Metatarsal pain


Metatarsal pain often arise from Injuries, Misalignments of the feet or overload. Depending on the cause, the treatment of the complaints is very different. The type of pain, as well as its precise location, can provide clues as to the underlying cause. Possible causes are listed below.

Metatarsus pain, outside

Pain in the metatarsus can preferably be outside of the metatarsus, i.e. in the area of ​​the outer metatarsal bones (Ossa metatarsalis) occur. This is the case, for example, when a patient bends his foot outwards. Women who walk on higher heel shoes are particularly at risk of their feet buckling outwards. This can not only lead to torn ligaments in the area of ​​the ankle, but also pain in the outer metatarsus. These are either due to the fact that the bone is compressed or that the ligaments of the metatarsal bones are crushed or have torn a small ligament. In rare cases, a fracture can also occur, which then leads to severe pain in the outer metatarsus. The fracture can either be caused by a hard blow to the metatarsal bones or it can result from a too heavy load to a fatigue fracture, i.e. a fracture caused by permanent overloading of the metatarsal bones. In this case, the pain in the outer metatarsus is not quite as great as in a “real” fracture caused by an external trauma. However, both fractures should be splinted or operated on depending on their severity.

Read more on the subject at: Pain on the edge of the foot

Figure pain ankle

Figure foot pain

Foot pain

  1. Achilles tendonitis /
    Achilles tendon rupture
  2. Broken bones - toes,
    Metatarsus, tarsus
    (here outer ankle fracture)
  3. Ligament stretch / torn ligament
    at the ankle
  4. Lower and upper heel spurs
    Calcaneus spur
  5. Hammer toe and claw toe
    (Deformities of the toe bones)
    Digitus malleus
  6. Plantar warts
    Verrucae plantares
  7. Hallux valgus -
    (Deviation of the big toe
    in the base joint)
  8. Hallux rigidus -
    (Joint wear of the
    Metatarsophalangeal joint)
  9. Inflamed nails / nail fungus
  10. Osteoarthritis / arthritis -
    degenerative change of
    Joints / inflammation of the joints

You can find an overview of all Dr-Gumpert images at: medical illustrations

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Athletes (joggers, soccer players, etc.) are particularly often affected by diseases of the foot. In some cases, the cause of the foot discomfort cannot be identified at first.
Therefore, the treatment of the foot (e.g. Achilles tendonitis, heel spurs, etc.) requires a lot of experience.
I focus on a wide variety of foot diseases.
The aim of every treatment is treatment without surgery with a complete recovery of performance.

Which therapy achieves the best results in the long term can only be determined after looking at all of the information (Examination, X-ray, ultrasound, MRI, etc.) be assessed.

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Metatarsus pain inside

Pain in the area of ​​the inner metatarsus can have many causes. On the one hand, it can simply be that the patient feels the Kicked foot and there is now pain in the area of ​​the inner metatarsus. Especially in women, pain in the area of ​​the inner metatarsus is common, as many women suffer from the so-called hallux valgus which is a deviation of the inner first metatarsal bone, which then becomes a large bony one Elevation in front of the first big toe and thus the big toe in tilt offset. If the patient now wears shoes that are too tight or heels that are too high, they may press on the head of the first metatarsal bone and then close Bruises which the patient feels as uncomfortable pain in the inner metatarsus feels. It is therefore important that patients who suffer from hallux valgus suitable footwear wear so that there is no pain in the inner metatarsus. However, the pain in the inside of the metatarsus can also be caused by a Upsetting or one bruise be evoked. Most of time swells the foot in the affected area is also slightly sensitive to pressure. In addition, the bones of the metatarsus can either be through a outer Violence break or through a fatigue fracture, i.e. a fracture caused by long-lasting overload was caused. In addition, there is a very rare disease which also leads to severe pain in the inner metatarsus. In very rare cases it can actually lead to a Bone infarction of the metatarsal bone. Most of the time it is first metatarsal affected, i.e. the innermost, which is why the pain mainly occurs in the inner metatarsal area. This bone infarction goes with you Metatarsal death together, this process is called aseptic bone necrosis or after its discoverer as Köhler-Freiberg's disease. Due to the slow decline of the bone, there is initially one Inflammatory responseSo the patient notices a pain in the inner metatarsus as well swelling. The cause has not yet been clarified, but wearing high shoes and overstressing the foot probably promote bone infarction. In general, however, the disease is considered very rare and should therefore not be considered first.

Metatarsus pain when walking

The pain can come from the wrong footwear.

It comes with To run Too pain in the metatarsal area may initially turn to one overload be due. Above all, athletes who previously did less sport and now want to get started often overload their feet with it. It can be too Bruises, little ones Torn ligaments or bruises which then lead to pain in the metatarsus when walking as they are then exposed to greater stress again. That too wrong footwear can sometimes severe pain guide in the metatarsus while running. If you put too much pressure on your metatarsal bones through your shoes, you will feel pain. You should therefore make the right choice of Sports shoes pay attention to this the Fit of the foot paste and thus cause no pain when walking. In rare cases, the pain while walking can be caused by a stress fracture caused by overstressing the metatarsal bones. Most of the time, the affected areas are also swollen and the pain in the metatarsus gets worse and worse while walking, so the patient should then consult a doctor so that he can examine the foot.

Metatarsal fracture

In the Metatarsal fracture it comes to Breakage of one or more metatarsals mostly through indirect violence, like that Twist with the foot or one bruise. Even if a great force acts directly on the metatarsus, for example if a heavy object falls on the footmetatarsal fracture can occur. The second metatarsal is most often affected.

The symptoms of a metatarsal fracture are usually one distinct pain on occurrence with the injured foot, as well swelling and often too Bleeding into the surrounding tissue. The metatarsal area is very tender on pressure. However, a X-ray image as the symptoms are relatively unspecific for the metatarsal fracture.

The Therapy of metatarsal fracture depends on their extent. If only one metatarsal bone is broken, it is often enough to have the foot with one plaster for about 6-8 weeks immobilize and then return to normal stress. However, the break is unstable or is that first metatarsal affected is often a surgical intervention indicated to get a good result. The fracture ends are marked with so-called Kirschner wires fixed to each other. It usually takes some time until the fracture has healed completely and the original load-bearing capacity is restored two to three months.

Morton's neuroma

The diagnosis takes place in the MRI.

Morton's neuroma (also Morton's neuralgia or Morton's metatarsalgia) usually develops in people with splayfoot. This leads to permanent mechanical irritation of the nerves that run between the metatarsal bones. Due to the splayfoot position, these are compressed there and react with thickening and connective tissue changes. One also speaks of a “neuroma”, as this term describes a benign growth of nerve tissue.

The symptoms of Morton's neuroma are sudden shooting pain in the metatarsus, which is also accompanied by pronounced tenderness in this area. The neuroma is usually located between the third and fourth metatarsal bones.

In order to be able to make the diagnosis, an ultrasound image or MRI of the foot must be made, in which the neuroma can be recognized and localized. This is important for the subsequent therapy.

If the symptoms are very severe, the Morton's neuroma can be surgically removed. Otherwise, it may also be sufficient to correct the splayfoot malposition, whereby the changes in the nerves can recede as soon as the mechanical irritation ceases. Since the complete removal of the changed nerve has long been considered the standard method, but this often brings complications with it, nerve-conserving surgery is increasingly being attempted.

Diseases of the joints

Metatarsal pain can also be caused by radiating pain from other areas of the foot. Osteoarthritis of the metatarsophalangeal joints is relatively common, which can cause discomfort due to its proximity to the metatarsus. Osteoarthritis usually develops as a result of wear and tear in the aging process and leads to changes in the joint surfaces. The cartilage is worn away, so that the joint partners no longer fit together optimally. The resulting increased friction in the joint then causes pain.


For example, all structures that make up the foot can penetrate overload or Improper loading, such as external injury with bacterial colonization ignite. So can the Tendons and Tapes, but also the Inflammate the metatarsal bones directly. A Periosteum inflammation to the metatarsal bones (Periostitis) can be very uncomfortable and lead to pain when stepping on, as well as tenderness in the metatarsus.

More about this topic can be found: Tendonitis in the metatarsus

Misaligned feet

Misaligned feet all kinds (Arches foot, Flat foot, Buckle foot, Arched feet, splayfoot) can cause pain in the metatarsus. This is because the changed anatomical position of the foot bones and surrounding structures other pressure conditions train in the foot that are not optimal for the load on the foot. This makes it secondary to Irritation from nerves running there or to Entrapment of tendons, nerves, or ligamentswhich then causes pain.

Often one can already orthopedic insole for the shoes help relieve symptoms. The insoles are individually adapted to the conditions of the foot and have a special profile that corrects the anatomical position of the foot structures. As a result, the pressure is better distributed again and the pain is reduced.

You can read more about this topic at: Pain on the instep.