Metatarsalgia – Forefoot Pain

What problems might I have with the forefoot and toes?

Problems with the forefoot can be caused by many things. These include arthritis in the joints, bunions, nerve related problems and there are some other less common causes. 

The problem often starts with pain in the ball of the foot, most commonly under the base of the 2nd metatarsal bone of the 2nd toe. This may be secondary to hallux valgus (bunion) or a long 2nd metatarsal or tightness of the calf muscles.

The MTP joint (metatarsophalangeal joint) at the base of the toe becomes overloaded and painful. 

Overload of the bones of the forefoot (the metatarsal heads) can lead to formation of corns or callosities. These are painful areas of thickened skin on the sole of the ball of the foot.

Eventually this overloading may cause a plantar plate rupture and can later lead to deformity of the small toes such as:

• hammer toes
• claw toes
• mallet toes
• curly toes

The deformity of the toes can make it difficult to wear comfortable shoes.  There can be painful rubbing of the knuckles or the tips of the small toes and skin can breakdown.

Morton’s Neuroma is also a common cause of forefoot pain. 

What treatments are there for problems with the forefoot and small toes?

There are simple treatments which do not involve an operation.

These include: 

• wearing deeper toed and wider fronted shoes 
• padding over any bumps 
• well made insoles to take the load of the bones in the ball of the foot

One of our specialist podiatrists will be able to give advice on these types of treatment. 

What about surgery for problems with the forefoot and small toes?

Find out about surgical options >