Metatarsalgia

Metatarsalgia is pain and inflammation in the ball of your foot, often felt right where your toes meet your foot. It can make walking, standing or exercising uncomfortable, but most cases improve with simple, nonsurgical care. Our foot and ankle specialists can help you find relief and get back to your normal routine.

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Anatomy of the ankle and foot, showing ligaments, tendons, and bones, labeled for clarity.

Anatomy of the foot

The foot has three main parts: the hindfoot, or heel, the midfoot, or arch, and the forefoot, which includes your toes and the ball of your foot. Metatarsalgia affects the forefoot, where several important structures work together to support your weight and help you move.

Your metatarsals are five long bones that form the ball of the foot, numbered one through five from your big toe to your pinky toe. They bear weight every time you stand or take a step. The metatarsophalangeal, or MTP, joints connect these bones to your toes and bend each time you push off the ground. The plantar fascia, a thick band of tissue running from your heel to your toes, helps support your arch and spread pressure evenly. When too much pressure builds under the middle of the foot, pain from metatarsalgia often follows.

Overview

Symptoms

You may have metatarsalgia if you notice:

Sharp, burning or aching pain in the ball of your foot
Pain that worsens when walking, running or standing
Numbness or tingling in your toes
A feeling like you're walking on a pebble or marbles

Some people also develop calluses under the ball of the foot from added pressure. Treating the problem early can help prevent long-term discomfort or changes in the way you walk.

Causes

Metatarsalgia happens when too much pressure is placed on the ball of the foot. This can be related to:

High-impact activities like running or jumping
Shoes that don't provide enough support
Foot shape or toe alignment issues, such as bunions or hammertoes
Stress fractures or arthritis
Tight calf muscles or irritation of the nerve between your toes, known as Morton's neuroma

Risk factors

Certain factors can raise your chances of developing metatarsalgia, though having one or more doesn't mean you'll definitely experience it.

These include participating in high-impact sports, wearing shoes with little cushioning or support, having a foot shape that places extra pressure on the forefoot and carrying excess body weight. Your foot and ankle specialist can help you understand which factors may be contributing to your symptoms.

Diagnosis

Your foot and ankle specialist will examine your foot and talk with you about your symptoms, activities and footwear. Your visit may include a focused exam of your foot alignment, walking pattern and pressure points, along with X-rays to check for stress fractures, arthritis or other concerns.

We'll also review any factors that may be contributing to your pain. We'll explain what we find and answer your questions so you feel informed, comfortable and confident in your next steps.

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Preventing foot and ankle injuries

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