Treating and Managing Forefoot Problems

The front of the foot could be considered the front lines of our exposure to the world. Whenever we take a step, the front of our foot and our toes will always be heading into new territory first!

There are certainly some external hazards that we should watch out for (table legs and LEGOs, for a couple). But there are also internal conditions that can interfere with our comfort and mobility.

Some forefoot problems tend to be largely attributable to genetics, while others might be the result of overuse and environmental factors (such as workplace demands). For every condition, however, there is very likely something that can be done to either fully treat the condition or at least significantly manage its symptoms.

Ankle & Foot Specialist of N.J. also specializes in all manner of forefoot problems. We’ll take a closer look at a few of the more common ones here, and then look into some of the treatments that may be recommended.

Never be afraid to pursue treatment for these problems, by the way. If you are worried by the idea of surgery, know that it is almost never the only option!

Common Causes of Forefoot Trouble

The forefoot contains a great many bones, muscles, and other soft tissues, creating plenty of opportunity for problems. Here are a few of the most commonly seen by a podiatrist.

Bunions

A bunion is one of the most easily identifiable problems on the forefoot. It looks like a big, bony bump on the outside of the big toe because… well, that’s exactly what it is.

The joint at the base of the big toe can grow unstable, often based on genetic factors, and begin to shift. The big toe starts to move inward toward its neighboring toes, and the base of the joint begins to jut out from the side.

A bunion will often be painful and irritated from rubbing against the inside of a shoe. It may even develop a corn or callus as the foot tries to protect itself against the point of friction. Stiffness and mobility problems with the big toe are also a significant likelihood over time.

Hammertoes

A hammertoe, much like a bunion, is a deformity that can cause a joint to shift out of its normal stance. In this case, the middle joint of a toe will bend, causing the toe to angle upward in the middle. Bends at other joints of a toe may go by other names, such as mallet toe or claw toe, but are largely similar in shape and symptoms.

A hammertoe can also suffer from the same kind of friction-based problems as a bunion, developing a painful corn from rubbing against the top of a shoe.

While some people may be more genetically likely to get a hammertoe than others, other factors such as past trauma may have caused an imbalance in toe structure that results in the condition.

Metatarsalgia (Forefoot Pain)

Symptoms of metatarsalgia include a sharp or aching pain in the ball of the foot, just behind the toes. You might also feel a shooting pain or tingling in your toes, and it might feel as if a pebble is caught in your shoe.

Pain tends to be worse when you walk, run, or otherwise flex the foot, and tends to get better once you get off your feet.

Metatarsalgia is an overarching condition that can stem from a variety of causes. These can include overdoing it with activities, excess weight, or even a growth of fibrous tissue around a nerve (neuroma).

Stress Fractures

When a bone experiences too much stress—either in a relatively short time or over a sustained period of repetitive use—it may begin to develop small cracks along its surface. Bearing weight on these areas can lead to a sharp, pricking kind of sensation.

Any sort of activity or lifestyle that places a lot of pressure on the bones of the forefoot without providing much opportunity for them to rest and recover will increase the risk of stress fractures.

What to Do About Forefoot Pain

There is no one “cure-all” for every type of forefoot problem. The same type of treatment might not even be the most effective between two patients with the same diagnosis! So much depends not only on the problem involved, but the underlying causes and the needs of the patient as well.

That is why a thorough examination is always the first step in treatment. We must make sure we understand the problem fully, and that includes potential questions about your physical activity, workplace demands, and family history, among other things.

For some conditions, such as bunions and hammertoes, there is one hard truth: there is no way to reverse these conditions without surgery. However, that does not mean surgery is necessary! There are many conservative treatments that can help manage symptoms as well as keep the shifting joint from progressing.

Other conditions, however, such as stress fractures and various causes of metatarsalgia, can be fully recovered from with rest and other forms of assistance.

In many cases of forefoot trouble, whether in treatment or management, some changes may need to be made in order to relieve symptoms, allow opportunity to heal, or prevent future problems from developing. These options might include:

The use of custom orthotics to shift excess forces away from problem areas.
Exercises and stretches that can strengthen or condition necessary muscles and joints.
Changes in footwear or work environment (such as placing a cushioned mat in places you are prone to spend hours standing).
Medications and/or injections for pain management.
Splints and other devices to help hold joints in place at night.
If conservative methods do not happen to provide the results we need, then—and only then—is surgery considered as an option. If it is, we will discuss your options with you fully so you can make the best decision for you regarding your treatment.

Help Should Be Front and Center

If an issue in the front of your foot has been ailing you, no matter how long, taking the step to seek help will be worth it!
Call Ankle & Foot Specialist of N.J. to schedule an appointment at either of our three area offices:

• Warren – (732) 356-3668
• Edison – (908) 222-8980
• Hillsborough – (908) 722-3668