Stone Bruise or Metatarsalgia: Symptoms, Causes, Treatment

Stone Bruise is a painful or inflammatory condition in the forefoot especially in between joints of phalanx bones (phalanges) and metatarsal bones. This commonly occurs in second, third and fourth metatarsophalangeal joints.

1. Gradual increase of pain in and around forefoot area.
2. Worst pain in the MTP joints especially during weightbearing.
3. Callus formation will be more because of excessive pressure under the foot.
4. Difficulty to walk with full weightbearing.
5. When joint is pressed, then tenderness and pain is elicited.

1. Blunt Trauma.
2. Injury.
3. Excessive running leads to transferring of high impact of pressure onto the foot.
4. Excessive pronation of the forefoot.
5. Diabetes.
6. Gout.
7. Arthritis.
8. Condition related to pes cavus sometimes also increases the risk of metatarsalgia.
9. Morton’s Neuroma.
10. In cases where the extensor tendons are tight.
11. Metatarsalgia fractures occurred due to stress.
12. Metatarsalgia is commonly seen in aged people.

1. To reduce inflammation and pain non steroidal anti-inflammatory drugs (NSAIDs) are commonly prescribed by the doctor.
2. To avoid wearing high heel shoes and to prefer spacious and flat shoes.
3. Use of specially manufactured shoes which has insoles that have better cushion and can provide shock absorption.
4. As often as possible, stretching of the legs in particular calf muscles will help alleviate pain.
5. In order to equally distribute the weight, use of protective footwear and padding is suggested.

1. Specialized doctor who should be consulted in case of painful conditions related to foot is a Podiatrist. Initially, podiatrist will ask the patient to walk and will analyze the position of the foot. To confirm metatarsalgia further examination will be done.
2. Radiologic studies such as ultrasound scans, MRI, x-rays etc., of the forefoot will be done. These images will be reviewed by the radiologist and impression will be made based on which treatment modalities will be determined.
3. In some cases, blood tests are drawn to determine whether any other underlying disease conditions like gout, diabetes, etc., is causing metatarsalgia.
4. Insoles such as custom-made orthotics will be suggested by the doctor.
5. As a last resort, the doctor will suggest steroid injections.