14. Metatarsalgia

Pain in the forefoot accounts for about half the patients presenting with disorders of the foot. Of these cases, three-quarters present in women and are due to an alteration of the biomechanics of the forefoot, sometimes with primary pathology, sometimes secondary to disorders of the hindfoot. There is variation in the site of the pain, its degree of localisation, its severity and its mode of appearance. Common features are aggravation on standing and walking, progressiveness and irreversibility. The foot becomes increasingly disturbed during static weight bearing and loses its normal rolling action during gait. Secondary effects are produced more proximally. Without effective treatment, the irreversibility of changes will ruin this organ of static loading and propulsion. Etiology, diagnosis and consequent therapy are intricately related.