Metatarsalgia is caused by damage to the metatarsal bones in the foot.
The metatarsals
The metatarsals are five long bones that run underneath the soles of your feet. They connect your ankle bones to your toe bones.
The main purpose of the metatarsals is to support your weight when you are walking, jumping and running, specifically when you are pushing up with your feet.
However, the metatarsals can sometimes become painful.
Common causes
Some common causes of metatarsalgia include:
- Badly fitting footwear, high-heeled or tight, restrictive shoes or boots – shoes with a narrow toe area or high heels can force the ball of the foot into a small amount of space, which puts more pressure on that area.
- Being overweight or obese – this can increase the pressure on the foot.
- Age – older people are more susceptible to metatarsalgia as the fat pad that protects the foot can thin with age, making them more likely to feel pain in the ball of their foot.
- Bone structure of the foot – narrow, high-arched feet or flat feet can increase the chance of metatarsalgia.
- High-impact sports, such as running or tennis, put extra pressure on the foot.
- Stress fractures in the foot – these occasionally occur in athletes or walkers and cause pain to come on rapidly.
Medical conditions known to cause metatarsalgia
Several medical conditions can cause foot pain, which often changes the way you walk. This in turn places excessive weight onto your metatarsals, triggering metatarsalgia.
These conditions include:
- arthritis – pain and swelling of the joints, which can be the result of general wear and tear (osteoarthritis) or your immune system mistakenly attacking the joints (rheumatoid arthritis)
- gout – a condition where crystals form inside the joints causing them to become very painful and inflamed
- bunions – an abnormal deformity of bone that can occur in the big toe, which can weaken the toe placing excessive pressure on the other metatarsals
- Morton's neuroma – a common condition in which the nerves inside the feet become compressed causing a sharp or dull pain between the toes
- diabetes – the high levels of blood sugar associated with diabetes can, over time, cause nerve damage and pain affecting the feet
- hammertoe – when one of your middle toes is bent downwards, which can cause an uneven distribution of weight onto your metatarsals
