Pain in the mid foot is usually due to osteoarthritis in the metatarsocuneiform (MTC) joints. The commonest cause of arthritis in these joints is altered foot biomechanics, previous injury or neuroarthropathy. Other causes of pain in this region include Tibialis Posterior Insufficiency, Charcot neuroarthropathy or Rheumatoid arthritis.

Patients usually suffer pain on walking or sporting activities, swelling on the mid part of the foot and can have difficulty with footwear.

Initial management of arthritis includes pain medication, health supplements such as glucosamine/chondroitin sulphate, alteration or modification of activities, change in footwear and/or insoles. If these measures fail and continued pain is affecting the patient’s quality of life then surgery may be necessary.

Mid foot arthritis usually affects the 1st, 2nd and 3rd metatarsocuneiform joints, but there are numerous joints in the midfoot and so careful investigation is usually required before selective arthrodesis (fusion) is undertaken. Commonly x-ray guided selective injections are performed, but CT and MRI scans can also be helpful.