Midfoot Arthralgia, also known as Tarsometatarsal Arthralgia, is characterized by 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.
“Arthrlagia” Greek for joint pain can be experienced in any joint of the body. This general word as it applies to the foot is most commonly seen in the joints of the midfoot which are located at the highest portion of the arch.
Unlike arthritis, in arthralgia x-rays do not reveal show visible signs of joint space narrowing, cyst formation within the bone as well as bone spurring.
The pain associated with midfoot arthralgia is generally experienced with initial weight bearing after prolonged non weight bearing periods. Getting out of bed in the morning is typically painful in the middle of the arch with the pain improving after a brief period of walking
Although, many different causes of joint pain in the foot and ankle exist, abnormal biomechanical stresses occurring in the foot and ankle during walking are the main cause.
The midfoot where the tarsal bones articulate with the metatarsal bones is where most of the mechanical joint pain occurs in the foot. The “keystone” or “apex” of the arch in the midfoot forms the peak of an imaginary triangle. During normal walking there are very high compressive and tension loads in this region of the foot which can lead to arthralgia. Over a lifetime of walking the midfoot region is a very common region to develop arthritis
Shoe and orthotic therapies are most commonly used to stabilize the midfoot region and reduce the mechanical stresses in the arch during walking. It is critical to wear an orthotic that provides “firm support” as compared to “cushioned support. Together, the shoe and the orthotic create a platform to decrease the mechanical stress in the midfoot region. The decrease in joint stress with the shoe and orthotic accompanied with the appropriate use of anti-inflammatory measures work well to reduce the pain associated with this condition.