Metatarsalgia
Pain in the sole, at the base of the toes. It is the area that carries most weight as the foot pushes off.
Metatarsalgia is the name for pain in the metatarsal area: the part of the sole just behind the toes, which carries almost all the weight at the moment the foot pushes off the ground. It is described as walking on a stone or feeling the bone against the floor, and it increases when walking barefoot, in thin-soled shoes or in heels.
It is nearly always a load-distribution problem: if one metatarsal head takes more pressure than its neighbours, that area becomes irritated and painful, and over time hard skin appears as a marker of where the excess is. Behind it there may be a toe that has lost its contact with the ground, a wide forefoot, loss of the fat pad in the sole —very common with age—, narrow or high-heeled footwear, or activity that has increased suddenly.
How it is approached
- Locating the painful area and the hard skin that accompanies it.
- Assessment of how pressure is distributed across the forefoot.
- Examination of the toes and of joint mobility.
- Review of footwear: width, sole and heel height.
- Offloading of the area and, where appropriate, insoles to redistribute load.
Does it feel like you are walking on a stone in the front of your sole?
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