Tarsal metatarsal (also called the tarso-metatarsal or lisfranc joint) joint pain occurs where the long foot bones (metatarsals) connect with foot bones near the ankle (tarsals). Pain can result from a strain, partial tear of the ligaments, arthritis, a dislocation or even a fracture. More severe injuries to this joint are usually caused by blunt force such as in an automobile accident, during sporting events or from a fall. Treatment can vary depending on the severity of the injury.
Since injuries to the tarsal metatarsal joint are somewhat uncommon, except in the case of blunt trauma, people who pain in this area may be suffering from just a strain. Arthritis is another possibility, especially for people over 40. Typical signs for strains can be aching, soreness and swelling. Arthritis pain may more acute and include a burning sensation. If an individual believes he has sustained an injury to this area, he should see a doctor and get a proper diagnosis. Surgery may be required.
Efffects of Rest, Ice & Heat
Anyone with tarso-metatarsal joint pain should stay off their feet for a few days. This can prevent further injury to the joint and give the ice time to reduce inflammation and pain. Ice is most effective in reducing inflammation and pain if it is compressed against the joint with an ice pack. Elevating the feet may also help reduce the swelling. If swelling and pain subside after a few days, heat can be used to promote blood (with its healing properties) flow to the area.
Types of Medications
Anti-inflammatory medications such as ibuprofen and naproxen can help reduce pain and inflammation in the Lisfranc joint. These medications reduce pain by inhibiting Cox-2 enzymes from producing inflammation-producing prostaglandins, which is the body's natural reaction to an injury. For more severe pain, a doctor may prescribe steroids.
Types of Non-Operative Treatments
Even if there is a tear in the ligament with no widening between the bones, non-operative treatments can be effective. A person may be placed in a removable plastic cast (4-6 weeks) for purpose of mobility. This will take direct pressure off the injured area, reduce pain and inflammation and enhance the effects of other treatments.
In addition to ice and anti-inflammatory medication, massage can help reduce any lingering inflammation. Massage can help remove scar tissue, relieve tension in the joint and promote blood flow. A physical therapist or physiotherapist (Great Britain therapist) can help a person work through any residual pain and introduce mobilizing techniques to relieve stiffness in the joint.
Benefits of Surgery
Surgery is usually required when metatarsal bones are fractured or dislocated from the joint. Pain and swelling can prevent a person from functioning at this point, and traditional treatment will only provide permanent relief after the bones have been set. Most surgeries attempt to reduce tarso-metatarsal pain by using wires or screws. This gives the ligaments time to heal. According to aaoc.org, a newsletter published by The American Academy of Family Physicians, "if surgical repair is warranted, it should be done within the first 12 to 24 hours after the injury." Alternatively, a surgery can be delayed 7-10 days to allow inflammation and consequential pain to subside.
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