Metatarsalgia, literally metatarsal pain and colloquially known as a stone bruise, is any

pain Pain is a distressing feeling often caused by intense or damaging stimuli. The International Association for the Study of Pain defines pain as "an unpleasant sensory and emotional experience associated with, or resembling that associated with, ...

ful

foot The foot ( : feet) is an anatomical structure found in many vertebrates. It is the terminal portion of a limb which bears weight and allows locomotion. In many animals with feet, the foot is a separate organ at the terminal part of the leg mad ...

condition affecting the

metatarsal The metatarsal bones, or metatarsus, are a group of five long bones in the foot, located between the tarsal bones of the hind- and mid-foot and the phalanges of the toes. Lacking individual names, the metatarsal bones are numbered from the me ...

region of the foot. This is a common problem that can affect the

joint A joint or articulation (or articular surface) is the connection made between bones, ossicles, or other hard structures in the body which link an animal's skeletal system into a functional whole.Saladin, Ken. Anatomy & Physiology. 7th ed. McGraw- ...

s and

bone A bone is a rigid organ that constitutes part of the skeleton in most vertebrate animals. Bones protect the various other organs of the body, produce red and white blood cells, store minerals, provide structure and support for the body, ...

s of the metatarsals. Metatarsalgia is most often localized to the first metatarsal head – the ball of the foot just behind the big toe. There are two small

sesamoid In anatomy, a sesamoid bone () is a bone embedded within a tendon or a muscle. Its name is derived from the Arabic word for 'sesame seed', indicating the small size of most sesamoids. Often, these bones form in response to strain, or can be prese ...

bones under the first metatarsal head. The next most frequent site of metatarsal head pain is under the second metatarsal. This can be due to either too short a first metatarsal bone or to "hypermobility of the first ray" – metatarsal bone and medial cuneiform bone behind it – both of which result in excess pressure being transmitted into the second metatarsal head.

Signs and Symptoms

Metatarsalgia is characterized by a sharp pain in the ball of the foot.

Causes

One cause of metatarsalgia is

Morton's neuroma Morton's neuroma is a benign neuroma of an intermetatarsal plantar nerve, most commonly of the second and third intermetatarsal spaces (between the second/third and third/fourth metatarsal heads; the first is of the big toe), which results in th ...

. When toes are squeezed together too often and for too long, the nerve that runs between the toes can swell and get thicker. This swelling can make it painful when walking on that foot. High-heeled, tight, or narrow shoes can make pain worse. This is common in runners, particularly of long distance. The ball of the foot takes a lot of weight over the years and if running on pavement or running in ill-fitting running shoes, the odds of developing Morton's neuroma increase. Changing to shoes that give the toes more room can help.

Diagnosis

Diagnosis is often done by patient self report. If a patient feels pain in the ball of the foot a podiatrist is the best source for a diagnosis. A podiatrist is a trained expert who can offer treatment options.

Management

The most common treatments are: * Rest * Ice *

NSAID Non-steroidal anti-inflammatory drugs (NSAID) are members of a therapeutic drug class which reduces pain, decreases inflammation, decreases fever, and prevents blood clots. Side effects depend on the specific drug, its dose and duration of ...

* Properly fitted shoes * Metatarsal pads * Arch Supports Removing excess callouses may be helpful. In extreme cases, injection or surgery may be indicated.

References

External links