What are the causes of metatarsalgia (forefoot pain)?

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Last updated: April 23, 2025View editorial policy

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Differential Diagnosis for Forefoot Pain

  • Single most likely diagnosis
    • Metatarsalgia: This condition is characterized by pain and inflammation in the ball of the foot, which is a common complaint in individuals with forefoot pain. It can be caused by various factors such as poorly fitting shoes, overuse, or abnormal foot mechanics.
  • Other Likely diagnoses
    • Morton's neuroma: A condition where a nerve in the foot becomes irritated, causing pain, numbness, and tingling between the toes.
    • Plantar fasciitis: Inflammation of the plantar fascia, a band of tissue that runs along the bottom of the foot, can cause pain in the heel and forefoot.
    • Sesamoiditis: Inflammation of the sesamoid bones, which are located under the first metatarsal bone, can cause pain and swelling in the forefoot.
    • Bunion or bunionette: A bony growth on the joint of the big toe or little toe can cause pain, redness, and swelling in the forefoot.
  • Do Not Miss diagnoses
    • Osteomyelitis: A bone infection that can cause severe pain, redness, and swelling in the affected area, and can lead to serious complications if left untreated.
    • Deep vein thrombosis (DVT): A blood clot in the deep veins of the leg can cause pain, swelling, and warmth in the affected area, and can be life-threatening if it breaks loose and travels to the lungs.
    • Diabetic foot ulcer: Individuals with diabetes are at risk of developing foot ulcers, which can cause pain, numbness, and tingling in the forefoot, and can lead to serious complications if left untreated.
  • Rare diagnoses
    • Freiberg's disease: A rare condition that affects the metatarsal bones, causing pain and stiffness in the forefoot.
    • Kohler's disease: A rare condition that affects the navicular bone, causing pain and swelling in the midfoot and forefoot.
    • Charcot foot: A rare condition that affects individuals with diabetes, causing nerve damage and degeneration of the joints in the foot, leading to pain, numbness, and tingling in the forefoot.

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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