Stride Orthopaedics and Footwear


What is metatarsalgia?

Metatarsalgia is a general name given to pain in the front part of your foot under the heads of your metatarsal bones. This is the area on the sole of your foot, just before the toes. It is sometimes called the ball of your foot. Metatarsalgia can be caused by a number of different conditions affecting the foot. It is really a symptom of other problems rather than a specific disease itself.

What causes metatarsalgia?

Metatarsalgia can be caused by a number of different conditions. Common causes can include:

  • Overuse. For example, in runners and athletes, which can cause some mild inflammation in the metatarsal heads and nearby joints.

  • Wearing high-heeled shoes. This can put extra stress on the metatarsal heads.

  • Being overweight. This can put extra stress on your feet in general.

  • Morton's neuroma. This is sometimes called Morton's metatarsalgia. It is a condition that affects one of the nerves that run between the metatarsal bones in the foot (the plantar digital nerves). The exact cause is not certain. Symptoms include pain, burning, numbness and tingling between two of the toes of the foot.

  • Pes cavus. This is also known as claw foot. In pes cavus, your foot has a very high arch which does not flatten when you put weight on your foot. It happens because of an imbalance in the muscles of the foot. It can run in families. Sometimes pes cavus can happen out of the blue but most people with pes cavus also have a neurological problem such as cerebral palsy, spina bifida, muscular dystrophy or polio. Pes cavus can mean that extra stress is placed on the ball of your foot, which can lead to metatarsalgia.

  • Hammer toe or claw toe deformity.

    • With a claw toe you have an abnormal position of all three of the joints in the toe. The joint with the metatarsal bone is bent upwards, the middle joint in the toe is bent downwards and the end joint in the toe may also be bent downwards. The toe resembles a claw.

    • With a hammer toe, your toe is permanently bent at its middle joint so that it looks like a hammer. There are a number of conditions that can cause these toe deformities. These can include poorly fitted shoes, injury to the toes, bunions and rheumatoid arthritis. Hammer and claw toe can also occur in someone with pes cavus. They can also run in families. These toe deformities can mean that extra stress is placed on the ball of your foot, which can lead to metatarsalgia.

  • Bunion (Hallux valgus) A bunion is a deformity of the base joint of the big toe. Your big toe is angled towards your second toe. This causes a bump on the side at the base of the big toe. There is often thickening of the skin and tissues next to the affected joint. The thickened skin and tissues may become inflamed, swollen and painful. Because of the bunion, extra stress is put on the ball of the foot and this can lead to metatarsalgia.

  • Arthritis or gout. This can cause inflammation of the joints in the ball of the foot or of the big toe and can be a cause of metatarsalgia.

What are the symptoms of metatarsalgia?

Metatarsalgia causes pain in the ball of your foot that can be made worse by walking or running. Some people describe the pain as 'walking on pebbles', others describe more of a general aching pain. The pain can occur in one or both feet. In some people the pain is felt under one or two metatarsal heads, in others it is felt under all of them. Morton's neuroma has other specific symptoms and is explained further on a separate page.

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