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Causes of Foot Pain Behind the Toes

by Dr. David R. Northcutt
Dr. David Northcutt is a podiatrist and foot and ankle surgeon at Dallas Podiatry Works in TX.

“I’m Dr. David Northcutt and I’d like to give you some information on Metatarsalgia. Metatarsalgia is a generalized term for pain in the forefoot. The pain typically occurs just behind your toes on the bottom of the foot. Oftentimes pain will occur or be worse with walking barefoot on hard surfaces. You may experience metatarsalgia from overuse from activities such as running and jumping. Sometimes this pain can develop by wearing an ill-fitting pair of shoes – this also can include high heeled shoes, due to the excess of pressure placed on the front part of the foot. Certain foot types can cause more weight to be placed on the ball of the feet, which can predispose you to developing metatarsalgia. Another contributing factor includes obesity, which applies excessive pressure to the feet.
Sometimes pain in the ball of the foot can be capsulitis, which typically affects the second toe joint. This occurs when ligaments surrounding the joint at the base of the second toe become inflamed. Pain is usually worse when walking barefoot on hard surfaces. If this is not treated, there will be continued weakening of the surrounding ligaments, which can cause dislocation of the toe, and a hammertoe deformity.
The diagnosis of capsulitis and metatarsalgia will include a history and physical exam of the foot and ankle, including range of motion tests and testing for the stability of the joints. X-rays will be taken. Treatment of these conditions usually begins with resting and ice. It also includes reducing pressure to the area, or anti-inflammatories also can be helpful. Shoe modifications and padding are used to take pressure off of the painful areas and taping or splinting of the toes sometimes can be beneficial.
Usually stretching exercises also are performed if you have tight calf muscles.
If these nonsurgical treatments fail, surgery may need to be performed. If caught early, typically nonsurgical treatments often are sufficient. If you have any symptoms of pain in the front part of your foot, just behind the toes, please contact us at Dallas Podiatry Works. We would love to be a member of your healthcare team.”

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