Metatarsalgia - Causes of metatarsalgia

Metatarsalgia is caused by a wide variety of conditions.

The metatarsals

The metatarsals are five long bones that connect the bones around your ankles to your toe bones.

They support your weight when you are walking, jumping and running, specifically when you are pushing up with your feet.

A lot of pressure is put through the metatarsals, which means they are a common source of pain.

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 because their feet have more wear and tear, and 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 or flat feet can increase the chance of metatarsalgia as one metatarsal bone may be much longer than the others
high-impact sports such as running or tennis put extra pressure on the foot
stress fractures in the foot – these occasionally occur in athletes, runners 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 on 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 which can occur in the big toe, weakening the toe and placing excessive pressure on the other metatarsals
bursitis – inflammation and swelling of a bursa, which is a fluid-filled sac under the skin that acts as a cushion between the tendons and bones
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
hammer toe – when one of your middle toes is bent downwards, which can cause an uneven distribution of weight onto your metatarsals