This condition is an irritation of the ball of the foot. It can result in sharp pain, numbness or tingling sensations that can be very problematic, especially for athletes.
Metatarsalgia is caused by excessive stress on the heads of the metatarsals (the long bones of the forefoot that end at the base of the toes). High-impact athletic activities such as running or jumping are a common trigger, because during these activities the ball of the foot absorbs repeated, intense loads. This impact can be magnified if the person also wears ill-fitting or worn out shoes. In many cases, metatarsalgia is related to the development of stress fractures in the metatarsals, which causes a change in stride and weight distribution in the foot.
A variety of other factors can also place harmful stress on the metatarsals, including being overweight, having an abnormally high arch or an abnormally long second toe, and having deformities such as bunions or hammertoes. It can also develop as a result of atrophy of the fat pad beneath the ball of the foot.
Symptoms of metatarsalgia may include sharp, aching or burning pain in the ball of the foot. Pain may be centered in the area beneath the big toe, or it may be felt beneath the second, third and fourth toes. Some report the sensation of having a pebble in the bottom of the shoe. Metatarsalgia may also cause sharp or shooting pain (or numbness and tingling) in the toes. Symptoms typically increase during physical activity and when the toes are flexed, and improve during rest.
Treatment options may include rest, weight loss, properly-fitted shoes, and orthotics or shoe inserts. If the pain is caused by a compressed nerve or a problem such as a bunion or hammertoe, surgery may be needed to correct the issue.