Understanding Metatarsophalangeal Joint Disorders (MTP)


The metatarsal bones are the long bones that connect the ankle and toes. Between the heads of the metatarsal bones and the base of the proximal phalanges (toe bones) are the metatarsophalangeal joints .

In other words, the metatarsophalangeal joints connect the bones of the toes with the bones of the foot. These joints are surrounded by a thin joint capsule and have ligaments to support them.

It is also helpful to know that the first metatarsophalangeal joint is commonly known as the big toe joint and the little finger joint is known as the fifth metatarsophalangeal joint. The first metatarsal bone (big toe) also connects to the two sesamoid bones on the plantar surface of the foot (bottom of the foot).

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Conditions that affect the metatarsophalangeal joints.

There are a number of conditions that affect the metatarsophalangeal joints, also called MTP joints. Some of these conditions include:


Metatarsalgia is actually used to describe any pain in the ball of the foot, the soft, squishy part of the sole of the foot that covers the metatarsal bones. Still , the most common source of pain in this area is the metatarsophalangeal joint. …

Bunion of the big toe

The bunion is a bony lump that forms on the outer edge of the first joint of the MTP. As a result of bursitis, a condition called hallux valgus can develop, where the big toe deviates or points toward the other toes. When the first finger pushes the second finger, a hammer blow can occur. A common cause of hammer toe bursitis is wearing inappropriate shoes (such as high heels or shoes that are too tight) .

Also, you may have heard the term "bone," which means the formation of a bone in the little finger or the fifth metatarsophalangeal joint.

Peat sock

Turf occurs when the big toe is overstretched, such as when playing soccer. More specifically, toe turf injures the MTP joints and surrounding ligaments and tissues, and can even dislocate the joint.


In the inflammatory condition of rheumatoid arthritis, MTP joint pain can occur when standing or walking. Morning stiffness in an MTP joint can also be an early sign of rheumatoid arthritis. The inflammation of the joint in this disease can also lead to a toe deformity.

Osteoarthritis, a non-inflammatory form of arthritis, can also occur in the MTP big toe joint. With osteoarthritis of the foot , the cartilage in the joint wears down, which can cause pain and difficulty walking.

Gout is another form of arthritis that can affect the foot, especially the first MTP. Symptoms of a gout attack include sudden severe pain, redness, and warmth in the big toe.

Eventually, septic arthritis of the MTP joint can occur. Although septic arthritis is less common than gout, it should be ruled out because it indicates a bacterial infection of the joint. A procedure called arthrocentesis , in which joint fluid is removed and examined under a microscope, allows you to distinguish between the two conditions.

Hammer toe

Hammer toe is a displacement of the MTP joint, often the second toe. There are several potential causes of hammer toe. For example, a hammer toe can develop after a bone has formed, causing the big toe to move or tilt toward the second toe.

Hammer toe can also occur in rheumatoid arthritis , when the fatty tissue in the ball of the foot is pushed forward under the toes. Traumatic toe injuries can also cause hammer blows, and some people are simply born with hammer toes.

Finally, it's important to note that if hammer toe is left untreated , more problems can develop, including calluses and reactive bursae, fluid-filled sacs that form when the fatty tissue in the foot is subjected to high pressure or friction.


To monitor the condition of the MTP joint, your healthcare professional (such as an orthopedic surgeon who specializes in treating the foot or an orthopedic surgeon) will consider surgery or non-surgical strategies.

Non-surgical strategies

Most of the problems associated with MTP joints are resolved non-surgically. For example, in the case of bursitis (a common MTP problem), the healthcare provider will often recommend that the person wear proper shoes, including non-standard orthotics (special shoe inserts made for their feet). For bursitis, wide-toed shoes that are soft and stretchy can be helpful. Big toe pads can also protect the bone from rubbing.

Orthopedics can help manage other MTP problems, such as metatarsalgia. In this case, wide shoes or pads on the forefoot can help alleviate discomfort.

Other non-surgical approaches include using ice or taking anti-inflammatory medications (such as ibuprofen) to relieve pain and reduce swelling.

Surgical strategies

There are several different surgical procedures available to address your specific MTP problem. However, surgery is generally only considered when non-surgical strategies don't work.

For example, one procedure is called a first joint MTP fusion, and it involves permanently fusing the bones of the big toe and first metatarsal bone. This can be done in cases of arthritis where the articular cartilage is worn down and the resulting pain is not relieved by conservative or non-surgical methods.

The first MTP joint fusion is often done in a day hospital, but recovery can take six months. Metal screws and often a metal plate are used to stabilize the connection .

Another procedure, called first MTP joint replacement, is done in arthritis to relieve pain that does not go away with conservative treatment. The bunion is removed and implants are used in its place. They can be made of metal or plastic. It differs from fusion in that the implant mimics the action of the original joint.

Get the word of drug information

The foot is a complex but flexible part of the body, and the joints of the foot are especially important for movement. If you have MTP pain that causes pain when walking, be sure to see your doctor for a proper evaluation.

Also, if you experience sudden redness, warmth, or swelling of the MTP joint (most commonly the first MTP joint), seek urgent medical attention to rule out infection.

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