Metatarsalgia

Metatarsalgia is a symptom — pain under the metatarsal heads at the ball of the foot — rather than a single diagnosis. Causes include fat pad atrophy, elevated metatarsal head pressure (from cavus foot, claw toes, or tight calf), a previous surgery on the adjacent ray, synovitis of the MTP joint, plantar plate tear, or stress fracture. Identifying the underlying cause is essential to effective treatment.

Weight-bearing X-rays assess metatarsal length, alignment, and any stress fracture. MRI evaluates the plantar plate, intermetatarsal bursa, and synovium. Ultrasound is useful for dynamic assessment of plantar plate integrity.

1. Corticosteroid injection

   For MTP joint synovitis or intermetatarsal bursitis.

Surgery targets the underlying deformity: Weil osteotomy to shorten an elongated metatarsal, plantar plate repair for instability, or correction of claw toe deformity.

External patient-education references and related OSI pages for additional background:

• Britannica — Ankle (anatomy)
• AAOS OrthoInfo — patient education library
• OSI glossary — orthopedic terminology in plain language