Clinical Presentation & Protocol
Patient Usually Complains Of
Patient presents with localized pain in the plantar aspect of the left forefoot, specifically localized to the metatarsal heads. Symptoms are exacerbated by weight-bearing activities, prolonged standing, and wearing tight-fitting or high-heeled footwear. Patient denies history of acute trauma, numbness, or radiating paresthesia. Pain is described as [sharp/aching/burning] in nature.
Clinical Examination Findings
Physical examination of the left foot reveals tenderness upon palpation of the second and third metatarsal heads. No evidence of erythema, edema, or deformity. Callus formation noted under the second metatarsal head. Range of motion of the metatarsophalangeal joints is within normal limits, though provocative testing (Lachman’s test for MTP joint stability) is negative. No signs of Morton’s neuroma (negative Mulder’s click).
Treatment Protocol
Conservative management initiated: recommendation for metatarsal pads or orthotic inserts to offload pressure from the affected metatarsal heads. Advised to transition to footwear with a wider toe box and cushioned sole. Non-steroidal anti-inflammatory drugs (NSAIDs) prescribed for pain management. Referral to physical therapy for intrinsic muscle strengthening and gait analysis.