What is the cause of metatarsalgia at the 2nd toe?

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Last updated: April 4, 2025View editorial policy

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Differential Diagnosis for Pain at the Ball of the 2nd Toe of the Feet

Single Most Likely Diagnosis

  • Morton's Neuroma: This condition is characterized by a benign growth of nerve tissue in the ball of the foot, often between the 2nd and 3rd toes, causing pain, numbness, and tingling. The location and nature of the pain described make Morton's Neuroma a highly plausible diagnosis.

Other Likely Diagnoses

  • Metatarsalgia: This refers to pain in the ball of the foot, which can be caused by various factors including poor foot mechanics, overuse, or ill-fitting shoes. Given the location of the pain, metatarsalgia is a reasonable consideration.
  • Stress Fracture: A small crack in one of the bones in the foot, often caused by overuse or repetitive stress. The 2nd metatarsal bone is a common site for stress fractures, which could explain pain in the ball of the foot.
  • Bursitis: Inflammation of a bursa, a fluid-filled sac that cushions bones, tendons, and muscles near joints. Bursitis in the foot can cause pain in the ball of the foot, especially if the bursa near the 2nd toe is affected.

Do Not Miss Diagnoses

  • Gout: Although less common in the toes other than the big toe, gout can cause sudden, severe pain in any joint, including those in the ball of the foot. Missing a diagnosis of gout could lead to prolonged suffering and potential joint damage.
  • Infection (Cellulitis or Abscess): Infections in the foot can cause significant pain and have serious consequences if not treated promptly, including the potential for spreading to other parts of the body.
  • Deep Vein Thrombosis (DVT): While DVT typically presents with swelling and pain in the calf, in rare cases, it can cause pain in the foot. Given the potential for serious complications, including pulmonary embolism, DVT should not be missed.

Rare Diagnoses

  • Freiberg's Disease: A rare condition that affects the metatarsal bones in the foot, causing pain and stiffness, especially in the 2nd metatarsal bone. It is more common in adolescents and young adults.
  • Kohler's Disease: A rare bone disorder causing pain and swelling in the foot, typically affecting the navicular bone but can sometimes affect other areas, including the ball of the foot.
  • Charcot Foot: A condition that affects the nerves and joints in the foot, causing pain, redness, and swelling, often in people with diabetes or other conditions that affect nerve function. It can lead to significant deformity if not managed properly.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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