Metatarsalgia Series
Part 2 Metatarsalgia Case Study
Let’s look at Metatarsalgia Case Study!
A 50-year-old female presented with burning pain under the ball of her right foot for the past three months. She reported increased discomfort when walking and while standing for long periods. Symptoms developed gradually with no specific injury.
Clinical Background
The patient works in retail and spends most of the day standing. She has no significant medical history but often wears flat, unsupportive shoes with thin soles.
Symptoms
– Burning pain under the forefoot
– Sensation of walking on a pebble
– Pain worsens with standing and walking
– Tenderness under the metatarsal heads
– Symptoms improve with rest
Clinical Findings
Examination revealed localized tenderness under the 2nd and 3rd metatarsal heads. There was increased forefoot pressure and mild fat pad thinning with no joint restrictions.
Answers
Diagnosis
Central Metatarsalgia (based on localized forefoot pain, pressure distribution, and symptom pattern).
Management Plan
– Prescription of Custom Orthotics with metatarsal support to offload pressure
– Footwear modification with cushioned soles and wider toe box
– Education on proper footwear selection
– Activity modification to reduce prolonged standing (take more rests)
– Follow-up to monitor symptom improvement and adjust orthotics if needed
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