What is Metatarsalgia? (Forefoot Pain)
Metatarsalgia is a broad term used to describe pain and inflammation in the forefoot area at the metatarsal heads. Various foot conditions present with similar symptoms of metatarsalgia.
Metatarsalgia is most often caused by overloading or placing too much pressure on your forefoot over a long period of time. Possible causes may include:
Poor footwear such as pointy toed shoes or high heels
- High impact sport or exercise such as running or jumping
- High arched feet
- Changes in bone structure such as arthritis
- Altered biomechanics that causes uneven weight distribution on the forefoot
Common Conditions
Morton’s Neuroma
A Morton’s neuroma can occur in the intermetatarsal space and is sometimes referred to as intermetatarsal neuroma. The swelling and thickening of the nerve is due to compression from poor footwear such as high heels and narrow shoes.
Intermetatarsal Bursitis
Intermetatarsal bursitis is inflammation of a small fluid filled sac (intermetatarsal bursa) that lies between the metatarsal heads. The small fluid filled sac can become swollen and place pressure on the nerves in your forefoot.
Sesamoiditis
Sesamoiditis is inflammation of the tendons attached to the sesamoid bones at the base of the big toe. This condition is common in dancers and athletes who often bear weight on their forefoot.
Plantar Plate Injury
A plantar plate injury is a tear in the plantar plate area which leads to pain and instability due to the toes changing position. This is most commonly caused by overload of pressure on the metatarsophalangeal (MPJ) joint.
Symptoms
The main symptom of metatarsalgia is pain in your forefoot. Symptoms can also include:
- Aching or burning pain
- Sharp or shooting pain
- Pain that increases during physical activity (such as running or jumping) and remains after physical activity
- Pain that increases with flexion of the toes
Treatment
Treatment for metatarsalgia should not require surgical intervention until conservative treatment methods have been tried first. Metatarsalgia is most often managed with non-invasive treatment methods. These treatments often include one or more of the following:
Insoles and Orthotics
Prefabricated insoles and custom made orthotics by a podiatrist can reduce pressure and compression on the forefoot area.
Padding
Padding in the form of a metatarsal dome or a metatarsal gel pad can help splay the metatarsals into their natural position and reduce pressure and compression on the forefoot when worn. STRYDA Soles have been designed with an inbuilt metatarsal dome which splays the forefoot structure and reduces the pressure on the forefoot area.
Changing Your Footwear
Changing poor footwear is important if you want to relieve metatarsalgia and prevent it from worsening. Avoid shoes with an elevated heel, a pointed toe box or narrow and cramped shoes.
Activity Modification
Playing sports that require you to place a lot of pressure on your forefoot such as jumping, tennis or running can increase your risk of developing metatarsalgia or worsen symptoms. Activities that place pressure on the forefoot should be avoided or reduced until metatarsalgia improves.
Stretching and Strengthening Exercises
This may include calf stretches, Achilles tendon stretches and ankle extensions
Always consult your health professional before beginning any new treatments.