Dropped Metatarsal Head & Metatarsalgia

What is it?

A dropped metatarsal head is a condition where one of the metatarsal bones (usually the second metatarsal) is lower than the others at the distal end.

What are the common symptoms/complaints?

Patients complain of pain and the sensation that they are walking on a stone. The patient will usually have a callus under the head of the dropped metatarsal.

How is it caused?

This condition is very common and the cause is considered to be almost strictly hereditary. Over-pronation does play a role as abnormal weight distributions in an abnormally pronated foot tend to throw too much weight to the second metatarsal.

How is it treated?

Orthotics should be used to redistribute the pressure and off-load the dropped metatarsal head. A metatarsal pad should be added just proximal to the dropped metatarsal to off-weight it and alleviate the pain.

Metatarsalgia

What is it?

Generalized pain underneath the metatarsals.

What are the common symptoms/complaints?

Patients will complain of pain or tenderness on the plantar surface of the foot in the metatarsal area and/or diffused pain in the metatarsal joints.

How is it caused?

This condition is very common and the cause is abnormal weight distribution due to abnormal pronation.

How is it treated?

Orthotics should be worn to correct abnormal pronation and redistribute the weight more evenly along the plantar surface. If shoe fit allows, a metatarsal bar will assist by off-loading the metatarsal heads, alleviating pain localized under the metatarsal heads.