Metatarsalgia is a well-known injury characterized by plantar pain associated with increased pressure on the metatarsal heads. When metatarsalgia is present, the presence of a stress fracture should be ruled out first and not be confused with other causes of metatarsalgia.
It is usual and correct to refer to metatarsalgia as a symptom and not as a specific disease.
We must remember that the feet support the entire weight of the body throughout life. The pressure produced on the first and second metatarsals is maximum during the monopodal stance and toe-off stages, as well as when running.
There are anatomical alterations such as pes cavus or Greek foot that can produce this painful condition. In these cases, there are alterations on the support of the head of the first or second metatarsal, which produces a transfer of pressures that often causes plantar pain.
Metatarsalgia affects women more frequently and is directly related to the type of footwear. The prolonged use of heels increases the pressure exerted on the metatarsal heads, that is, in the forefoot area, sometimes causing pain.
There are several conditions that are often diagnosed separately and often lead to metatarsalgia. We must highlight interdigital neuroma or Morton’s neuroma, metatarsophalangeal synovitis, avascular necrosis, sesamoiditis and rheumatoid arthritis, among others.
Finally, metatarsalgia occurs with great frequency in patients with bunions, where the first metatarsal begins to deviate towards the midline of the foot, this produces a shortening of the foot that leads to metatarsalgia due to pressure transfer.
Likewise, the bunion produces a deviation of the first toe towards the lesser toes, producing deformities (claw/hammer) of the same and aggravating the deformity and metatarsalgia, which can become disabling.
The most frequent symptoms are: pain in the sole of the foot (central area), calluses (hyperkeratosis), pain and inflammation of the metatarsophalangeal joints, and finally, claw or hammer toe deformity.
The treatment in the initial stages is orthopedic, which requires the making of custom-made insoles under a plaster cast. In advanced cases with claw, hammertoe or bunionette deformities, the definitive treatment is surgical (
It is important to remember that the feet support our weight throughout our lives, we must take care of them and keep them healthy, because any alteration in the feet over time can have serious repercussions on our health.
Link of interest Morton’s neuroma
Article prepared by Clínica San Román
Date of publication: 11-08-2017
Revision date: 31-01-2020