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Metatarsalgia (forefoot pain)

Metatarsalgia is a common condition of the forefoot in which the ball of your foot becomes painful and inflamed. You might develop metatarsalgia if you participate in activities that involve running and jumping. Other causes including foot deformities and poorly fitted shoes.

Properly fitted shoes with good support or insoles can help prevent metatarsalgia.


Symptoms of metatarsalgia can include:

  • Sharp, aching or burning pain in the ball of your foot.

  • Pain that worsens with any activity and improves when you rest

  • Sharp or shooting pain, numbness, or tingling in your toes

  • A feeling of having a pebble in your shoe


Metatarsalgia is typically caused by several issues:

  • Intense training or activity. Distance runners are at risk of metatarsalgia, primarily because the front of the foot absorbs significant force when a person runs. But anyone who participates in a high-impact sport is at risk, especially if your shoes fit poorly or are worn.

  • Certain foot shapes. A high arch can put extra pressure on the metatarsals. So can having a second toe that's longer than the big toe, which causes more weight than normal to be shifted to the second metatarsal head.

  • Foot deformities. Wearing too-small shoes or high heels can cause your foot to be misshapen. A downward-curling toe (hammertoe) and swollen, painful bumps at the base of your big toes (bunions) can cause metatarsalgia.

  • Excess weight. Because most of your body weight transfers to your forefoot when you move, extra pounds mean more pressure on your metatarsals. Losing weight might reduce or eliminate symptoms.

  • Poorly fitting shoes. High heels, which transfer extra weight to the front of your foot, are a common cause of metatarsalgia in women. Shoes with a narrow toe box or athletic shoes that lack support and padding also can contribute to the problem.

  • Stress fractures. Small breaks in the metatarsals or toe bones can be painful and change the way you put weight on your foot.

  • Morton's neuroma. This noncancerous growth of fibrous tissue around a nerve usually occurs between the third and fourth metatarsal heads. It causes symptoms that are similar to metatarsalgia and can also contribute to metatarsal stress.

  • Fat pad atropy. Thinning of the protective fat pad of the forefoot causing direct contact of the ground and the heads of your metatarsals.


Risk factors

Almost anyone can develop metatarsalgia, but you're at higher risk if you:

  • Participate in high-impact sports that involve running and jumping

  • Wear high heels, shoes that don't fit properly or shoes with spikes, such as cleats

  • Are overweight 

  • Have other foot problems, including hammertoe and calluses on the bottom of your feet

  • Have inflammatory arthritis, such as rheumatoid arthritis or gout


Left untreated, metatarsalgia might lead to pain in other parts of the same or opposite foot and pain elsewhere in the body, such as the low back or hip, due to limping from foot pain.

Treatments usually include anti-inflammatory, high grade orthotics, or better shoe gear.

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