II. Definition

  1. Pain beneath Metatarsal head

III. Etiology

  1. Abnormally high arch
  2. Improper shoe selection
  3. High heeled shoes
  4. Tight Achilles tendon

IV. Associated Conditions

V. Symptoms

  1. Burning or cramping pain at Metatarsal heads
  2. Middle Metatarsal heads usually affected
  3. Symptoms worse with activity
  4. Relieved by rest

VI. Signs

  1. Tender calluses develop under Metatarsal heads
  2. Dorsal contractures of metatarsophalangeal joints

VII. Management

  1. See Proper Shoe Fit
  2. Hard soled shoe or cast for 4-6 weeks
    1. Casting especially indicated for fifth Metatarsal
  3. Transfer weight from Metatarsal heads to neck or shaft
    1. Low-heeled shoe with sufficient forefoot room
    2. Anterior Metatarsal bar
      1. Transfers weight behind Metatarsal heads
    3. Metatarsal pads
  4. Sorbothane pads
    1. Available at Running stores
  5. Visco Heels
    1. More expensive
  6. Trimming or paring callus with pumice stone
    1. Provides only temporary relief
    2. Pressures must be removed from Metatarsal heads
    3. Calluses disappear with time if pressure changed
  7. Warm soaks
  8. Surgery
    1. Indicated if conservative management fails

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Related Studies

Ontology: Metatarsalgia (C0025587)

Definition (MSH) Pain in the region of the METATARSUS. It can include pain in the METATARSAL BONES; METATARSOPHALANGEAL JOINT; and/or intermetatarsal joints (TARSAL JOINTS).
Concepts Sign or Symptom (T184)
MSH D037061
ICD10 M77.4 , M77.40
SnomedCT 268090002, 202878000, 156663001, 10085004
English Metatarsalgia, METATARSALGIA, metatarsalgia (diagnosis), metatarsalgia, Metatarsalgia, unspecified foot, Metatarsalgia [Disease/Finding], metatarsalgias, Metatarsalgia NOS (finding), Pain in ball of foot, Metatarsalgia (finding), Metatarsalgia NOS
Japanese 中足骨痛, チュウソクコツツウ
Swedish Metatarsalgi
Czech metatarzalgie, Bolest nártu
Finnish Jalkapöytäkipu
Portuguese METATARSALGIA, Metarsalgia, Metatarsalgia
French METATARSALGIE, Métatarsalgie
German METATARSALGIE, Metatarsalgie
Korean 발허리뼈통
Polish Ból śródstopia
Hungarian Metatarsalgia
Norwegian Metatarsalgi
Spanish metatarsalgia, SAI, metatarsalgia, SAI (hallazgo), metatarsalgia (hallazgo), metatarsalgia, Metatarsalgia
Dutch Metatarsalgie, metatarsalgie, Metatarsalgia
Italian Metatarsalgia