Metatarsalgia

Author: Britt A Durham, MD; Chief Editor: Sherwin SW Ho, MD more...

Updated: Feb 28, 2010

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Background
Epidemiology
Functional Anatomy
Sport-Specific Biomechanics
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Background

Metatarsalgia is a common overuse injury described as pain in the forefoot that is associated with increased stress over the metatarsal head region. Metatarsalgia is often referred to as a symptom, rather than as a specific disease. Common causes of metatarsalgia include interdigital neuroma (also known as Morton neuroma), metatarsophalangeal synovitis, avascular necrosis, sesamoiditis, and inflammatory arthritis; however, these causes are often diagnosed separately. (See also the eMedicine articles Morton Neuroma [in the Physical Medicine and Rehabilitation section], Morton Neuroma [in the Orthopedic Surgery section], and Avascular Necrosis [in the Rheumatology section].)

For excellent patient education resources, visit eMedicine's Arthritis Center and Bone, Joint, and Muscle Center. See also Medscape's Arthritis Resource Center.

Frequency

United States

Athletes who participate in high-impact sports that involve the lower extremities commonly present with forefoot injuries, including metatarsalgia.^{[1, 2]}

Functional Anatomy

Body weight is transferred to the foot by gravity. This transfer of force is increased to the forefoot during the mid-stance and push-off phases of walking and running.^{[2, 3]}In the forefoot region, the first and second metatarsal heads receive the greatest amount of this energy transfer. Peak vertical forces reach 275% of body weight during running, and a runner may absorb 110 tons per foot while running 1 mile.^[2]Pressure studies have shown that runners spend most of the time weighted over the forefoot while running.

Sport-Specific Biomechanics

Athletes who take part in high-impact sports that involve running or jumping are at high risk of forefoot injuries.^{[1, 2]} Although track-and-field runners are exposed to the highest level of traumatic forces to the forefoot, many other athletes, including tennis, football, baseball, and soccer players, often present with forefoot injuries.

Proceed to Clinical Presentation

Contributor Information and Disclosures

Author

Britt A Durham, MD Director of Risk Management, Department of Emergency Medicine, Martin Luther King Medical and Trauma Center, King-Drew Medical Center; Assistant Professor of Emergency Medicine, Drew College of Medicine; Assistant Clinical Professor of Emergency Medicine, UCLA School of Medicine; Partner and Chief Financial Officer, Durcress Medical Group, California Medical Board District Medical Consultant, Lakewood Atheletic Sports Medicine Team Physician

Britt A Durham, MD is a member of the following medical societies: American Academy of Emergency Medicine

Disclosure: Nothing to disclose.

Specialty Editor Board

Anthony J Saglimbeni, MD President, South Bay Sports and Preventive Medicine Associates; Private Practice; Team Internist, San Francisco Giants; Team Internist, West Valley College; Team Physician, Bellarmine College Prep; Team Physician, Presentation High School; Team Physician, Santa Clara University; Consultant, University of San Francisco, Academy of Art University, Skyline College, Foothill College, De Anza College

Anthony J Saglimbeni, MD, is a member of the following medical societies: California Medical Association and Santa Clara County Medical Association

Disclosure: Nothing to disclose.

Francisco Talavera, PharmD, PhD Senior Pharmacy Editor, eMedicine

Disclosure: eMedicine Salary Employment

Russell D White, MD Professor of Medicine, Director of Sports Medicine Fellowship Program, Medical Director, Sports Medicine Center, Head Team Physician, University of Missouri-Kansas City Intercollegiate Athletic Program, Department of Community and Family Medicine, University of Missouri-Kansas City School of Medicine, Truman Medical Center Lakewood

Russell D White, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Family Physicians, American Association of Clinical Endocrinologists, American College of Sports Medicine, American Diabetes Association, and American Medical Society for Sports Medicine

Disclosure: Nothing to disclose.

Jon B Whitehurst, MD Clinical Instructor of Surgery, University of Illinois College of Medicine; Partner, Rockford Orthopedic Associates; Orthopedic Chairman, Rockford Memorial Hospital

Jon B Whitehurst, MD is a member of the following medical societies: American Academy of Orthopaedic Surgeons, American Orthopaedic Society for Sports Medicine, and Arthroscopy Association of North America

Disclosure: Nothing to disclose.

Chief Editor

Sherwin SW Ho, MD Associate Professor, Department of Surgery, Section of Orthopedic Surgery and Rehabilitation Medicine, University of Chicago

Sherwin SW Ho, MD is a member of the following medical societies: American Academy of Orthopaedic Surgeons, American Orthopaedic Society for Sports Medicine, and Arthroscopy Association of North America

Disclosure: Breg, Inc. Consulting fee Consulting; Biomet, Inc. Consulting fee Consulting; GMV, Inc. Arthroscopy Simulator Evaluation and teaching; Smith and Nephew Grant/research funds Fellowship funding; DJ Ortho Grant/research funds Course funding

References

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