About the condition
Lesser MTP Pain, Including Capsulitis, Plantar Plate Tears, and Transfer Metatarsalgia (Biomechanical Overload)
What is Lesser MTP Pain? Lesser MTP (metatarsophalangeal) pain refers to pain in the joints of the lesser toes (second to fifth toes). This pain can be caused by conditions such as capsulitis, plantar plate tears, and transfer metatarsalgia (biomechanical overload).
Capsulitis Capsulitis is the inflammation of the joint capsule surrounding the MTP joint. It often affects the second toe and can cause pain and swelling.
Plantar Plate Tears The plantar plate is a thick ligament that supports the MTP joints. Tears in the plantar plate can cause pain, instability, and deformity in the affected toe.
Transfer Metatarsalgia (Biomechanical Overload) Transfer metatarsalgia occurs when there is excessive pressure on the metatarsal heads, leading to pain and inflammation. This can be caused by biomechanical imbalances, such as high arches or flat feet.
Symptoms
• Pain and swelling in the ball of the foot.
• Tenderness around the affected MTP joint.
• Instability or deformity in the affected toe.
• Pain that worsens with activity.
Causes
• Overuse or repetitive strain on the MTP joints.
• Wearing improper footwear.
• Foot deformities such as high arches or flat feet.
• Previous injuries to the foot.
Diagnosis A podiatrist will diagnose lesser MTP pain based on your medical history and a physical examination of your foot. Imaging tests such as X-rays, ultrasound, or MRI may be used to assess the severity of the condition.
Treatment
• Relative Rest: Avoid activities that put stress on the MTP joints.
• Symptom management: Apply ice, using analgesics and/or ibuprofen, massage, stretches and night splints can help manage short term symptoms
• Fracture boot: often given initially in A&E but can be bought online cheaply in the acute stage.
• Footwear: Wear supportive shoes with good longitudinal support and cushioning under the ball of foot. HOKAs are ideal
• Orthotics: Use custom orthotic devices to support your feet and reduce pressure on the metatarsal head.
• Physical Therapy: A physical therapist can provide exercises and treatments to help alleviate pain and strengthen the foot.
• Injections: Corticosteroid injections may be used to reduce inflammation.
• Surgery: In severe cases, surgery may be necessary to repair the damaged structures and correct any deformities.
Prevention
• Wear supportive footwear with a wide toe box.
• Avoid high-heeled shoes.
• Take breaks and rest your feet during activities that put pressure on them.
• Maintain a healthy weight.
