Metatarsalgia

The metatarsalgia is a pain in the area of the metatarsus whereby only the pain in the area of the metatarsal bones (Os metacarpalis) 2-5 is included because pain in the area of the first metatarsal bone (Os metacarpalis I) is treated separately. In most cases, the pain of the metatarsus occurs during exercise, for example when walking.

Causes

The causes of primary metatarsalgia are usually due to an incorrect or excessive load, while secondary metatarsalgia is a pain in the middle foot due to chronic diseases such as rheumatism or gout. Furthermore, metatarsalgia can also be due to the wrong footwear. Particularly women, who like to wear shoes with high heels or force the foot into too tight shoes promote the malformation of the foot, which can cause a metatarsalgia.

Typical malformations of the foot are for example hallux valgus, hammer toe or claw toe. In addition, with age, the protective fat pad, which is physiologically located underneath the foot and thus cushions our steps, disappears more and more with increasing age (atrophy). This leads to the fact that our metatarsus has to withstand a greater load.

If it now comes to overloading or incorrect loading due to incorrect footwear, this can lead to metatarsalgia. Other causes can also be a so-called tendosynovitis, in which the tendons that draw to the bones of the foot are overloaded and become inflamed as a result and can then sometimes cause severe pain. Metatarsalgia can also occur if the ligaments (ligamenti) in the area of the metatarsus are overloaded.

Extremely rare is a soft tissue tumor in this area to blame for the pain in the area of the metatarsus. More often, however, metatarsalgia occurs after a fracture or bruise in the area of the metatarsus. Since the pain then occurs after the actual trauma (in this case the fracture), it is called post-traumatic metatarsalgia.

In extremely rare cases, aseptic bone necrosis (Köhler’s disease type II), a bone tumor or chronic periosteitis can be the cause of metatarsalgia. In the case of an already existing chronic disease, such as osteoarthritis, the secondary metatarsalgia mentioned above can occur. Here the actual disease (here, for example, arthrosis) spreads to other parts of the body, and in the case of the metatarsus, metatarsalgia is the result.

In general, however, the most common cause of metatarsalgia is incorrect footwear and the resulting malposition of the metatarsus. Extremely rarely is a soft tissue tumor in this area to blame for the pain in the area of the metatarsus. More often, however, metatarsalgia occurs after a fracture or bruise in the metatarsal region.

Since the pain then occurs after the actual trauma (in this case the fracture), it is called post-traumatic metatarsalgia. In extremely rare cases, aseptic bone necrosis (Köhler’s disease type II), a bone tumor or chronic periosteitis can be the cause of metatarsalgia. In the case of an already existing chronic disease, such as osteoarthritis, the secondary metatarsalgia mentioned above can occur. Here the actual disease (here, for example, arthrosis) spreads to other parts of the body, and in the case of the metatarsus, metatarsalgia is the result. In general, however, the most common cause of metatarsalgia is incorrect footwear and the resulting malposition of the metatarsus.