Forefoot Pain – Armadale

The forefoot is a complex region with multiple structures that are prone to injury. Arthritis of one or multiple joints in the forefoot is very common and can be quite painful if the joints are being overloaded. Improving foot mechanics with the use of padding and orthoses can reduce load through certain joints and therefore decrease pain. In severe cases offloading joints to reduce movement is the best treatment option.

Bursitis is another common cause of forefoot pain. Bursas are sacks of fluid, which cushion bony prominences, if these become irritated and inflamed due to too much pressure they can be very painful.

Another common cause of pain and even numbness in the forefoot is a morton’s neuroma. This occurs when the third and fourth metatarsal heads compress and irritate the nerve innervating the toes. Bursitis and neuroma have a similar cause with arthritis, foot mechanics and poor footwear being the most common.

Treatments for both conditions include massage, strapping, padding to reduce pressure between the bones, footwear advice, orthoses and activity modification. If conservative management fails then cortisone may be indicated and various surgical techniques can be used to remove or reduce the bursa or neuroma. Often bursitis and neuroma present together and may need imaging to differentially diagnose them.