In general, metatarsalgia manifests due to several causes working together. While the ball of your foot can handle most daily stressors, it needs time to recover. By placing several different stresses on the metatarsals, you’re more likely to do damage that results in pain and discomfort.
Intense running or other exercise is a common cause of ball of foot pain. Distance runners, in particular, suffer from metatarsalgia due to the constant impact on the front of the foot. While correct shoes with extra cushioning can help mitigate the stress, they may not be enough if you run long distances several times per week.
Certain foot shapes, like high arches, can put extra pressure on the metatarsals. A high arch usually puts a lot of stress on the front of the foot and can lead to foot pain. Individuals who have longer second toes than big toes also tend to suffer from ball of foot pain due to the increased strain on the second metatarsal.
Hammertoes and bunions can affect the way you walk, which can cause ball of foot pain. As you shift your weight to accommodate these aspects of your foot, you may put more strain on the metatarsals, resulting in discomfort and stress on the joints.
Poorly fitting shoes are a common culprit of metatarsalgia. High heels transfer most of the person’s weight onto the front of the foot instead of the heel, resulting in a high occurrence of ball of foot pain. Shoes that are too tight or have a narrow toe box can affect your foot shape, resulting in an uneven gait that can put stress on the metatarsals.
In some cases, metatarsalgia may not be a result of lifestyle or activity but as a symptom of Morton’s neuroma. This condition is a non-cancerous growth of tissue around the nerve situated between the third and fourth metatarsal head. The growth puts pressure on the nerve, which results in numbness and tingling radiating into the toes and can sometimes cause pain similar to metatarsalgia.