Symptoms of metatarsalgia is pain at the end of one or more of the metatarsal bones and Morton’s Neuroma (interdigital neuroma). The pain is typically aggravated when walking or running.

Athletes who participate in high-impact activities and may also have an inflammatory condition, such as Bursitis, often have diffused forefoot and mid-foot pain. Most often, the pain comes on over a period of several months, rather than suddenly.

Morton’s Neuroma produces symptoms of metatarsalgia due to irritation and inflammation of a nerve at the site of pain. People with Morton’s Neuroma may experience toe numbness in addition to pain in the forefoot.


The foot can be injured during sports activities. As with many other overuse injuries, the condition may be the result of an alteration in normal biomechanics that has caused an abnormal weight distribution. Persistent stress can lead to chronic irritation and inflammation of the bone covering and adjacent tissues, such as ligaments and tendons.

The following factors can contribute to excessive localized pressure over the forefoot:

  • High level of activity
  • Prominent metatarsal heads
  • Tight toe extensors (muscles)
  • Weak toe flexors (muscles)
  • Hammertoe deformity
  • Hypermobile first foot bone
  • Tight Achilles Tendon
  • Excessive pronation (side to side movement of the foot when walking or running)
  • Ill-fitting footwear

Some anatomical conditions may predispose individuals to forefoot problems, like:

  • High arch
  • Short metatarsal bone often seen in people with Morton Toe; the normal forefoot balance is distributed, resulting in the shifting of increased weight to the second metatarsal.

Any of the above musculoskeletal problems may contribute to forefoot trauma in athletes.


Xrays may be helpful in excluding other causes of forefoot pain and a bone scan can pinpoint places of inflammation. An ultrasound can help identify conditions such as Bursitis or Morton’s Neuroma that can be causing pain in the metatarsal region of the foot.

The doctor may also ask for an MRI to help detect and diagnose many causes of pain in the metatarsal and mid-foot regions that could include:

  • Traumatic disorders
  • Circulatory conditions
  • Arthritis
  • Neuroarthropathies
  • Biomechanical Imbalance