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.