What is it?

This is a painful condition occurring at the ball of the forefoot in which the patient experiences pain while weightbearing. There is often calluses under the foot as a result of excessive pressure on these areas. Sometimes ulceration may occur if the condition is long standing.

What causes it?

It often occurs following a procedure to the big toe resulting in shortening of the big toe and transfer of forces onto the rest of toes particularly the second toe. A tight calf muscle can also cause pain in the forefoot as a result of the toes pointing more downwards. Other conditions that attribute towards transfer metatarsalgia include arthritis of the big toe and increased mobility of the joint in the big toe.

How do I know if I have it?

There are many causes of pain under the forefoot and the treatment for each is quite different. Anyone complaining of long standing pain should seek consultation with an orthopaedic surgeon to decide if you may be suffering from this condition

What treatments are available?

The underlying issue is increased pressure to the base of the forefoot so therefore treatment strategies are aimed at offloading the involved areas via orthotics. Skin creams are effective at treating callused areas and keeps them soft. Exercises to stretch the calf muscles are very effective if the etiology is due to a tight calf muscle. If the deformity is rigid or conservative measure fail then surgery may be required to resolve the problem.