(See also Overview of Foot Problems.)
Metatarsal joint pain is a common cause of pain in the ball of the foot (metatarsalgia).
Metatarsal joint pain commonly results from misalignment of the joint surfaces, which puts pressure on the joint lining and destroys cartilage in the joints.
Metatarsophalangeal joint misalignment can be caused by disorders, such as rheumatoid arthritis, that inflame the joints. In rheumatoid arthritis, hammer toes can develop, which can worsen joint pain and misalignment. Fat tissue, which helps cushion the joints when bearing weight, can be pushed forward under the toes, resulting in a loss of cushioning in the ball of the foot. This loss of cushioning normally occurs as many people age but makes people more susceptible to pain when the ball of the foot is stressed or injured repeatedly (for example, by running or by walking excessively). This loss of cushioning may lead to damage to the nerves of the foot and to the development of calluses and small bursae (fluid-filled sacs).
Metatarsophalangeal joint pain can also result from osteoarthritis or stiffening of the joints of the ball of the foot, often at the big toe joint. Most people with these disorders have an abnormal motion of the foot when bearing weight and walking.
Orthoses (devices placed in the shoe) usually provide effective treatment for metatarsal joint pain. Shoes that have thicker soles than normal and rounded heels (called rocker sole modifications) also help reduce pressure and abnormal motion. Occasionally, when these measures are ineffective, surgery is needed.