]

Metatarsalgia is a generic term for complaints in the forefoot and the metatarsophalangeal joints II-IV. However, it does not describe a specific clinical picture but rather a complex of symptoms, which can have different causes. There are mechanical causes, e.g. due congenital or acquired malformations of the foot. Splayfeet with a bunion malformation combined with transfer a common cause. Other examples include brachimetatarsalgia or an instability of the first ray. Other, non-mechanical causes are Morton's neuroma, stress fractures, systemic diseases (rheumatoid arthritis, gout) or infections and aseptic necrosis. Metatarsalgia is described as stress-dependent pain in the ball of the forefoot, which often has a burning or stabbing character. Sometimes a foreign body feeling is reported, as if one were walking on a «pebble». Wearing tight and hard shoes further provokes the symptoms. The therapy depends on the causes and should initially cover conservative options. This includes wearing proper shoes, foot gymnastic/stretching exercise, orthopedic insoles or even orthopedic shoes. Surgical options comprise of Morton's neuroma removal, deformity correction and ligament reconstruction.