Forefoot problems

• Pain to 1^st MTPJ area or generalised forefoot pain
• Increase pain and stiffness to 1^st MTPJ
• Gradual onset of pain
• Swelling
• Bony prominence/deformity
• Loss of function
• Crepitus of joint mobilisation
• Parasethesia/pins and needles to lesser digits
• Painful callus
• Daylight sign
• Family history
• Limping
• Inability to carry out normal sporting activity or walk long distances

• Hallux-Abducto Valgus, Hallux Limitus, Hallux rigidus
• Morton's neuroma
• Plantar plate tear
• Capsulitis
• Lesser toe deformities
• Gout
• Osteoarthritic changes

Evidence suggests that 80% of MSK problems are self limiting and will recover within 12-18 months. It is important to rule out serious pathology or any problem that warrants escalation but for all other cases a period of initial self directed rehabilitation should be given before any further intervention is considered.

• Footwear advice
• POLICE (Protect, Optimal Loading, Ice, Compression, Elevate)
• Sign post to NHS Inform - www.nhsinform.scot
• Sign post to NHS Doing More – www.dgdoingmore.co.uk

If symptoms persist following 12 weeks of self management

Patients can self refer via SAP 030 3333 3001

They will be triaged into appropriate service i.e. Physiotherapy, Orthotist or Podiatrist.

SCI-Gateway referral should be completed for the following more urgent presentations: