What does it feel like?
Mostly the second metatarsal is involved, especially if it is longer than the first metatarsal, as this puts greater pressure on the head of the second metatarsal, making it more vulnerable to stress injuries.
A dull pain in the ball of the foot behind the 2nd toe, which gets worse on walking, especially in high heels
The affected area may become swollen
The skin over the affected area may also become red
The joint (metatarso-phalangeal joint) becomes stiff and there is pain on moving the joint (a limp during walking)
A cracking or grinding sound when the joint is moved
How is it discovered?
The symptoms, along with X-ray findings, are helpful in confirming the diagnosis. However, in many patients, the condition produces no symptoms at all and is diagnosed accidentally, when the foot is examined for some other problem.
MRI (magnetic resonance imaging) is another helpful investigation method, and is preferred when surgical treatment is planned.
How is it treated?
Many cases are either asymptomatic (no pain or problem) or resolve spontaneously without any treatment. However, if any such problem arises it is better to seek early treatment.
In the early stages, the condition responds well to a conservative treatment approach. This involves:
Rest, no stressful movements or weight-bearing activities. Take a break for 4 to 6 weeks until the symptoms improve.
Use pain killers and anti-inflammatory medicines
Support the foot during walking by using innersoles. Choose comfortable footwear; avoid high heels, use metatarsal pads to support the painful area.
Intensive pain and swelling require applying a cast to completely immobilize the area for about a month.
If the symptoms get worse and a conservative approach fails to solve the problem, surgery is the final solution. It depends upon the extent of damage and may involve any of the following:
Cleaning and removing the damaged bone
Placing new bone at the site (bone grafting)
Shortening the length of the metatarsal bone (osteotomy)
Reconstructing/realigning the joint to eliminate pain and stiffness (arthroplasty)