Midfoot arthralgia
Pain at the junction of the metatarsal bones and the midfoot bones including the cuneiform bones first, second and third metatarsal and the cuboid-fourth and fifth metatarsal bones.
Symptoms
• Pain to the top of the midfoot region noted with initial weight bearing activity
• Pain relieves after short warm up period
• Rare associated swelling to the top of the foot
• Achy quality discomfort noted
• Increase pain with barefoot ambulation
Radiography
• Plain film radiographs can demonstrate joint space narrowing between the metatarsal and cuneiform and cuboid bones.
• X-rays are difficult to interpret because of the overlap of bones in this area
• CT scan can be used to demonstrate potential arthritis in the midfoot level as needed based on continuing symptoms
Treatment
• Use of over the counter or custom orthotic
• Supportive shoe with torsion stability to decrease foot pronation
• Shoe with removable innersole to accommodate orthotic device
• Use of shoe and orthotic at all times with NO barefoot walking during recovery period
• Activity limitation/modification
• Non steroidal antinflammatory therapy
• Ice twice daily