What is metatarsalgia?

Metatarsalgia refers to pain under the metatarsal heads at the forefoot, most of which is concentrated under the metatarsophalangeal joint. It is more common in people with foot malalignment, athletes, middle-aged people and women who wear high heels or thin bottom shoes.


  • Foot malalignment: Such as pronated feet or high arched feet which cause uneven pressure distributed on the metatarsal heads of the forefoot, increasing the pressure in localised areas. It also increases the friction between the metatarsals, which can lead to Morton’s neuroma.
  • Toe deformities: E.g. claw toes, hammer toes, which increase pressure on the metatarsal joint.
  • Wearing poor footwear: E.g. high heels, narrow toe and thin-bottom shoes.


  • The more you walk, the more painful your forefoot becomes.
  • Pain may also occur when the toes are dorsiflexed (extend).
  • Numbness appears if you experience Morton’s neuroma.
  • Feel like walking on a rocky path while walking on a flat surface


  1. Choose the right shoe: Avoid high heels or narrow toe and thin-bottom shoes. Toe box should be wide enough.
  2. Rocker-soled shoes: Thick and stiff soled functional shoes with a large toe spring to avoid bending of the metatarsal joint during walking, thus effectively reducing the pain of metatarsalgia caused by toe dorsiflexion.
  3. Metatarsal pad: A small teardrop-shaped pad that redistributes the pressure on the metatarsal head, supports the transverse arch and reduces the chance of pinching the nerves.
  4. Forefoot pad: A shock-absorbing pad to relieve pressure on the forefoot.
  5. Custom-made foot orthoses: Supports and stabilizes the foot, increases the contact area of plantar surface, and further redistributes the pressure on the forefoot.

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