Forefoot Pain

Painful conditions can occur in this area separately or in combination at the metatarsophalageal joint intersection. Common causes of pain in this region of the forefoot include:

Calluses, which either spread out over a broad area or are isolated beneath a single metatarsal head. Calluses may have structural or functional causes.

Some structural causes could be:

1. Enlarged Metatarsal Head


2. Depressed Metatarsal (a bone that sits lower than the others)


3. Abnormally long metatarsal


4. Abnormal Sesamoid Bone


5. Foreign Bodies embedded in the foot


6. Degenerative changes to the joints from inflammation or Arthritis

Some Functional causes could be:

1. Abnormal biomechanical function of the foot. These abnormalities include:flatfeet, high- arched feet and contracted toes. Each entity will produce specific callus patterns on the ball of the foot.


2. Loss or thinning of the fat pad naturally occurs with age. Atrophy of the fat pad can be accelerated by diseases such as Rheumatoid Arthritis. Thinning of the fat pad is also common in postmenopausal women.


3. Displacement of the fat pad exposes the metatarsal heads to abnormal pressure. Displacement occurs mostly with people who have unnaturally high-arched feet or with individuals heavily involved in sport activities over a long period of time, when there is continuous strain on the ball of the foot( i.e; jogging, basketball, tennis, and volleyball).

Other causes of forefoot pain include:

1. Rheumatoid Arthritis or Osteoarthritis


2. Bursitis with or without associated calluses


3. Warts, which commonly resemble calluses or corns


4. Foreign bodies, such as splinters, glass or embedded hairs


5. Neuroma or Neuritis, a condition or small nerves in between the metatarsals


6. Tendonitis


7. Cysts


8. Diabetes with neuropathy - causing burning pain or pins-and-needles tingling sensation


9. Trauma/Stress Fractures
   

What are Metatarsals?

Metatarsals comprise the ten long bones located in the feet, similar to knuckles on your hand. They are positioned right before the toes and sometimes referred to as the "ball of the foot." Painful conditions that involve the central metatarsal region (or second, third and fourth metatarsals) are referred to a metatarsalgia.

The entire weight of the body is distributed across the ten metatarsals and their related metatarsophalangeal joint. This area, which spreads forward from the metatarsal bones to the toes, is known as the forefoot. The forefoot encompasses an inter-related structure of bone, ligaments, tendons, muscles, nerves, blood vessels and skin.

Positioned underneath the metatarsal heads in a normal foot lies a "fat pad." The fat pad serves to protect and provide shock absorption to the ball of the foot.