Clinical Presentation & Protocol
Patient Usually Complains Of
Patient presents with localized pain in the right forefoot, specifically at the plantar aspect of the metatarsal heads. Symptoms are exacerbated by weight-bearing activities, prolonged standing, and wearing narrow-toed footwear. Patient denies trauma, numbness, or radiating neurological symptoms. Pain is described as a dull ache or burning sensation, relieved by rest and offloading.
Clinical Examination Findings
Right foot examination reveals tenderness to palpation at the second and third metatarsal heads. No evidence of erythema, edema, or skin breakdown. Callus formation noted beneath the second metatarsal head. Range of motion of the metatarsophalangeal joints is within functional limits, though provocative testing (Lachman test) is negative for instability. No signs of Morton's neuroma or stress fracture.
Treatment Protocol
Conservative management initiated: recommendation for orthotic inserts with metatarsal pads to redistribute pressure. Patient advised to transition to footwear with a wider toe box and adequate cushioning. Implementation of a structured stretching program for the gastrocnemius-soleus complex. NSAIDs prescribed for pain management as needed. Follow-up in 4-6 weeks to assess clinical improvement.