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Forefoot pain

What are the causes of forefoot pain? image

There are many causes of forefoot pain, however the most common is due to abnormal mechanical stresses as a result of:
  * An increase in the intensity of weight bearing or an increase in duration of weight bearing
  * Inadequate footwear or a change of footwear
  * Forefoot, rearfoot or lower limb structural malalignment
  * Injury
  * Build up of skin resulting in a mass of tissue, often creating a localised inflammation and irritation
  * An increase in body weight leading to an increase in overall stress to the forefoot
  * Uneven and unforgiving training and walking surfaces may lead to an increase in ground reaction forces

These can create excessive and prolonged stress on certain parts of the forefoot during gait bearing which leads to greater soft tissue and bone stress resulting in inflammation and or degeneration.
 

Other common causes of forefoot pain may be:

  * Morton’s Neuroma: swelling of the nerves between the metatarsals
  * Sesamoiditis: inflammation of the sesamoid bones beneath the big toe joint
  * Bunions or Hallux-Abducto-Valgus: a structural deformity of the bones and the joint between the foot and big toe normally with an enlargement of bone or tissue around the joint at the base of the
    big toe                          
  * Gout: a type of arthritis caused by a build-up of uric acid in the form of crystals, typically in the big toe joint
  * Corns and callus: skin build-up and excessive pressure often leading to discomfort
  * Verrucae: viral infection with subsequent build-up of a stubborn skin mass
  * Metatarsal fractures: caused by micro-trauma, injury, abnormal biomechanics, malnourishment or over training
  * Joint capsule tears: predominantly from injury and over extension or flexion of the joints

How can we help?
Assessment of forefoot pain is aimed at targeting the cause of the pain whether it be a structural or functional abnormality, localised or systemic, acute or chronic trauma.
Most of these conditions can be treated effectively by conservative means without surgery or pain.
Treatment is often done by reducing the abnormal pressures under the forefoot therefore eliminating undue stress on the various soft tissue structures.
Not seeking treatment may lead to further breakdown of the soft tissues or bone and permanent damage.

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