Metatarsalgia – Overview


Metatarsalgia is a catch-all term for pain in ball of foot.  “-algia” meaning pain and metatarsals being the long bones in the foot.  The heads of the metatarsal bones are the bony prominences that are palpable in the ball of the foot.

Cause of Pain in Ball of Foot


Metatarsalgia can be associated with various deformities such as bunions, hammertoes, or relatively long or short adjacent metatarsal bones.  This can lead to increased pressure underneath one or more metatarsal bones.

Other causes include fat pad atrophy which happens with age, stress fractures, neuromas, calluses, plantar warts, contractures of tendons or joints, joint effusions, damaged joint cartilage, ruptures of joint capsules or tendons, avascular necrosis, etc.

Metatarsalgia Signs and Symptoms


  • Ball of foot pain related to deformities or metatarsal length discrepancies is generally dull and aching in nature.  This can lead to stress fractures which are associated with significant swelling.
  • Neuromas are typically associated with numbness and tingling of the toes and the feeling as though one is walking on a pebble which is stuck underneath the foot.
  • Plantar warts and calluses are associated with skin lesions which are tender to direct palpation.
  • Other metatarsalgia symptoms include sharp localized pain or radiating, electrical, shooting type into the ball of the foot and or the toes.

Diagnostic Testing


Clinical Exam –  in which your doctor may be able to feel a clicking sensation in the ball of the foot which could be consistent with a neruoma.  He or she may also be able identify skin lesions and determine if a biopsy is indicated.

Xrays – often needed to identify bony deformities including angular and flexion deformities of the toes and length discrepancies of the metatarsals and to rule our stress fractures.

Diagnostic injections – with local anesthetic are sometimes used to systematically eliminate one or more of the differential diagnoses and MRI’s are sometimes needed to evaluate the plantar nerves, joint cartilage and tendons about the toes.

Metatarsalgia Treatment

Proper diagnosis is key to initiating the proper treatment for ball of foot pain.

Metatarsalsgia is a nonspecific catch-all term that encompasses multiple diagnoses and the treatment for each diagnosis can be quite different.

Depending on the cause of metatarsalgia, treatment can include:

  • Shoe modification
  • Metatarsal pads
  • Orthotics
  • Injections
  • Immobilization
  • Off loading
  • Surgery
If You’re Experiencing Ball of Foot Pain, Try Discussing it with Dr. Black …

Make an Appointment with Dr. Black for a consultation about Metatarsalgia.
The Florida Center for Foot and Ankle Reconstruction
at Orthopedic Associates of Cape Coral