Metatarsalgia

What is Metatarsalgia?

Metatarsalgia is a condition in which pain and inflammation are caused due to overuse or injury to the ball of the foot - the area between the toes and the arch. This condition mainly affects the joints at the base of the five-toe bones. 

Causes of Metatarsalgia

Metatarsalgia can be caused by many factors, the most common including:

• Intense physical activity as in sports
• Ill-fitting shoes
• High-heeled footwear
• High-arched foot
• An unusually long metatarsal bone - usually of the second toe
• Toe deformities such as hammertoe
• Overlapping or underlapping toe
• Weak toe muscles
• A tight or short Achilles tendon
• Excess body weight
• Conditions such as arthritis, gout, Morton’s neuroma and bursitis

Symptoms of Metatarsalgia

Symptoms of metatarsalgia include:

• Pain in the ball of the foot, which feels like a deep bruise and worsens when you stand or walk, especially when barefoot
• Feeling like you have a stone at the base of your foot
• An area of hardened skin (callus) on the ball of the foot
• Swelling of the joints near the base of the toes (metatarsophalangeal joints)

Diagnosis of Metatarsalgia

Your doctor will discuss your symptoms and activities and perform a physical examination. Diagnostic tests that may be carried out include:

• X-rays: To identify any bone fractures
• Ultrasound: To evaluate soft tissue conditions such as bursitis or Morton’s neuroma
• MRI scan: To visualize the soft tissues surrounding the metatarsal bones
• Blood tests: Such as uric acid levels to help detect conditions such as gout

Treatment for Metatarsalgia

Metatarsalgia is normally treated by conservative methods that include:

• Applying ice over the area of pain
• Taking medications to reduce pain and inflammation
• Changing footwear
• Using pressure bandages on the foot
• Using a metatarsal pad
• Losing bodyweight
• Avoiding barefoot walking

When conservative methods are not found to be effective, surgery may be recommended for removing calluses, correcting deformities and realigning the metatarsal bones.