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One cause of metatarsalgia is Morton's neuroma. When toes are squeezed together too often and for too long, the nerve that runs between the toes can swell and get thicker. This swelling can make it painful when walking on that foot. High-heeled, tight, or narrow shoes can make pain worse. This is common in runners, particularly of long distance.
It is more common in soldiers, but also occurs in hikers, organists, and other people whose duties entail much standing (such as hospital doctors). March fractures most commonly occur in the second and third metatarsal bones of the foot. [1] [2] [3] It is a common cause of foot pain, especially when people suddenly increase their activities. [4]
Localized pain in the forefoot, particularly during weight-bearing activities. The pain is often described as sharp or aching and may worsen with prolonged standing or walking. Swelling Edema around the affected metatarsal head, which can be visible and palpable. The swelling may fluctuate but is generally persistent. Stiffness
Additionally, an intermetatarsal bursitis between the third and fourth metatarsal bones will also give neuroma-type symptoms because it too puts pressure on the nerve. Freiberg disease, which is an osteochondritis of the metatarsal head, causes pain on weight-bearing or compression.
A Lisfranc injury, also known as Lisfranc fracture, is an injury of the foot in which one or more of the metatarsal bones are displaced from the tarsus. [1] [2]The injury is named after Jacques Lisfranc de St. Martin, a French surgeon and gynecologist who noticed this fracture pattern amongst cavalrymen in 1815, after the War of the Sixth Coalition.
Mulder's sign is a physical exam finding associated with Morton's neuroma, which may be elicited while the patient is in the supine position on the examination table. The pain of the neuroma, as well as a click, can be produced by squeezing the two metatarsal heads together with one hand, while concomitantly putting pressure on the interdigital space with the other hand.