Causes of Metatarsalgia
Most metatarsal problems mainly occur due to the foot impacting hard surfaces while walking or running and poor biomechanics that affect the way weight is distributed in the foot. This can put extra pressure on the metatarsal bones, which leads to inflammation and pain, especially in the metatarsal heads--the rounded ends of the bones that connect with the phalanges (toe bones). Metatarsalgia also can be caused by the following:
- Intense training or sudden increase in activity level.
- Your foot shape. A high arch can put extra pressure on the metatarsals, as can a Morton’s toe (in which the second and/or third toe extend in length beyond the big toe), causing more weight than normal to be shifted to the second or third metatarsal heads.
- Hammer toe, which occurs when one of the toes (usually the second) curls downward because of a bend in the middle toe joint. This contraction has the effect of depressing or dropping the metatarsal heads.
- Bunions. A swollen, painful bump at the base of the big toe (hallux) can develop due to hereditary factors or from wearing high heels or shoes that are too small. A bunion can weaken the big toe, putting extra stress on the ball of the foot. Ironically, surgery to correct a bunion can lead to metatarsalgia if the person does not get sufficient rest after surgery.
- Obesity or excess weight. Extra pounds put pressure on the metatarsals. Losing weight may reduce or eliminate some of the symptoms of metatarsalgia.
- Your shoes. High heels, which cause more weight to be transferred to the forefoot, are a common cause of metatarsalgia in women. Shoes with narrow toe boxes and athletic shoes that lack sufficient support and padding can also contribute to metatarsal issues.
- Stress fractures. Small fractures in the metatarsals or phalanges can be painful. They can also change the way weight is distributed on the foot.
- Morton's neuroma. This benign growth of tissue around a nerve usually occurs between the third and fourth metatarsal heads and causes symptoms that are similar to metatarsalgia. It can also contribute to stress on the metatarsals.