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Coeur d’Alene Foot and Ankle Surgery Center


What is Metatarsalgia?
Metatarsalgia is a general term used to refer to a painful foot condition in the metatarsal region of the foot (the area between the arch and toes, or ball of the foot). This is a common foot disorder that can affect the bones and joints at the ball-of-the-foot and occurs when one of themetatarsal joints becomes painful or inflamed. The ball of the foot is a weight bearing area where the metatarsals bear the greatest amount of weight and pressure. If one or more of these metatarsals is out of alignment then excessive pressure is generated in the area producing a callus. Many people say the painful feeling is "like walking on rocks".

Metatarsalgia Anatomy

The ball of thefoot is known as the metatarsophalangeal joint (MTPJ) region. The long bones of the forefoot (metatarsals) and the toes (made up of phalanges) form the MTPJ's.

Metatarsalgia pain usually centers on one or more of the five bones (metatarsals) in the mid-portion of the foot. Also known as dropped metatarsal heads, metatarsalgia can cause abnormal weight distribution due to overpronation.Metatarsalgia is caused by the compression of a nerve between two displaced metatarsal bones.

Causes of Metatarsalgia

Foot Structure: Metatarsalgia can develop from an abnormal foot structure and biomechanics, both of which are inherited features. Some inherited foot defects such as a high arch can put extra pressure on the metatarsals. So can having a second toe that's longer than the big toe, whichcauses more weight than normal to be shifted to the second metatarsal head. Also, if one leg is shorter than the other, the metatarsal-phalangeal joints of the shorter leg receive additional stress.

Footwear: High heels, which cause more weight to be transferred to the front of the foot, are a common cause of metatarsalgia in women. Shoes with a narrow toe box or athletic shoes that lackproper support and cushioning can also contribute to metatarsal problems. Improper footwear can exacerbate the problem caused by the original genetic structure.

Excess weight. Because most of your body weight transfers to your forefoot when you move, extra pounds mean more pressure on your metatarsals. Losing weight may help reduce or eliminate symptoms of metatarsalgia.

Foot Deformities:Conditions such as digital deformities that create retrograde pressure on the metatarsal head (hammertoes); orthopedic condition where a metatarsal is very long; bunion deformities where big toe is weakened and extra stress is put on ball of foot; arthritis, especially anterior ankle arthritis where the foot can not be brought up into the ankle joint; metatarsal stress fractures; neuromas; and evengout can cause pain and inflammation that change the way you walk and the distribution of weight in your feet.

Aging: As we get older, the fat pad in our foot tends to thin out, making us much more prone to pain in the ball of the foot.

Symptoms of Metatarsalgia

Pain in the ball of your foot, which can be sharp aching or burning. Pain usually will increase when you're walking barefoot,especially on a hard surface. May feel as if you're walking with a rock in your shoe.

Pain in the toes area around your second, third or fourth toes — or, only near your big toe
Pain can be a sharp or shooting pain in your toes and may be accompanied with numbness or tingling.
Sometimes these symptoms develop suddenly — especially if you've increased your usual activity of running, jumping orother high-impact exercise. However, usually problems develop over time.

Diagnosis of Metatarsalgia

Physical exam: Physical examination begins with observation of the foot for abnormalities and foot biomechanics such as a high arch, flat feet, excessive pronation, hammertoe or bunion deformity, tight Achilles tendon, or prominent...
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