What is it?
Metatarsalgia means pain under the ball of the foot. One common cause is a tear of the plantar plate, a strong ligament under the joint at the base of a toe (usually the second). When it tears, the toe can drift sideways or lift upwards.
What causes it?
- Overloading of the ball of the foot, for example from a long metatarsal bone, a bunion or a high arch.
- A tight calf muscle.
- High-heeled shoes.
- Thinning of the natural fat pad with age.
Common symptoms
- Pain under the ball of the foot, often near the second toe.
- Swelling around the base of the toe.
- The toe drifting towards the big toe or crossing over it.
- A feeling of walking on a pebble.
How is it diagnosed?
Your surgeon will examine the joints and test the stability of the toe. X-rays are taken, and an ultrasound or MRI scan can show a plantar plate tear.
Things you can do now
- Wear cushioned shoes with a low heel, or try a rocker-soled shoe to take pressure off the ball of the foot
- Use a metatarsal pad or insole
- Stretch your calf muscles daily
- Tape the affected toe down if it is starting to lift
Treatment
Treatment is tailored to your individual needs, symptoms and goals. Depending on your situation, it may include supportive footwear, metatarsal pads or insoles, calf stretching, taping or splinting the toe and surgery to repair the plantar plate, shorten the metatarsal bone or correct the toe.
Mr Jeyaseelan will talk you through the options that are right for you at your consultation.
When to see a specialist
- Pain under the ball of the foot persists despite insoles and footwear changes
- A toe is drifting, lifting or crossing over
- There is swelling at the base of a toe
What to expect
Most metatarsalgia settles with footwear and insoles. A plantar plate tear that is causing a toe to drift may need surgical repair to stop it getting worse.
Common questions
Where can I see a specialist about metatarsalgia & plantar plate tears in London?
Mr Lucky Jeyaseelan, a consultant orthopaedic surgeon who specialises only in the foot and ankle, sees private and insured patients with metatarsalgia & plantar plate tears at Align Orthopaedics on Harley Street, The London Clinic on Devonshire Place, HCA London Bridge Hospital, HCA UK at The Shard, HCA UK City of London on Old Broad Street and The Holly Hospital in Buckhurst Hill, Essex. See all clinic locations or request an appointment.
Do I need a GP referral?
Self-funding patients can book directly, though a GP letter is helpful. Most insurers need a GP referral before they authorise your consultation, so check with yours first.
This information is general and is not a substitute for a medical consultation. Your diagnosis and treatment plan will be tailored to you.