Foot Problems - Forefoot Pain (often referred to as Metatarsalgia)

What is metatarsalgia?

Metatarsalgia is pain in the ball of the foot. It is usually felt in the sole of the foot and sometimes feel like "walking on pebbles". Other people feel a more diffuse vague pain, ache or burning. Some people have trouble around only one area of the foot. It is a generalized term as further investigation is required to determine the actual cause.

What causes metatarsalgia?

Anything which puts extra stress on the front of the foot can cause metatarsalgia. Common examples are:

• being overweight
• high-heeled shoes

certain foot shapes such as a high-arched "cavus" foot in which the bones in the front of the foot (metatarsals) point down into the sole to an excessive extent, or a long metatarsal bone which takes extra pressure.

Claw or hammer toes which press the metatarsals down towards the ground

A stiff ankle which cannot be drawn up to right angles with the leg but points the foot down to the ground.

A bunion or arthritis in the big toe can weaken the big toe and throw extra stress onto the ball of the foot. This can also happen after an operation on the big toe, such as a bunion correction.

A stretched or irritated nerve in the ball of the foot (interdigital neuroma) or behind the ankle (tarsal tunnel syndrome) can produce pain in the ball of the foot. Diabetes can also produce irritation of the small nerves in the foot leading to a burning pain.

Athletes or walkers occasionally get stress fractures of the metatarsal bones.

Arthritis, gout or inflammation of the joints in the ball of the foot (metatarso-phalangeal joints) can produce local pain.