Metatarsophalangeal Joint Pain: The Complete Guide

Did you know that metatarsophalangeal joint (MTP) pain can be the reason for foot pain? This joint links your bones and toes to the main part of the foot. Many factors can cause pain. Luckily, it is manageable and treatable. Learn what causes MTP joint pain and how it gets treated in this article. Get a consultation with the best Podiatrists in Brooklyn.

Causes MTP joint pain

Metatarsophalangeal joint pain is caused by two main factors – biomechanics and arthritis.

1. Biomechanics:

It means the way your bones, muscles, joints, tendons, and ligaments work together, along with the forces and stresses you apply to them when you move. When this biomechanics goes off balance, pressure from weight-bearing shifts toward the front of the foot, where your toes and MTP joints are, causing the following problems that cause pain and other symptoms:

• Bunions: It is a bony deformity that occurs on the side of the MTP joint of your big toe. This occurs when the big toe pushes against your second toe, forcing the end of the bone in the MTP joint to stick out. It can also occur in the little toe, which is known as a bunionette. Mostly, it is caused due to wearing poorly fitting shoes.
• Turf Toe: This happens when the foot pushes off the ground with the heel lifted, like when you play football and run from a crouched position. Too much force on the big toe and overextension may stretch the tissue, causing pain and swelling, and may even partially or completely tear the tissue, which dislocates the MTP joint.
• Arthritis:

It is a common joint disorder that causes joint inflammation. Several types of arthritis affect the MTP joint and cause symptoms like pain, stiffening of the joint that makes walking difficult, and swelling in and around the joint. These conditions are:

• Gout: This occurs when there’s too much uric acid in your blood, which forms crystals that settle into the joint. This mostly occurs in the MTP of the big toes.
• Osteoarthritis: This occurs when cartilage (a band of tissues that works as a cushion between two joints or bones) deteriorates with age and makes bones rub/grind against each other.
• Rheumatoid arthritis (RA): This occurs when the joint lining gets inflamed and swollen. Often, it occurs in small joints, including the MTP joints.
• Psoriatic arthritis: It is a chronic autoimmune disease that causes a red rash with silvery scales on multiple areas of skin on the body, accompanied by inflamed joints, including the MTP joints.
• Septic arthritis: This occurs when joints get infected, generally with bacteria that enter the bloodstream. It can also happen when medications, such as corticosteroids, are injected into the joint with a needle. It makes the injected joint red or warm. It is a medical emergency; you should see your doctor right away if you notice redness and warmth after joint treatment.

Some other causes of MTP joint pain occur due to biomechanical problems but are not caused by the MTP joint problem itself. It includes – Morton’s neuroma, corns and calluses, hammer toe and mallet toe, capsulitis, or stress fracture.

Risks of Metatarsophalangeal Joint Pain

Certain risk factors, like diseases that cause inflammation in other joints or parts of your body, can also affect the MTP joints, causing pain and walking issues. Other factors include:

• Unusual positioning of your foot, like pes cavus, ankle equinus, or Achilles tendon deformities.
• Poor choices of footwear.
• Having a chronic inflammatory condition like rheumatoid arthritis.

These conditions can be painful and debilitating but are mostly treatable without the need for surgery.

Location

An MTP joint in your foot joins one of your toes (a phalangeal bone) to a long bone (a metatarsal bone). There are 5 MTP joints on each foot – one for each toe; however, the term “MTP joint” is mostly used for big toe joints. This MTP joint mostly causes problems and plays a key role in making the toes move to ensure proper walking with a balanced gait.

Diagnosis

To diagnose MTP joint pain, the doctor examines your joint by performing a physical examination to check your symptoms and medical history. In this physical exam, the doctor squeezes all your MTP joints together, and if you experience pain, it indicates joint inflammation. If you have numbness, burning pain, and tingling, then it indicates neuralgia/neuroma. Similarly, if you have redness, warmth, swelling, and edema, then it indicates infection. Your doctor may recommend imaging tests like X-ray, CT, and MRI to confirm the underlying cause and plan your treatment accordingly.

Treatment

MTP joint pain treatment focuses on lowering the inflammation in the joint that occurs from both biomechanical problems and arthritis along with lowering the pressure and stress on the joint.

You can ease inflammation and related pain at home with these home remedies:

• Give rest to your foot and limit your physical activity to improve your symptoms and speed up healing.
• Take nonsteroidal anti-inflammatory drugs like ibuprofen and naproxen to lower pain and inflammation.
• Use cold therapy to reduce inflammation several times a day.
• Use the best shoes for your feet.
• Look for new strategies to work, like working from home or using a stool to keep your foot above the ground to lower the pressure on the joints.

Your doctor may suggest corticosteroid injections that are injected directly into the joint or may prescribe medication to treat different types of arthritis to lower joint inflammation.

To treat your biomechanical problems of the MTP joint, the doctor may recommend any one or a combination of the following:

• Taping and padding the affected area: It can help lower the pain and make you more active.
• Orthotics: These are custom-made devices placed in your shoe to manage your weight and pressure on the ball of your foot, including the MTP joints. It relieves the pain and stops further damage.
• Physical therapy: These exercises are guided by a physical therapist to relieve the pain and inflammation and make the joint strong, flexible, and mobile.
• Surgery: This is the last resort to treat the joint when all other treatment fails. Your doctor tells you which type of surgery is suitable for your case (whether you need a repair or realignment of the bones and other tissues in the MTP joint).

The best thing you can do to treat and prevent biomechanical problems is to wear the right shoes that fit properly. It includes shoes that have enough space to wiggle your toes. You should avoid shoes that are too tight or high heels because they can damage or worsen the problem.

MTP joint pain can occur due to many conditions and wearing improper-fitting shoes. However, arthritis is treatable without the need for surgery, and you can find the right-fitting shoes that improve your condition and prevent further damage. Make sure you don’t ignore the pain and take prompt action to manage the pain.

Need help with MTP joint pain? Visit our pain management clinic in Brooklyn to get professional medical help. Call us to book your appointment now!!!!! Doral Health & Wellness employs Podiatrists with extensive education and expertise. Trauma to the tendons, muscles, and bones of the foot is quite common. It’s not a good idea to put off seeing Foot Doctor Brooklyn until you are in a lot of pain. Our address is 1797 Pitkin Avenue, New York, NY 11212. To make an appointment, please call +1-718-367-2555 or send an email toinfo@doralhw.org.