Metatarsalgia: Symptoms, Causes, Diagnosis, Treatment


Metatarsalgia refers to pain and inflammation in the ball of the foot. This is the area between the arches and toes on the bottom of the foot. Metatarsalgia centers under the five bones at the bases of the toes, the metatarsals.

The pain of metatarsalgia can be caused by a number of conditions and can have varied treatments.


Who gets metatarsalgia?

Anyone can get metatarsalgia, although runners and others who take part in high impact sports or spend more time on their forefoot have the condition more frequently than others.

People with high arches also have metatarsalgia more than others. High arches put extra pressure on the metatarsals and heels. People with a second toe longer than their big toe may also experience metatarsalgia more frequently.

People with foot deformities such as hammertoes and bunions may also experience more metatarsalgia.

What causes metatarsalgia?

Not all of the causes of metatarsalgia are known. In addition to being a frequent runner, wearing ill-fitting shoes or high heels can cause metatarsalgia.

Excess weight can also contribute to metatarsalgia.

Having rheumatoid arthritis, osteoarthritis or gout can also contribute to metatarsalgia.

What are the symptoms of metatarsalgia?

The main symptom of metatarsalgia is pain in the metatarsal area under the ball of the foot. Metatarsalgia may or may not be accompanied by bruising and swelling or inflammation. Symptoms can come on quickly or develop over time. They include:

  • Pain in the ball of the foot: this can be sharp, aching or burning. The pain may get worse when you stand, run or walk.
  • Numbness or tingling in your toes
  • The feeling of a pebble in your shoe

If you have any of these ongoing symptoms, you should see your doctor. Untreated metatarsalgia can lead to hammertoes, can cause you to limp and cause pain in other parts of the body, including the lower back and hip when you compensate and begin to walk abnormally.

How is metatarsalgia diagnosed?

Your doctor will begin an exam for metatarsalgia by asking about your symptoms. He or she will also examine your foot manually. You may need an X-ray to rule out stress fractures or other problems that could be causing your pain. Other times an ultrasound or MRI may be ordered to assess the soft tissues surrounding your metatarsophalangeal joints.

How is metatarsalgia treated?

Metatarsalgia is usually easily treated without surgery. Your doctor may recommend that you use a metatarsal pad, a surgical shoe, or a shoe insert to offload the painful part of your foot. Athletic shoes or rocker soled shoes may be recommended. Other helpful tips include:

  • Picking shoes with good soles, a wide toe box and a lower heel
  • Avoiding walking barefoot
  • Soaking and using pumice stone on your feet to help remove calluses. Removing these calluses can help relieve pressure. People with diabetes should consult their physician first before doing this.

If these measures do not help relieve your metatarsalgia, an injection or surgery may be necessary to resolve the underlying cause of your pain.

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