Metatarsalgia & plantar plate concerns
Ball-of-foot pain.
Pain beneath the front of your foot can make every step uncomfortable. Find out what may be behind it—and how an evaluation can guide your next step.
Understanding the terms
One area.
Several possible causes.
Metatarsalgia means pain around the ball of the foot. It describes where you hurt; it doesn’t identify the cause.
Pressure & irritation
Activity, footwear, foot shape, or a painful callus can contribute to discomfort in this area. Joint problems, nerve irritation, and bone injuries can also cause similar pain.
What is the plantar plate?
It’s a strong band of tissue beneath a toe joint that helps keep the toe stable. A plantar plate injury, often involving the second toe, can cause pain under the joint and changes in toe position.
What you may notice
More than a sore spot.
- Aching or tenderness beneath the front of the foot
- A feeling of walking on a pebble or a bunched-up sock
- Swelling near the base of a toe
- A toe lifting, drifting, or beginning to overlap another toe
These symptoms can overlap. Burning or tingling may also occur with Morton’s neuroma; activity-related pain can also occur with a metatarsal bone injury.
At your appointment
Find the cause.
Make a plan.
Your physician will ask where you hurt, when it started, and what makes it better or worse. Bring the shoes you wear most and any relevant outside imaging.
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Examine the foot
Check the painful area, toe alignment, and joint stability.
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Consider imaging
X-rays may help assess bones and alignment. An MRI or other imaging may be considered when more information about soft tissue is needed.
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Discuss your options
Connect the findings with your symptoms, daily activity, and goals.
Treatment choices
A plan that fits
the problem.
Treatment depends on the diagnosis and the stability of the toe. A visit does not automatically mean surgery.
Nonsurgical care
Your plan may include reducing pressure and protecting the joint through:
- Changes to activities that aggravate pain
- Supportive footwear with enough toe room
- Properly fitted pads or orthotic support
- Taping or a splint when appropriate, with guidance on how to use it
When surgery is considered
Persistent pain, toe deformity, or instability may lead to a surgical discussion. Options can include repairing the plantar plate, adjusting one of the long bones in the foot (metatarsals), or correcting a related toe problem.
Your surgeon will explain the procedure, alternatives, risks, and recovery before you decide.
Recovery & returning to activity
Recovery depends on the diagnosis and treatment. After surgery, a protective shoe or boot and limits on weightbearing may be needed. Toe stiffness, swelling, and delayed healing can affect recovery.
Ask when you can drive, return to work, wear your usual shoes, and resume sports. Your plan should spell out those steps.
Common questions
A little clarity
before your visit.
Is this the same as plantar fasciitis?
They involve different tissues. The plantar plate supports a toe joint; the plantar fascia supports the arch. Plantar fasciitis commonly causes pain near the heel.
Does a pebble feeling mean I have a tear?
No. A similar feeling can occur with joint inflammation, a plantar plate injury, or a nerve problem such as Morton’s neuroma. An examination helps distinguish them.
What should I do about a toe that is drifting?
Arrange an evaluation rather than waiting for the position to change further. Toe alignment and joint stability help guide the treatment discussion.
Your next step
Let’s understand
what’s hurting.
Schedule a visit online, or contact our team for help arranging an appointment.
Online scheduling is provided through athenahealth. To change an existing appointment, please contact our team.