Forefoot Pain / Metatarsalgia

Metatarsalgia is a general term that denotes a painful condition that involves the metatarsal region of the foot, just before the toes, sometimes referred to as the "ball of the foot."

The forefoot is anatomically composed of bones, ligaments, tendons, muscles, nerves, blood vessels and skin, which all interrelate. Any of these cause painful conditions alone, or in combination at the junction known as the Metatarsal-Phalange Joints (the toe bones are known as Phalanges).

Calluses

Pain in this area may be caused by calluses, which may diffuse and spread over a broad area or be very localized and deep-rooted. They may or may not have a painful bursa associated with them (a bursa is a fluid filled sac that lies between skin and bone and functions to cushion, lubricate and protect).

Calluses may be caused by a great number of things, which are structural, i.e. anatomic variations present, or functional, i.e. caused by variations in the way the foot functions while walking or standing.

Structural Causes of Calluses:

1. Enlarged Metatarsal Head
2. Depressed Metatarsal (a bone that sits lower than the others)
3. Abnormally long Metatarsal
4. Foreign bodies embedded in the foot
5. Degenerative changes to the joints from inflammation or Arthritis

Functional Causes:

1. Abnormal biomechanical function of the foot (biomechanics is the dynamic study of the changes that occur with weight bearing or walking). These abnormalities include: flatfeet, high arched feet, and contracted toes. Each entity will produce specific callous patterns on the "ball of the foot"
2. Loss of the fat pad or displacement of the fat pad under the ball of the foot that serves to cushion and protect. This naturally occurs with age. It can also occur in people who have abnormally high arched feet, in people who are involved with sports activities, who constantly have pressure on the ball of the foot, i.e. jogging, basketball, tennis, and volleyball.

Other causes of pain on the ball of the foot include

1. Arthritis, rheumatoid or osteo
2. Painful bursitis without associated calluses
3. Warts-commonly resembling calluses or corns
4. Neuroma or neuritis, a condition of the small nerves to the toes
5. Tendonitis
6. Cysts
7. Foreign bodies, splinters or hairs
8. Diabetes-causes pain from poor circulation (usually burning or pins and needle tingling pain occurring at night)
9. Trauma
10. Stress Fractures

If pain occurs on the ball of your foot or elsewhere, please consult with your podiatrist. To find a podiatrist near you click here