Welcome to the Podiatry Arena forums

You are currently viewing our podiatry forum as a guest which gives you limited access to view all podiatry discussions and access our other features. By joining our free global community of Podiatrists and other interested foot health care professionals you will have access to post podiatry topics (answer and ask questions), communicate privately with other members, upload content, view attachments, receive a weekly email update of new discussions, access other special features. Registered users do not get displayed the advertisements in posted messages. Registration is fast, simple and absolutely free so please, join our global Podiatry community today!

  1. Everything that you are ever going to want to know about running shoes: Running Shoes Boot Camp Online, for taking it to the next level? See here for more.
    Dismiss Notice
  2. Have you considered the Critical Thinking and Skeptical Boot Camp, for taking it to the next level? See here for more.
    Dismiss Notice
  3. Have you considered the Clinical Biomechanics Boot Camp Online, for taking it to the next level? See here for more.
    Dismiss Notice
Dismiss Notice
Have you considered the Clinical Biomechanics Boot Camp Online, for taking it to the next level? See here for more.
Dismiss Notice
Have you liked us on Facebook to get our updates? Please do. Click here for our Facebook page.
Dismiss Notice
Do you get the weekly newsletter that Podiatry Arena sends out to update everybody? If not, click here to organise this.

5th mpj pain

Discussion in 'Biomechanics, Sports and Foot orthoses' started by Kath Higham, Jul 22, 2008.

  1. Kath Higham

    Kath Higham Member

    Members do not see these Ads. Sign Up.
    Hi folks,
    I am treating a middle aged lady, carrying some extra weight who is complaining of pain to her 5th mpj. There is some minor visible swelling and the lady has been in pain for some months and had physio treatment. This appears to be an injury whilst playing tennis and is identical to a previous incident some years ago for which she was given orthoses that she reports did help, but does not have anymore. MRI shows no fractures, no mortens, no arthritic involvement, but a small amount of fluid around the joint. I do not want to prescribe orthoses whilst I am unsure of the diagnosis, however there is a reduced arch profile and I suspect the previous insole would have been anti pronatory. Any ideas gratefully appreciated. Thanks Kath
  2. Craig Payne

    Craig Payne Moderator

    When weightbearing, how much force is needed to elevate the 4th and 5th met heads with your fingers?
  3. Heather J Bassett

    Heather J Bassett Well-Known Member

    Hi, when you palpate can you create the pain? HOw does pt describe pain? Exactly where is pain? Does it linger?
    Would be good to have more detail.
  4. DaVinci

    DaVinci Well-Known Member

    If its bilateral, rule out RA.
    CP is getting at some sort of lateral overload syndrome. See this thread.
  5. Kath:

    Good to be back from a brief time of vacation from Podiatry Arena that has allowed me to take care of some business.

    Plantar 5th metatarsal head pain may be caused by the side to side actions of the foot that are common to the sport of tennis. Remove the sockliner from the lady's shoes and add a piece of 1/8" (i.e. 3 mm) adhesive felt plantar to the 1st through 4th metatarsal heads, on the plantar aspect of the sockliner. This will likely help reduce the ground reaction force plantar to the 5th metatarsal head sufficiently to help reduce her pain. A custom foot orthosis with an intrinsic forefoot valgus correction and a forefoot extension plantar to the 1st through 4th metatarsal heads would work even better. I would also have her ice her foot 20 minutes twice daily, especially on those days she plays tennis.

    This one would be a good one to talk about when Craig and I lecture together in Sydney and Melbourne in a few weeks.:drinks
  6. Kath Higham

    Kath Higham Member

    Hi All , thanks for your input
    Craig, in response to your ? and on a scale of 1 - 10 the latter being heavier I would say 7 - 8.
    Heather, the pain is focused 5th but radiating through to 3rd dorsally, pt describes as a sore ache no extra pain or clicking was reproduced on palpation. The pt describes the pain as constant, worse when active.
    Kevin thank you for your thoughts, we seem to be on the same wavelength.
    Un-named, I have ruled out RA and looked at the thread you suggested which I found extremely useful.

Share This Page