Metatarsalgia
Metatarsal osteotomy for treatment of Metatarsalgia
Ball of the foot pain, also known as as metatarsalgia, can be caused by many reasons including but not limited to: over use, fat pad atrophy, swelling of the metatarsophalangeal joints, abnormal biomechanics, tight calf or Achilles tendon, and hammertoes.
Some other issues can cause pain in this area as well such as neuromas, calluses, and stress fractures which need to be ruled out during your evaluation.
Non surgical treatments consist of shoe gear modification, orthotics with metatarsal pads, anti-inflammatory therapy, activity modification, and can include cortisone injections. Physical therapy may also be implemented.
When fat pad atrophy is suspected a fat pad filler such as Liposana can be injected to relieve pain. Liposana is a natural tissue product derived from human fat tissue, donated by healthy individuals through a strictly regulated process. Fat tissue naturally supports the structure of your feet, helping absorb pressure from every step. Liposana is minimally processed to preserve these natural qualities, providing a supportive framework to help repair or rebuild damaged tissue in your foot, so you can move with greater comfort.
When to consider surgery?
If you have failed multiple attempts of conservative therapy then considering surgery is reasonable.
To restore normal biomechanics and relieve pressure in the ball of the foot your surgeon can do a bone cut known as a Weil osteotomy. This procedure shortens the length of the metatarsal bone thus offloading the plantar foot.
Additional surgical procedures are often performed in conjunction such as hammertoe corrective surgery and Achilles tendon lengthening or Gastrocnemius muscle release.
Elderly patients who are suffering from this condition and where extensive surgery may not be an option can be excellent candidates for a Minimally Invasive floating osteotomy of the affected bone. This involves making a cut in the bone through a small nick in the skin and allowing the bone to move up and float. The patient is walking immediately with minimal discomfort.