Pain in this area can be due to a number of conditions. These may include:
Metatarsalgia – this is a general term referring to an inflammation around the metatarsal phalangeal joint, which gets a lot of pressure from walking, running or wearing heels. It is usually a result of poor foot alignment and the resulting compensation of tight soft tissues in the area. It is common to see a dropped metatarsal arch associated with this condition, which causes increased more pressure through the area. This also becomes a common area for stress fractures.
Morton’s neuroma or nerve entrapment — a Morton’s neuroma is the most common of the nerve entrapments and occurs between the third and fourth toe. It is caused by a poor gait developed from the misalignment of the foot. Other nerve entrapments are common because this area receives a lot of pressure from the way the foot is placed on the ground when running or walking. If nerve entrapments are not treated promptly, the nerve can sometimes become permanently inflamed and must be cut out. Immediate treatment is indicated.
Metatarsal bursa — this is less common than the other conditions, but it can be extremely painful. A bursa is a fluid-filled sack that absorbs pressure. This area of the foot has many airbags that can puff up and become tender unless the underlying cause (usually foot misalignment) is corrected. The bursas usually return to normal unless treatment has been put off.