Written by Dr Gowreeson Thevendran, MBChB (Bristol), MRCS.Ed, Dip. Sports Med.Ed, FRCS.Ed (Trauma & Ortho. ), FAMS (Singapore)
What Is Metatarsalgia?
Metatarsalgia is a condition that affects the metatarsals, which are the bones that connect the ankle bones to the toes. It is a common condition characterised by pain and inflammation and develops when you constantly participate in physical activities involving running and jumping. It could also form due to foot deformities or unsupported footwear. Although metatarsalgia may not be serious, it may still cause discomfort. However, some treatments and remedies can often help manage and relieve symptoms, preventing major foot issues.
Symptoms of Metatarsalgia
Apart from pain under the ball of the foot, metatarsalgia may also be accompanied by swelling, bruising and inflammation. Signs and symptoms include:
- Sharp, aching or burning pain in the ball of your foot
- Numbness or tingling in your toes
- Pain that worsens when you stand, run, or walk, especially when barefooted on a hard surface
- Callus or corn formation under the ball of the foot
- The feeling of having a pebble in your shoe
If you have any of the above symptoms, consult an orthopaedic specialist in Singapore as soon as possible. Untreated metatarsalgia may progress to serious conditions like hammer toes, limping, or pain in other parts of the body. While not all cases require surgery, it may be essential for severe cases like toe deformities or when other forms of treatment have failed.
Diagnosing Metatarsalgia
Before diagnosing your condition, a foot and ankle doctor will examine your foot in both standing and sitting positions. They will also ask you some questions to understand your lifestyle, including:
- What is the nature of your work?
- How much time do you spend on your feet daily?
- What type of shoes do you usually wear?
- Have you started a new physical activity recently?
Your doctor may also order an X-ray to rule out other causes of foot pain. With a bone scan, they will be able to pinpoint the area with inflammation. You may even be asked to undergo an MRI to look for other causes of pain in your midfoot area and metatarsals. The MRI will assess the condition of the soft tissues surrounding your metatarsophalangeal joints. If you have other underlying medical conditions, such as diabetes, make sure to inform your doctor as well.
Non-Surgical Metatarsalgia Treatment
Treatment for your metatarsalgia will depend on the cause of your condition. However, common options an orthopaedic specialist will prescribe you include:
- Have the affected foot rested and elevated
- Applying a cold compress to reduce inflammation and swelling
- Wearing footwear with good arch support and cushioning
- Making use of orthotic inserts or pads that will help redistribute pressure on the foot
- Physical therapy
If your metatarsalgia is more severe due to complications from other foot conditions, your doctor may advise you to undergo metatarsalgia surgery.
Metatarsalgia Surgery
Metatarsalgia surgery is carried out to relieve associated pain and/or help reduce the deformity and prominence of a joint. It targets the metatarsal bones, the long bones in the feet that connect to the toe bones, which are crucial for movement and balance. Here's what you need to know about the process:
- Procedures Involved:
- Bone Repositioning: Adjusting the position of the metatarsal bones to alleviate pressure and pain
- Bunion Surgery: Conducted on the first metatarsal bone behind the big toe to correct bunion deformities. Performed on the second to fifth metatarsal bones to address ulcers or calluses at the bottom of the foot
- During the Surgery:
- You will be placed under general anaesthesia, ensuring you feel no pain during the procedure
- The surgery is typically completed in less than an hour
- After the Surgery:
- Immediate Care: A gauze bandage will be applied to your foot, providing protection and support. This bandage will be removed during your first follow-up visit with the doctor to ensure proper healing
- Stitch Removal: Skin stitches are usually removed in two to three weeks, depending on their location and the healing progress
Recovery Period For Metatarsalgia
Generally, the bone takes six to eight weeks to heal after metatarsalgia surgery. Depending on the nature of your work, the orthopaedic specialist may recommend taking at least a week off to recover at home, with the affected foot elevated after the surgery. Elevating your foot can help prevent fluid accumulation, reducing swelling and pain.
Additionally, ensure your foot remains dry while stitches are in place to prevent infection. The doctor may also require you to wear a knee cast and/or use crutches. In some cases, wearing a postoperative shoe that allows limited walking on the affected foot is recommended.
Dr Gowreeson Thevendran
MBChB (Bristol), MRCS.Ed, Dip. Sports Med.Ed, FRCS.Ed ( Trauma & Ortho. ), FAMS (Singapore)
Dr Gowreeson Thevendran is an orthopaedic surgeon in Singapore who specialises in lower limb orthopaedic conditions, trauma, and fracture surgeries of both the upper and lower limbs. He received his medical education from the University of Bristol and completed his surgical training in the UK and Canada. Before establishing his private practice, he served as Chief of Foot & Ankle Surgery, Department of Orthopaedics at Tan Tock Seng Hospital, Singapore.
Dr Gowreeson Thevendran’s Qualifications and Awards:
- Bachelor of Medicine and Surgery, University of Bristol, England
- Fellow of the Royal College of Surgeons, Edinburgh
- Diplomate Faculty of Sports and Exercise Medicine, Royal College of Surgeons Edinburgh
- Fellow of the Academy of Medicine, Singapore
- SICOT PIONEER Founders Award 2020
- 2015 European Foot & Ankle Society ‘Best Podium Presentation’ Award
- 2013 Singapore Orthopaedic Association Junior Travelling Fellowship
- 2012 NHG Critical Talent Special Recognition Award
- 1998 Enid Lindt Prize in Clinical Surgery
- 1995 Public Services Department Full Medical Scholarship
Languages Spoken:
- English, Malay, Tamil
Frequently Asked Questions About Metatarsalgia Treatment in Singapore
Although metatarsalgia can often be managed with home treatments, consult a doctor if:
- Home remedies do not alleviate the pain
- The pain hinders your daily activities
- Severe pain or changes in foot shape occur, signalling a potentially serious foot issue needing immediate attention
Clinic Location
OrthofootMD@Novena
- Mount Elizabeth Novena
38 Irrawaddy Road #05-42 Mount Elizabeth Novena Specialist Centre Singapore 329563
OrthofootMD@Mount Alvernia Hospital
- (Mount Alvernia Hospital)
820 Thomson Road #01-01/02 Mount Alvernia Medical Centre A Singapore 574623
Dr Gowreeson Thevendran is currently an orthopaedic surgeon with Island Orthopaedic, a one-stop care centre for orthopaedic health under Healthway Medical Group. He specialises in treating lower limb orthopaedic conditions, as well as trauma and fracture surgery of both the upper and lower limbs. Prior to establishing his private practice, Dr Gowreeson was Chief of Foot & Ankle Surgery at the Department of Orthopaedics at Tan Tock Seng Hospital (TTSH). Today, he continues to serve the Orthopaedic Department at TTSH as a visiting consultant.