What is Metatarsalgia?

Metatarsalgia is a generic term for pain in the ball of the foot. There are a number of causes, the commonest of which are synovitis (inflammation) of the joint at the base of the 2nd toe (2nd MTPJ) and Morton’s neuroma. 2nd MTPJ synovitis is often associated with certain foot shapes as well as bunions. Synovitis may cause stretching of the soft tissue stabilisers of the joint which in turn can lead to a claw toe . In advanced cases the toe may dislocate.

What are the Symptoms?

Pain in the 2nd MTPJ is felt in the centre of the ball of the foot. Sometimes the pain can be felt on the top of the foot at the base of the 2nd toe. The pain is worse with walking but it can ache after activity. Walking barefoot on hard surfaces may be painful. Callus may be present on the ball of the foot if the 2nd metatarsal is longer than the 1st. 

What is the Treatment?

Comfortable footwear with soft cushioning innersoles, rest, analgesia (paracetamol or anti-inflammatories) or taping of the toe may help. Podiatry for maintenance of callus or more specific innersoles can be beneficial. A cortisone injection can be considered.

Orthopaedic surgical treatment is available for those not responding to other measures. Surgical procedures include Weil osteotomy and plantar plate repair but the specific operation depends on a number of factors.