Metatarsalgia (Forefoot Pain)

Pain in the ball of your foot, the area between your arch and the toes, is called metatarsalgia (met'-a-tar-sal'-gee-a). The pain usually centers on one or more of the five bones (metatarsals) in this area under the toes.

What causes foot pain?

Calluses: If one of your metatarsal bones is too long, the bone may take on extra weight. This extra pressure on the metatarsal bone can cause a callus, or buildup of skin, to form. The combination of the extra weight on the bone and the callus can cause pain; however, a callus does not need to be present for the patient to have pain.

Bunions: Metatarsalgia is also commonly associated with a bunion deformity of the big toe. In this case, the big toe metatarsal bone cannot support the weight it needs to, and the weight shifts to the smaller metatarsal bones.

Hammertoes: A hammertoe can also increase the chance of experiencing metatarsalgia pain. Hammertoes can cause the metatarsal bone to be pushed into the ground, which increases the pressure on the bone.

Shoes that don't fit properly: Tight shoes squeeze the foot and increase pressure; loose shoes let the foot slide and rub, which creates friction.

Torn ligaments or inflammation: Pain on the underside of the foot may indicate a torn ligament or inflammation of the joint. An orthopaedic foot and ankle specialist can do some simple tests to assess joint stability. 

How is foot pain treated?

Most of the time, practical measures can help ease foot pain.

  • Your doctor may recommend that you use a shoe insert (arch support) as a kind of shock absorber, or that you wear a different kind of shoe. Routinely, a pad is added to the orthotic to shift the weight off the painful metatarsal bones.
  • Sometimes, simply buying shoes that fit properly can solve the problem. Shoes should have a wide toe box that doesn't cramp your toes. Heels should never be higher than 2 1/4" high.
  • Soaking your feet to soften calluses and then removing some of the dead skin with a pumice stone or callus file will also ease pressure. Note, however, that diabetics should not do this themselves. Calluses should be taken care of by your physician or someone your physician recommends for taking care of diabetic feet. This is a short-term solution that removes the callus temporarily but does not fix the problem.
  • Occasionally, surgery may be necessary to remove a bony prominence or correct a deformity.

The American Orthopaedic Foot & Ankle Society (AOFAS) offers information on this site as an educational service. The content of FootCareMD, including text, images, and graphics, is for informational purposes only. The content is not intended to substitute for professional medical advice, diagnoses or treatments. If you need medical advice, use the "Find a Surgeon" search to locate a foot and ankle orthopaedic surgeon in your area.