The front of your foot or the area where your toes begin is called the forefoot. This area consists of your toe bones, your phalanges and your metatarsals, the long foot bones. This area is where you push off when ambulating and provides stability for forward propulsion. This is a complex anatomical area and more than a few pathologies can exist in this location but I will discuss a few of the most common. These include neuromas, capsulitis and stress fractures.
Neuromas are an entrapped nerve that can cause burning and tingling. These usually occur in the 3rd interspace. Most patients have a sensation that is electrical and is worse in shoes and relieved by taking off their shoes and rubbing the forefoot. These seem to be more common in women than men and especially around the 4th-6th decade of life. Neuromas have some great treatment options available one of most successful is dehydrated alcohol injections. The success rate with these injections approaches 89%.
Capsulitis is a term we use to describe inflammation of a joint. This most commonly occurs in the metatarsophalangeal joint of the foot. We tend to see this in a patient with a bunion or high arched foot. The main cause seems to be a biomechanical imbalance. It is important to get an x-ray with capsulitis as arthritis can have a similar presentation.
Stress fractures usually present with swelling. They often occur as one begins a new training program and can cause pain for weeks. Typically these will be relieved with rest and exacerbated by activity. Most will heal with a change in activities and calcium supplementation. However again an x-ray is warranted to rule out other pathologies and to monitor healing.
If you are having forefoot pain I can help. Schedule an appointment with Dr Brandon Nelson, give us a call at 425-391-8666 or make an appointment online.
Sincerely,
Board Certified Physician & Surgeon
