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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.

  • American Orthopaedic Society for Sports Medicine
  • American Association for Hand Surgery
  • American Academy Of Orthopaedic Surgeons
  • The American Board of Pediatrics
  • North American Spine Society
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