What are the most common forefoot problems?
Last update: 24 February 2020
Problems with the forefoot (palm of the foot) can be very painful on a daily basis. In addition to pain and inflammation on the sole of the foot (metatarsalgia), there are various other issues that may occur:
- Bone deformity
- Feeling of numbness
- Foot lesions
- Restricted movement
If the palm of your foot is sore, misshapen or irritated, it is important to consult a podiatrist quickly to prevent the situation from getting worse.
Let’s take a closer look at the most common forefoot problems most frequently treated in podiatry.
Metatarsalgia is one of the most common problems of the forefoot. It includes all the pain felt in the palm of the foot. This includes the metatarsus (which includes the 5 longest bones of the foot) and the phalanges. The pain, which is often acute, is heightened when standing up. It may be focused on a specific part of the forefoot or it may be present over the whole of the forefoot.
This pain in the forefoot is caused by an inflammation of the sole of the foot (metatarsal heads). This is an area that is under great strain, and subject to a lot of pressure when walking. As a result, complications may occur for a variety of reasons, resulting in metatarsalgia.
Metatarsalgia can occur for a variety of reasons. Sports injuries, arthritis, or wearing shoes that are too tight can be a contributing factor. It is often necessary to wear orthotics or inserts to relieve this pain in the metatarsal heads.
Bunion (hallux abducto valgus)
Bunions (hallux abducto valgus) are a frequent problem of the forefoot caused by a deformation of the first metatarsus. The big toe can sometimes deflect towards the second toe, creating a hump on the side of the foot. Hallux abducto valgus can occur on both feet at the same time. Its severity depends on the intensity of the deviation.
If not treated promptly, this hump can become painful. When it comes into contact with footwear, the resulting friction can also be very undesirable. Over time, this friction can cause inflammation. In extreme cases, it may be difficult to wear shoes.
Hallux abducto valgus can be triggered by various causes:
- Rheumatic diseases, such as arthritis
- A foot injury
- Poorly fitting shoes
Bunions generally occur in women aged 40 to 50. Overall, women represent approximately 90% of the population affected by this deformation.
One reason for this is that women’s joints are often more unstable. In addition, the foot muscles tend to relax during menopause. Wearing high heels may also be a contributing factor.
If the bunion becomes too large, it may be necessary to wear a special foot orthotic or orthopaedic shoe. Consult a podiatrist as soon as possible if you notice an abnormal bump on the outside part of your feet.
Hammer toe is also included in the problems of the forefoot often encountered in podiatry. The forward bending of the toe joints causes this deformation of the forefoot, which causes discomfort. The contraction of the toes causes an uncomfortable strain on the foot.
Of all the toe deformities, hammer toe is the most problematic because the deformation is more pronounced. Often, it is the second toe that is most affected. If not treated, over the long term this can lead to bursitis, corns or calluses on the feet.
In some cases, hammer toes are the result of a bunion. Other factors may also be involved:
- Wearing shoes that are too narrow
- A biomechanical problem
- Joint inflammation
Hammer toes usually cause a burning sensation at the sole of the foot. There are a few home remedies to help relieve discomfort, but it is essential to consult a foot care professional if the pain persists.
Your podiatrist can evaluate any mechanical problems with your foot and establish the most appropriate treatment for your condition. Sometimes you will need to wear a loose, cushioned shoe. In some rare cases, an operation to correct the bone deformation may be necessary.
Foot calluses are callosities that form hard, thick bumps on the skin. These mainly affect the toes or the palm of the foot. These forefoot problems occur when your foot’s skin is exposed to friction or excessive pressure. This forefoot problem can also occur between the toes, which is called a severe corn.
Calluses are different than warts, even if they may appear similar at first glance. Warts are viral, benign and contagious, while calluses are smaller, deep, non-contagious and painful.
This pain in the forefoot can be caused by:
- Improper footwear that does not adequately support your feet
- Frequently wearing shoes without stockings
- Poor foot care
- Hammer toes or other toe deformations
In order to prevent calluses, you must keep your feet dry, avoid overstressing them, apply moisturizing cream and practise proper foot care on a regular basis.
While calluses can be treated with certain creams, callus plasters or pumice stones, it is nevertheless necessary to consult a podiatrist for the purpose of prevention or relief. The use of orthopaedic insoles is sometimes used to correct the situation. Don’t wait until the calluses on your feet become painful or too big!
Morton’s neuroma is a condition in the forefoot that often requires surgery. This pathology is not visible to the naked eye. This problem is due to a nerve that becomes painful, normally between the 3rd and 4th toes.
The compression of this nerve causes inflammation in your foot, which often causes intense pain in the foot’s metatarsal heads. The pain can feel like a tingling, swelling, burning sensation or small electrical shocks in the forefoot.
In addition to plantar nerve compression, caused by footwear that is too tight, some other causes of Morton’s neuroma can include:
- An old foot injury, left untreated
- Flat or hollow feet
- Excessive foot pronation
As with bunions, women experiencing menopause are predominantly affected by Morton’s neuroma. However, everyone should be more vigilant.
Morton’s neuroma can be relieved with anti-inflammatory drugs or ice. However, it is often necessary to seek the assistance of a podiatrist. They can perform an ultrasound scan to clearly see the structure and treat it effectively. Ultrasound-guided cortisone injections or the use of plantar orthotics are sometimes necessary.
Capsulitis is a condition of the forefoot that affects all of your body’s joints. Capsulitis mainly affects the shoulder, but it can also affect the foot, knee, jaw or elbow. It is an inflammation of the capsule, a fibrous membrane that surrounds all your joints.
The swelling of the capsule produces a feeling of stiffness and limits your movements. This condition affects your daily life, as it makes it more difficult for you to travel.
This condition can be caused by various reasons:
- Sedentary lifestyle
- Excessive pressure on the joint
- Trauma to the system
To properly recover from capsulitis, it is necessary to perform specific exercises on a daily basis in order to regain mobility and reduce the stress on the joint when walking or running. As mentioned above, taking anti-inflammatory drugs and cortisone injections can be an effective solution. Taping, physical manipulation and orthotics are also recommended solutions for treatment. The podiatrist can also take an ultrasound scan of the foot to more accurately evaluate your condition.
Seek prompt medical attention if you think you may have capsulitis. This will help you to regain greater mobility and freedom of movement.
Treating metatarsalgia and common forefoot problems through podiatry
It is always advisable to consult a podiatrist to effectively treat any forefoot pain (metatarsalgia) and other conditions affecting the sole of your foot. This foot professional has all the equipment and expertise necessary to properly diagnose your situation and establish the best treatment.
Don’t wait for the pain to become unbearable. Contact a PiedRéseau clinic near you to regain your health. We have more than thirty clinics throughout Quebec to ensure you receive the service you require.