Forefoot Pain- Adult Leeds

1.  Information Resources for Patients and Carers

Quick info:

Patient information

Please see attached patient information leaflet on sprained ankle. Please see attached patient information leaflet on plantar fasciitis

Please see attached patient information leaflet on achilles tendinopathy.

Please see attached patient information leaflet on Morton's Neuroma.

Please see attached patient information leaflet on hallux rigidus.

Please see attached patient information leaflet on hallux valgus. Please see attached patient information leaflet on ganglions.

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2.  Referral Forms

Quick info:

Referral Forms:

Quick View - PDF

MSK7 Foot Ankle V3

MSK 8 Specialist Foot Management V3

MSK14 Problem Not on Pathway Form V3

Mail Merged

The forms below are provided as a repository. They can be downloaded to your computer and be imported to your clinical system. This is so all practices have access to the most up to date forms.

EMIS - merged
MSK7 Foot Ankle V3
MSK 8 Specialist Foot Management V3
MSK14 Problem Not on Pathway Form V3

SystmOne - merged
MSK7 Foot Ankle V3
MSK 8 Specialist Foot Management V3
MSK14 Problem Not on Pathway Form V3

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3.  Forefoot Pain

Quick info:

GP information

The forefoot consists of anything distal to and including the metatarsals   see attached image.

Metatarsals are prone to fracture. This usually occurs as a result of trauma; however, underlying bone pathology can be of a non- traumatic origin, eg pathological. If the foot is painful and swollen over the metatarsal region, a fracture must be ruled out. An X- Ray should be obtained but caution that X-Rays may be normal early on with stress fractures. If clinical suspicion persists, onward referral to the MSK-MDT should be considered (some stress fractures will never be visible on plain X-Ray).

Pain under the ball of the foot, which is relieved with removing shoes, may be due to an intermetatarsal neuroma, often referred to as "Morton's Neuroma". These can present in other ways such as pins and needles or a painful numbness in the ball of the foot. There may be numbness in adjacent toes or a feeling like walking on a stone. The commonest interspace is the 3rd & 4th, but a neuroma can exist in any interspace.

Other forefoot pains can be the result of:

• inflammatory arthropathy
• diabetic neuropathy
• intermetatarsal bursitis (similar symptoms to Morton's Neuroma)
• joint osteoarthritis (OA)
• MTPJ dislocation (or pre-dislocation syndrome)
• fat pad atrophy
• tendinitis
• osteochondromas (Freiberg's infraction)
• ganglions
• tumours
• poor-fitting, worn, or poor-quality footwear

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4.  Morton's Neuroma

Quick info:

Patient information

Please see attached patient information leaflet on Morton's Neuroma.

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6.  Refer Tier 1 Podiatry Referral Form (MSK7)

Quick info:

Referral Forms:

The forms below are provided as a repository. They can be downloaded to your computer and be imported to your clinical system. This is so all practices have access to the most up to date forms.

EMIS - merged

MSK7 Foot Ankle V3

SystmOne - merged

MSK7 Foot Ankle V3

Choose and Book

You can find this clinic on Choose and Book under:

Speciality:Podiatry

Clinic type:Biomechanical

Provider information

The only provider of Tier 1 Podiatry in the city is the Leeds Community Health Service. This service is directly bookable via Choose and Book. Please complete the appropriate form and send via Choose and Book.

If symptoms persist, referral to Tier 1 Podiatry is appropriate, who will refer onward to MSK-MDT if symptoms persist or there is diagnostic doubt.

Tier 1 Podiatry can provide the following:

• Orthotics
• Silicone splints
• Padding
• Specialist footwear advice
• Advice on managing their individual presentation
• Onward referral to the MSK-MDT if required

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12. Refer MSK-MDT Referral Form (MSK7)

Quick info:

Referral Forms:

The forms below are provided as a repository. They can be downloaded to your computer and be imported to your clinical system. This is so all practices have access to the most up to date forms.

EMIS - merged
MSK7 Foot Ankle V3

SystmOne - merged
MSK7 Foot Ankle V3

Choose and Book
You can find this clinic on Choose and Book under:

Speciality: Orthopaedics

Clinic Type: Foot and Ankle Pain

Provider information

The only provider of the MSK-MDT clinic in the city is the Leeds Musculoskeletal Service. This is a multiprofessional clinic including senior physiotherapists and musculoskeletal physicians.

This clinic provides diagnosis, investigation, treatment and onward referral if needed.

This service is directly bookable via Choose and Book. Please complete the appropriate form and send via Choose and Book.

Key Dates

Published: 09-0ct-2015, by Leeds

Valid until: 17-Jun-2016

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