Midtarsal Joint Dysfunction

Bone and Joint Conditions· Also known as: midtarsal dysfunction, Chopart joint dysfunctionUpdated Nov 2026

Reviewed by Andrew Schox, BSc(Hons) PGradDipPod MPod, November 2026

At a Glance

Midtarsal joint dysfunction is a problem with the joints in the middle of your foot, where the back of the foot meets the arch. It isn't yet clearly defined as its own condition, so much of what is known comes from related midfoot problems such as midfoot arthritis, which affects about 1 in 8 adults aged 50 and over. The main symptom is midfoot pain that is worse after long periods on your feet. Care usually starts with non-surgical steps such as pacing activity, shoes, exercises and shoe inserts.

What is it?

The midtarsal joint (also called the Chopart joint) sits in the middle of your foot. It links the back of your foot to the arch. The midfoot is the highest point of the arch, made up of small bones that glide against one another. This makes walking more efficient while still supporting your body weight.

Midtarsal joint dysfunction means this part of the foot is painful, stiff or not working as it should. It isn't yet clear how the condition is defined or how it differs from general midfoot pain. Much of what is known comes from related problems, especially midfoot osteoarthritis (wear in the joints of the midfoot) and injuries to the midfoot.

Who does it affect?

There are no figures for midtarsal joint dysfunction itself. The closest information is about midfoot osteoarthritis, which affects about 1 in 8 adults aged 50 and over. That figure shouldn't be read as the rate of midtarsal joint dysfunction.

Midfoot osteoarthritis is linked to being older, being female, lower socioeconomic standing, carrying extra weight, pain in other weight-bearing joints, other medical conditions and an earlier foot or ankle injury. A family link and conditions such as rheumatoid arthritis may also play a part. These are links, not proven causes.

Signs and symptoms

In midfoot osteoarthritis, the pain is usually worse after standing or walking for long periods. There can also be pain and stiffness first thing in the morning or when you start to move, and swelling around the midfoot joints.

Some signs point to something more serious and are described here so you know what they can mean:

After an injury, being unable to put weight on the foot or rise onto your toes, bruising under the foot, marked tenderness in the midfoot or pain when the midfoot is squeezed can mean a fracture or a Lisfranc injury (an injury to the neighbouring midfoot joints).
A foot that looks out of line, or that has shifted or dislocated, can mean an unstable injury.
A sudden tendon rupture or a broken bone can also cause midfoot pain.
Redness, heat and swelling can be a sign of infection, including a bone infection (osteomyelitis).
In people with diabetes, midfoot pain with swelling, redness or heat, or a foot that changes shape quickly, can mean Charcot foot. This is damage to the bones and joints of a foot with nerve and blood vessel problems. It starts with a strong inflammatory reaction that can look like an infection.
Tingling, numbness or loss of feeling in the foot can point to a nerve or blood supply problem.

Midfoot injuries can be missed at first, especially when the ankle is injured too. About a quarter of Lisfranc injuries are thought to go undiagnosed or to be found late.

What causes it?

No single cause has been named for midtarsal joint dysfunction itself. Injury is the best-supported cause in related conditions. Arthritis in the midtarsal joint is usually posttraumatic (it follows an injury), often in people who play sport. The injury may be a more severe fracture or dislocation, or a lower-energy sprain.

These injuries usually happen when the ankle twists so that the foot turns inwards and points down. This stretches the ligaments (tough bands that hold bones together) at the front of the ankle and the midtarsal joint. A midfoot sprain like this often happens together with a tear of the ligaments on the outer side of the ankle.

Other things may play a part. Long-term poor alignment of the foot, overuse, or damage to the ligaments and tendons that support the arch can lead to midfoot arthritis. Problems with the navicular bone (a bone in the middle of the foot) are linked to repeated stress on bone with a poor blood supply, or to delayed bone formation. The risk factors listed under "Who does it affect?" apply here too. Age, sex, genes and past injury can't be changed. Body weight and activity load are the factors that affect how much load goes through the foot joints.

How is it diagnosed?

Your podiatrist will ask how the pain began, how it has changed, how severe it is, how it limits what you can do, and whether the foot has changed shape or swells. They will check how well the foot moves, both when they move it and when you do, press along the bones to find tender spots, test muscle strength, and watch how you walk. There are no agreed tests or criteria that are specific to the midtarsal joint, so this process also rules out other problems.

Before settling on a joint problem, they will look for signs of nerve or blood supply problems, a fracture or Lisfranc injury, infection and inflammatory arthritis. A X-ray is usually the first scan, often taken while you stand. If it doesn't give a clear answer, an ultrasound, CT scan or MRI may be added. X-rays can miss minor ligament injuries and small breaks.

Other conditions can cause similar pain:

Midfoot osteoarthritis
Lisfranc fracture or dislocation
Stress fracture (a small crack in a bone from overuse, with a dull pain that builds with activity and eases with rest, and is more painful when the bone is pressed)
Charcot foot or a bone infection
Problems with the navicular bone
Dorsal midfoot compression syndrome, posterior tibial tendon dysfunction (a problem with a tendon that helps hold up the arch), spring ligament insufficiency (a weakness in a ligament that supports the arch), cuboid syndrome and inflammatory arthritis

Treatment

First-line care is non-surgical. The evidence for these options is limited and mostly comes from midfoot arthritis, so it isn't yet known which works best for midtarsal joint dysfunction.

Looking after it at home

Learning about the problem and pacing your activities: for example, splitting a big gardening job over a few days with rest breaks.
Swapping high-impact activities that flare the foot, such as running, for cycling.
Shoes that are not completely flat. A heel up to 1.5 inch is acceptable, and a firm rocker sole may help. Lacing techniques can also change how a shoe feels.
Looking after your body weight where this is relevant, to reduce load on the foot joints.
Pain relief, including anti-inflammatory medicines and creams.

Treatment from your podiatrist

Your podiatrist may suggest exercises for the small muscles of the foot, calf and Achilles tendon stretches, and balance exercises. Strengthening the muscles around the foot and ankle is described as giving good long-term benefit. Exercises are stopped straight away if they bring on pain or make you feel unwell.

Your podiatrist or physiotherapist may also use taping and hands-on (manual) therapy. Orthoses (shoe inserts) may be offered, and rocker-sole footwear may be suggested. Orthoses shaped to support the arch may reduce pain and improve function over the short and medium term, and they were well tolerated. Inserts that stiffen the shoe may help in the short term.

Other options

A corticosteroid injection may help midfoot arthritis. Your practitioner may refer you on if the first steps haven't worked, the diagnosis isn't clear or symptoms are getting worse. Before a referral to an orthopaedic specialist, your practitioner will check that the pulses in your foot can be felt, because this matters for surgery. Complex midfoot injuries are best seen early by foot surgeons.

Surgery

If non-surgical care hasn't worked, the usual operation for midfoot arthritis is arthrodesis (fusing the midfoot joints). It can mean a long time without putting weight on the foot. About 3 to 10 per cent of fusions don't join (nonunion).

For Lisfranc injuries, surgery is recommended when the joints are unstable, shifted, dislocated or out of line. Complications can include injury to a nerve on top of the foot, wound infection, arthritis after injury, midfoot stiffness, hardware failure and ongoing pain.

When a foot is in a cast and you can't put weight on it, the risk of a blood clot in the leg (deep vein thrombosis) goes up. A clot that reaches the lung could be fatal. Whether preventive treatment is needed is decided by the treating team.

Recovery

There is no clear information on how long midtarsal joint dysfunction takes to settle or how often it comes back. Strengthening the muscles around the foot and ankle is described as having good long-term benefits in midfoot arthritis.

Midtarsal injuries that are missed or not treated well can lead to long-term instability and pain. After a Lisfranc injury, more severe injuries and joints that aren't put back in their exact position are linked to more arthritis later. Complex midfoot injuries are uncommon, can bring complications, and the outcomes range from poor to fair.

Preventing it

It isn't yet clear whether any particular footwear, orthosis or strengthening plan stops it coming back. What is known is that keeping the foot and ankle muscles strong helps stability and takes load off the joints. Pacing your activities, building up high-impact activity gradually rather than in sudden jumps, and looking after your body weight all help reduce the load on your foot. Having midfoot injuries properly assessed also matters, since missed injuries are linked to long-term problems.

Frequently asked questions

Is midtarsal joint dysfunction the same as midfoot arthritis?

No. Midfoot arthritis is wear in the joints of the midfoot. Midtarsal joint dysfunction isn't yet clearly defined as its own condition, so midfoot arthritis is the closest well-described problem. The two can share symptoms such as pain after long periods on your feet.

What is the difference between midtarsal and Lisfranc problems?

They involve neighbouring joints in the midfoot. The midtarsal joint sits between the back of the foot and the arch. The Lisfranc joints are in front of it. Lisfranc injuries have their own warning signs, such as bruising under the foot and being unable to bear weight.

Why is midfoot pain sometimes missed?

Midfoot injuries can be overlooked at first, especially when the ankle is hurt too. Many conditions cause similar pain, and standard X-rays can miss minor ligament injuries. This is one reason a careful examination and further scans may be used.