Metatarsal pain, often referred to as metatarsalgia, can be caused by several foot conditions, including Freiberg's disease, Morton's neuroma and sesamoiditis. According to the Merck Manuals website, metatarsal pain may originate in the joints and tissues near the ball of the foot or within the joints themselves. Metatarsal pain can range from mild to severe, and it can have a significant effect on a person's ability to perform the activities of daily living.
Freiberg's Disease
According to the Merck Manual's website, Freiberg's disease involves tissue death or necrosis of parts of the bones in the ball of the foot, usually the head of the second metatarsal bone. Freiberg's disease is caused by damage to the bone, and the condition is most common among young girls experiencing a growth spurt and people possessing a short bone connecting to the base of the big toe, or hallux. In both groups, the second metatarsal bone's head is vulnerable to repetitive stress. The Merck Manual's website notes that Freiberg's disease-related pain often is worse when a person bears weight on the involved foot, especially during forward propulsion or when wearing high-heeled shoes. It's common for the involved joint to be stiff and swollen. Conservative treatment of Freiberg's disease involves wearing low-heeled shoes or shoes with no heel at all. Shoes lacking heel elevation help relieve pressure in the involved joints, tissues and structures.
Morton's Neuroma
The Mayo Clinic website states that neuromas---nerve tissue growths---may develop in any part of the body. Morton's neuroma manifests in the foot, typically between the third and fourth metatarsal bones. Morton's neuroma involves a thickening of the nerve---the common intermetatarsal nerve---that runs to the toes. Common symptoms associated with Morton's neuroma include sharp or burning pain at the ball of the foot, and burning or numbness in the toes. Morton's neuromas develop when the common intermetatarsal nerve is squeezed and stretched, which may result from wearing conventional footwear, tissue irritation or injury. Morton's neuroma can be treated conservatively by wearing shoes that are flat, wide and flexible and using metatarsal pads to decrease the focal pressure on the involved nerve tissue on the ball of the foot.
Sesamoiditis
According to the Foot Health Facts website, a sesamoid is a bone embedded in a tendon, and there are two pea-shaped sesamoid bones in the ball of the foot, underneath the big toe, where the head of the first metatarsal bone meets the toe proper. The most common cause of sesamoiditis is repetitive injury. Occasionally, a fracture of the sesamoid bones will occur or the bones and the surrounding tissues will become irritated and tender. Individuals who have an increased risk of sesamoiditis include dancers, joggers and those who wear high heels on a consistent basis. Sesamoiditis-related pain typically is felt under the ball of the foot at the big toe and may be exacerbated by walking or wearing tight shoes. The area around the involved sesamoid bones may be inflamed and swollen. Conservative treatment options for sesamoiditis include avoiding footwear that may be contributing to the problem and participating in physical therapy.
