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Sunday, January 4, 2015

Metatarsalgia: General Treatment Thoughts

Metatarsalgia: General Treatment Thoughts

    Metatarsalgia mean pain in the metatarsals. I use this general diagnosis for many forefoot problems around the 2nd through 5th metatarsals during the first through 3rd visits with a patient I am beginning to treat until a definitive diagnosis is made (if ever). At the first visit, I have to decide if an x ray is appropriate, and then start treating what I see in the examination. Here are the top 10 initial treatments for metatarsalgia:

  1. Ice pack 2 times daily for 10 minutes, and contrast bathing if swelling is seen each evening the patient is home.dreamstime_m_27030528.jpg
                              Try to find some proper basins for soaking!!

     2. Experiment with various shoes to find the most comfortable. Do heels bother you? Does the shoe need cushion, flexibility, stiffness etc to help? You may be surprised.

     3. Avoid barefoot around the house.

     4. Use activity modification principles to avoid irritations, but expect some minor soreness (Good Pain vs Bad Pain).

     5. If the pain came on suddenly with impact activities, assume a stress fracture. Stress Fractures do not show on x ray for 2-4 weeks after injury, and sometimes never. Start taking 1500 mg calcium and 1000 units Vit D3 (via diet, sun, or supplements).

     6. If you feel you need crutches, definitely see a doctor.

     7. If you feel that the pain is neurological with numbness, burning, electric shocks, tingling, etc, try gentle non painful massage, neural flossing, Neuro-Eze, and see a physiatrist/neurologist  to look into back or sciatic nerve issues.

     8. Purchase an Anklizer Removable boot through Amazon if pushing off hurts a lot.

     9. Begin to strengthen your foot immediately with an exercises that do not hurt. You can go to YouTube and type drblakeshealingsole Foot and Ankle Strengthening Playlist.

    10. See if Hapads or Sole OTC inserts are helpful at relieving some of the symptoms.

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Thank you very much for leaving a comment. Due to my time restraints, some comments may not be answered.I will answer questions that I feel will help the community as a whole.. I can only answer medical questions in a general form. No specific answers can be given. Please consult a podiatrist, therapist, orthopedist, or sports medicine physician in your area for specific questions.