Sometimes a single factor can lead to metatarsalgia. More often, several factors are involved, including:

  • Intense training or activity. Runners are at risk of metatarsalgia, primarily because the front of your foot absorbs significant force when you run. But anyone who participates in a high-impact sport is also at risk, especially if your shoes fit poorly or are worn out.
  • Certain foot shapes. A high arch can put extra pressure on the metatarsals. So can having a second toe that's longer than the big toe, which causes more weight than normal to be shifted to the second metatarsal head.
  • Foot deformities. Wearing too-small shoes or high heels can cause your foot to be misshapen. Hammertoe, when one of your toes curls downward, and bunions, swollen, painful bumps at the base of your big toes, can result in metatarsalgia.
  • Excess weight. Because most of your body weight transfers to your forefoot when you move, extra pounds mean more pressure on your metatarsals. Losing weight may reduce or eliminate symptoms of metatarsalgia.
  • Poorly fitting shoes. High heels, which transfer extra weight to the front of your foot, are a common cause of metatarsalgia in women. Shoes with a narrow toe box or athletic shoes that lack support and padding also can contribute to metatarsal problems.
  • Stress fractures. Small breaks in the metatarsals or toe bones can be painful and change the way you put weight on your foot.
  • Morton's neuroma. This noncancerous growth of fibrous tissue around a nerve usually occurs between the third and fourth metatarsal heads. It causes symptoms that are similar to metatarsalgia and can also contribute to metatarsal stress.

    Morton's neuroma frequently results from wearing high heels or too-tight shoes that put pressure on your toes. It can also develop after high-impact activities such as jogging and aerobics.

May. 14, 2014

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