Forefoot Pain/ Metatarsalgia

Metatarsalgia is the word used to cover a variety of causes of pain the forefoot or ball of the foot. It can be caused by:

  • Increased weight-bearing to the front of the foot either through foot structure (especially high arch or clawed toes), footwear such as high heels or occupational such as standing at work or increased sport and activity
  • Injury to the bones, joint capsule, ligaments, nerves or small muscles in the area both acute or long standing
  • Increased body weight
  • Build up of hard skin

Forefoot pain should be investigated by a podiatrist if it recurs regularly or lasts more than 10days. This is especially important if there is any visible swelling or if you experience any numbness or tingling to the forefoot or through to the toes. Pain may get worse with activity or standing.

As there are a lot of structures in a relatively small area there can be many conditions that affect the forefoot. A podiatrist will assess the forefoot and possible refer on for x-rays, ultrasound scans or blood tests to determine what of the following is causing the pain:

  • Hard skin (callus) or corns or verruca (warts)
  • Gout or arthritis
  • Bony exostosis (growth on top of joint)
  • Sesamoiditis (inflammation of small bones under big toe joint)
  • Hallux valgus (bunion) angular deformity of big toe joint
  • Fracture
  • Ganglion
  • Capsulitis -inflammation around any joint (at base of toes most commonly)
  • Soft tissue tears- to joint capsule or ligaments between bones
  • Neuroma- fibrous inflammation in nerve between bones (most commonly between 3rd/4th toes)

Most of the above conditions can be treated conservatively by your podiatrist using a variety of methods. In some less common cases it may require a referral to doctor or orthopaedic surgeon and your podiatrist will arrange that if needed.