Metatarsalgia - Painful Foot Joints

Overview, Causes, & Risk Factors

Joints can become painful for a number of reasons. The reasons can range from an injury to a specific joint to an overall condition, such as arthritis, that affects many joints in the body.

What is going on in the body?

Painful foot joints are usually caused by physical stress to the foot. The stress can result from poor bone structure, ill-fitting shoes, being overweight, and overdoing certain activities.

Occasionally, arthritis can cause painful foot joints. Some of the more common conditions caused by arthritis that involve the joints of the feet include:

gout, a metabolic disease caused by deposits of uric acid in the joints

rheumatoid arthritis, a chronic inflammatory disease that affects the joints and surrounding tissues

systemic lupus erythematosus, a chronic inflammatory disorder that affects the skin, joints, and internal organs

psoriasis, a skin condition characterized by frequent episodes of redness, itching, and thick, dry scales on the skin

venereal disease, or sexually transmitted disease

Reiter's syndrome, a group of symptoms consisting of:

arthritis, which is inflammation of the joints

urethritis, which is inflammation of the urethra

conjunctivitis, which is inflammation of the lining of the eye

lesions of the skin and mucous membranes

What are the causes and risks of the disease?

Ignoring the symptoms can lead to the symptoms getting worse. It can also lead to permanent damage to the joints.

Symptoms & Signs

What are the signs and symptoms of the disease?

Symptoms usually consist of pain in one or more joints of the foot. These include:

the joint at the base of each toe

the joints of the toes themselves

the joints of the midfoot

the ankle

The pain can be dull and achy or it can be quite sharp and unbearable.

Diagnosis & Tests

How is the disease diagnosed?

Joint pain is diagnosed based on the location and type of pain, and when the pain started. Tests such as joint x-rays, magnetic resonance imaging (MRI), and computed tomography (CT scans) can help in the diagnosis. If arthritis is suspected, the healthcare provider will order additional testing. If gout is suspected, special blood tests can be done or a small sample of fluid from a joint can be analyzed.

Prevention & Expectations

What can be done to prevent the disease?

Joint pain can be prevented by protecting the joint from further damage. This can be done by:

selecting shoes that fit comfortably

using over-the-counter arch supports

having custom-made supports, or orthotics, built in some cases

having custom-molded shoes made

detecting and treating diseases that affect the whole body, such as arthritis

Individuals should also follow sports safety principles when exercising or participating in sports.

What are the long-term effects of the disease?

The long-term effects of painful feet and joints can keep a person from performing their usual daily routine. It can also keep them from exercising, even from something as simple as walking. This may lead to weight gain, loss of bone mass, loss of cardiovascular fitness, and general disability. The long-term effects of arthritis include increasing deformity of the joints and increasing disability.

Treatment & Monitoring

What are the treatments for the disease?

The most important treatment is to protect the affected joint from further injury. This can include:

careful shoe selection

arch supports

custom-made orthotics

custom-made shoes

A healthcare provider can identify any underlying causes and treat them with various medications such as steroids. A steroid injection into the joint can be helpful. In severe cases, surgery may be necessary to repair or rebuild a damaged joint.

What are the side effects of the treatments?

The side effects of treatment depend on the medications used. Steroid injections give short term relieve, but can contribute to long-term damage. The person may overuse the pain free joint, which can lead to further destruction. Side effects of steroids taken by mouth include thinning of the skin, bruising, osteoporosis, high blood pressure, and elevated blood sugars. There are complications with any surgery or anesthesia. These include bleeding, infection, and reactions to the anesthesia medications.

What happens after treatment for the disease?

A person with custom-made orthotics or shoes should consult the healthcare provider if there is any discomfort. The orthotics or shoes may need to be adjusted after they have been worn for a short while.

How is the disease monitored?

Treatment for arthritis and other conditions that affect the whole body must be constantly monitored. The doses of the various medications need to be carefully checked to be sure that the lowest effective dose is being used. Many of these medications have significant side effects. The side effects need to be monitored closely.