What is metatarsal drop and what causes It?
Metatarsal drop is a condition in which intense pain occurs in the sole of the foot, making walking difficult. The causes of metatarsal drop can include:
- The presence of hallux valgus (bunion).
- Metatarsal disproportion.
- Short Achilles tendon.
- Arthritis that accompanies metatarsal drop, such as stiff big toe, degenerative arthritis of other toes, rheumatoid arthritis, or gout.
- Morton’s neuroma.
- Age, as the likelihood of development increases with age.
- Increased body weight.
- Gender, as it is more common in women.
- A previous injury with foreign body penetration and persistence, leading to pain and inflammation.
- Stress fracture.
Sometimes, there may not be a clear cause. In these cases, metatarsal drop may result from prolonged use of inappropriate footwear, wearing high-heeled shoes, or chronic strain from physical activities such as running.
What symptoms are associated with metatarsal drop?
The characteristic symptom of metatarsal drop is pain in the sole of the foot, just before the toes, which occurs while walking. Typically, this pain is more pronounced in the morning and worsens throughout the day. The sensation reported by patients is often described as feeling like a pebble constantly present under the foot, causing intense pain and discomfort.
How is metatarsal drop diagnosed?
The orthopedic specialist can diagnose metatarsal drop based on the clinical presentation of the patient. The patient’s foot often shows painful calluses due to excessive and chronic pressure at this point. In addition to the clinical examination, a proper diagnosis is supported by radiographs of the foot, and sometimes magnetic resonance imaging (MRI) and pedography. To exclude other conditions, such as rheumatoid arthritis or gout, specific blood tests are recommended, which help the orthopedic specialist obtain a clear understanding of the diagnosis.
What treatments are recommended for managing metatarsal drop?
Metatarsal drop is generally not a severe condition, but it can negatively affect the patient’s daily activities. Rest, ice therapy, the use of appropriate shock-absorbing footwear, custom insoles, and anti-inflammatory medications can relieve symptoms and assist in managing the initial stages of metatarsal drop. If the symptoms persist and pain does not subside, surgical intervention may be required. Since there are several procedures to address the condition, the choice of the appropriate method depends on the causes of the metatarsal drop, the patient’s age, body weight, and lifestyle. Some of these methods include correction of hallux valgus, shortening of the affected metatarsals, and corrective osteotomies of the metatarsals. These surgeries are performed using minimally invasive techniques, ensuring optimal results for patients. After the procedure, patients can walk (within a short time) and do not require hospitalization. The recovery period typically lasts 2 to 4 weeks, depending on the type of procedure performed.