Metatarsalgia (or Metatarsophalangeal joint synovitis) is a generic term for denoting a painful foot condition in your metatarsal region. The metatarsal is the area near the toes or the ball-of-the-foot.

Numerous different conditions can trigger metatarsalgia that affect the foot. You might have to undergo a foot examination to find the exact cause of metatarsalgia. Keep in mind that treatment for this condition will depend mainly on its underlying cause. However, simple measures like changes to the footwear, losing weight and rest can sometimes be helpful.

Metatarsalgia is a somewhat familiar inflammatory condition that occurs most often in the second, third and fourth metatarsophalangeal joints, or it could be isolated in your first metatarsophalangeal joint.  It is a disorder, which can adversely affect the joints and bones at the plantar forefoot.

Frequency

Forefoot injuries, such as metatarsalgia, are quite common in athletes and sportsmen who participate in various high-impact sports. Most athletes who participate in high-impact sports that involve jumping or running are at a higher risk of forefoot injury.

Although track and field runners usually face high levels of traumatic forces to their forefoot, several other athletes, including football, tennis, baseball, as well as soccer players, typically sustain forefoot injuries.

Causes

You can injure your foot during various sports activities. As in the case of many other overuse injuries, this condition might be due to an alteration in regular biomechanics, which can lead to abnormal or excessive weight distribution.

Freiberg’s disease is a rare disease, characterized by death of some bone of the second metatarsal. It is most common in teenage girls. Diabetes can cause severe damage to the nerves in your feet and could be a leading cause of metatarsalgia in some people.

Also, keep in mind that persistent stress may lead to chronic inflammation and irritation of the bone covering as well as adjacent tissues, like ligaments and tendons. Note that the following factors could lead to excessive localized pressure over your forefoot:

• Prominent metatarsal heads
• High level of activity
• Tight toe muscles or extensors
• Weak toe muscles or flexors
• Hypermobile first foot bone
• Hammertoe deformity
• Tight Achilles tendon
• Ill-fitting footwear
• Excessive Pronation

Symptoms

Metatarsalgia often causes stinging pain in the ball of the foot that could worsen by standing, running or walking. Many people often describe this sharp pain as feeling like they’re walking on sharp pebbles.

On the other hand, some describe it more as a general aching pain.

Keep in mind that the pain may occur in either one or both feet. Some people feel the pain under one or more metatarsal heads. However, in some cases, the pain emerges under each metatarsal head. Another thing to remember is that metatarsalgia often comes on gradually over a couple of weeks instead of suddenly.

It is likely that the affected part of your foot will feel tender if you (or the doctor) press on it. A condition called Morton’s neuroma can produce symptoms of metatarsalgia because of irritation or inflammation of the nerve close to the site of pain. People who have Morton’s neuroma can experience toe numbness as well as pain in their forefoot.

Treatment for Metatarsalgia

Many quick and straightforward measures can help alleviate the symptoms associated with metatarsalgia. These include:

• Losing weight in case you are obese or overweight
• Resting with the feet elevated if possible.
• Wearing shoes or footwear that is low-heeled, well fitted, and has a wide toe area.
• Orthotic inserts and metatarsal pads for your shoes can help relieve the pain in your foot by lowering the pressure exerted on the heads of the metatarsal bones.
• Physiotherapy, in many cases, may also be very helpful. This can include various exercises to help your stiff ankle or exercises that can help stretch the Achilles tendon.
• Simple painkillers can also help a lot. These include paracetamol as well as non-steroidal anti-inflammatory painkillers like ibuprofen, which may help relieve your pain.
• Seeing a good podiatrist may help to determine if you have hard skin (or callus) build-up. This can alter the way a person bears weight.

There are many other treatments as well, but they will depend mainly on the underlying cause of the metatarsalgia.

Therefore, for instance, if diabetes is the culprit, you will need to control your diabetes better to improve your condition. On the other hand, if arthritis or gout is the cause, you might need specific treatment for these conditions.

At times, surgery is necessary to treat metatarsalgia; this is especially true if other treatment options have failed. Again, this would depend on your underlying cause – for instance, straightening of claw toes or hammer or surgery for Morton’s neuroma.