You may be experiencing pain to the side or top of the middle part of your foot (the area that sits underneath or just below the knot in lace-up shoes). This is an area with many small bones and joints and forms the roof of your foot’s arch.
You may have a flattened arch (sometimes referred to as overpronation) and this may have always been the case or developed over a relatively short space of time. For more information on Flat Feet please click here.
Some people have an unusually high arch and this can cause problems as your foot tends to be less flexible and therefore a less effective shock absorber when walking or running.
In many cases midfoot pain may be a symptom of arthritis developing in one of the many joints in this area.
After an examination, x-rays may well be needed to determine the nature of the underlying problem. Many people will be helped with simple footwear advice or activity modification. Sometimes insoles can be used to help support the midfoot. Occasionally more invasive treatments may be offered and these may include injections of steroid (click here for more information) or even surgery.
Surgery for arthritis in the midfoot is most commonly a fusion procedure. This is done to remove the arthritic joints and eliminate movement between the bones in order to reduce your pain. Special metal plates, screws and staples may be used to hold the bones still while they heal.
Surgery is usually carried out under a general anaesthetic (with you asleep) and in most cases you will go home the same day although occasionally an overnight stay may be required. In order to allow the bones to heal, you will be put into a plaster cast and be asked not to put weight through your foot for the first 6 weeks. You will be encouraged to rest as much as possible for the first 3 weeks in order to allow the wound to heal before the stitches are removed. In most cases, after 6 weeks, a removable walking boot is then used. Swelling is common and can last for a few months in some cases.
X-rays would be used post surgery as one way to determine bone healing. There is a risk that the bone does not heal with more bone (around 1 in every 10 cases) and this may lead to continued pain requiring further intervention.