Pain in the Foot-ball: Part 1

Well, the season is over.  In NYC, the season was over some time ago anyway.  Not much of a sports fan, however for all my NYC podiatry patients who hail from the Chesapeake, I’m genuinely happy for you, as if my Patriots won.  But this blog isn’t about that kind of football, it’s more about the ball of the foot, as in the ball of the foot (insert your own joke here).  One of the more common complaints in my NYC podiatry office (no, it’s not the wait time) is pain in the ball of the foot.  Most commonly this is due to one of two conditions: metatarsalgia, orMorton’s Neuroma.

Metatarsalgia, or as I like to call it, Manhattanitis, is a very common condition involving pain in the ball of the foot, usually in the area of the second metatarsal, and directly on the bone.  The metatarsal bones are the long bones in the foot, and the ball of the foot is comprised of the heads of the metatarsals.  The best way to imagine this bone is to think of the long bone of a chicken, and imagine that in your foot.  Sorry, it’s an analogy that most of my carnivorous patients, and even some of the vegetarians, can use.  Anatomically, the second metatarsal is usually the longest and lowest of the metatarsals, and subject to more stress than the other metatarsals.  High heels, increased activity, weight gain, walking a lot through the streets of NYC can all generate more force on the area of the ball of the foot, and specifically on the second metatarsal, and that is where the pain is felt, as opposed to a neuroma, which is usually felt in-between the metatarsals.  All that force concentrated in a small surface area means someone needs to see a NYC podiatrist.

So what next?

First, an X-ray may be obtained to rule out a stress fracture.  Next, it’s important to determine the root cause of pain, and we work together on shoegear or lifestyle modification.  This may involve the use of a flatter shoe, specialized padding, and an orthotic.  Cortisone injections can also help to jumpstart the treatment by reducing inflammation.  And the rare case that doesn’t respond to conservative care can be treated with an outpatient surgical procedure.

So if you are walking through the streets of NYC with pain in your foot-ball, consider Manhattanitis.  Could it beMorton’s Neuroma?  Tune in next week to find out…

See you in the office.

Dr. Ernest L. Isaacson