Metatarsalgia Forefoot Pain

Metatarsalgia is a generic word used to describe pain in the tissues around and under one or more of the joints of the ball of the foot.  It is a symptom of another problem and not a specific disorder. Metatarsalgia pain is usually experienced when walking or running and can range from very mild to severe and may include swelling and inflammation in the ball of the foot. Generally metatarsalgia pain starts gradually and gets worse over time.

Common causes of metatarsalgia or forefoot pain:

  • Prominent or dropped metatarsal heads
  • Forefoot pressure from wearing thin soled, high heeled shoes
  • Loss of the fat pad that cushions the forefoot as we age
  • Spreading of the forefoot and hammer toe formation that occurs with aging or disease
  • Excessive pronation or flat feet
  • Increased forefoot pressure often associated with high arches
  • Inflammation of the joint capsule
  • Stress fractures
  • Nerve pinching known as Morton's Neuroma


The first step in treating metatarsalgia is to identify the cause of the pain. This can include X-raysUltrasound, Bone Scans and MRI's to detect and identify the cause of the pain. The vast majority of forefoot pain, however, is not serious in nature and can be treated with rest, footwear changes including lowering heels and wearing athletic shoes, daily icing and physical therapies including ultrasound and laser. Many cases of forefoot pain respond well to treatment with custom foot orthotics that include metatarsal pads and cut outs to redistribute pressure away from the painful area. Stubborn cases of metatarsalgia may require a cortisone injection and as a last resort surgery.