Metatarsalgia is a common overuse injury described as pain in the forefoot associated with increased stress over the metatarsal head region. Metatarsalgia often is referred to as a symptom, rather than as a specific disease. Common causes of metatarsalgia include interdigital neuroma, metatarsophalangeal synovitis, avascular necrosis, sesamoiditis, and inflammatory arthritis; however, these causes often are diagnosed separately.
- The primary symptom of metatarsalgia is pain at one or more of the metatarsal heads. Diffuse forefoot pain and midfoot pain are often present in athletes with combinations of high-impact inflammatory conditions.
- Pain typically is aggravated during the midstance and propulsion phases of walking or running.
- A history of gradual chronic onset is more common than acute presentation. Chronic symptoms may be of gradual onset over 6 months.
- Morton neuroma (interdigital neuroma) produces symptoms of metatarsalgia due to irritation and inflammation of the digital nerve located in the web space between the metatarsal heads. Patients with Morton neuroma may complain of toe numbness, in addition to pain in the forefoot. The term Morton neuroma is a misnomer because no neuroma truly exists. Rather, the lesion results from a mechanical entrapment neuropathy.