What is Metatarsalgia?

By Kelly Rocheleau, PT

What is Metatarsalgia?

The quick answer, Metatarsalgia, is a pain in the ball of your foot. Several different reasons can cause pain. Metatarsalgia is a condition involving pain and inflammation of the ball of your foot.

This is the area between the arch and toes on the bottom of the foot. This is a prevalent overuse injury, sometimes developed after performing activities that involve running or jumping. Usually, this condition is not serious and requires at-home treatments such as rest, ice, and wearing proper footwear.

The most common reason for this condition is wearing shoes that are too tight or too narrow.  This can easily be fixed by discontinuing the use of these shoes.  But, often, the pain and irritation can remain.  It is important to decrease the inflammation w of ice, trying to stay off the foot as much as possible.

Another cause for metatarsalgia is shoes that do not have good arch support for the foot.  It is important to have shoes that are comfortable and shoes that support your arch of the foot.  This is really important for people who are on their feet for the majority of their day.

Symptoms of Metatarsalgia

Symptoms of metatarsalgia can include:

• Pain to the ball of your foot (the part of your sole just behind the toes). This pain can be sharp, burning, or aching.
  • Usually, this pain will increase when you stand, walk, run, or flex your feet. This pain will also increase when you walk barefoot on hard surfaces.
  • Most often, the pain comes on over a period of several months rather than suddenly.
• Numbness or tingling in your toes. It could feel like a pebble in your shoe.

Causes of Metatarsalgia

A single factor can cause Metatarsalgia, but more likely is caused by multiple factors such as:

• Overuse activities, including running or high-impact sports. This is because the front of the foot absorbs the most force with these activities.
• Poor-fitting shoes. Wearing high heels or shoes that are too tight or loose can cause metatarsalgia.
• Excess weight can transfer pressure to your forefoot, contributing to pain symptoms.
• Certain foot shapes. High arches put extra pressure on the metatarsals. Having a second toe longer than the first can cause more weight to be shifted to the second metatarsal head. Other foot problems such as hammertoe and calluses on the bottom of your feet can put you at a higher risk of developing metatarsalgia.
• Morton’s Neuroma. This condition happens when the tissue around a nerve leads to a toe thickens from irritation or compression. This is a noncancerous growth of fibrous tissue around a nerve and causes symptoms that are like metatarsal.
• Stress fractures. A break in the metatarsal bone happens with repeated injury or stress. The metatarsal bones are the long bones in your foot that connect your ankle to your toes.

Treatment

There are many ways to help ease metatarsalgia pain.

• Rest. Avoid walking, running, or any high-impact activities. Elevating your foot will also help. You might need to avoid your favorite sport for a while, but you can perform low-impact activities such as bicycling or swimming.
• Ice. Apply ice packs to the affected area for about 20 minutes, 3 – 4 times per day.
• Wear proper shoes. Wear shoes appropriate for your activity and avoid high heels or walking barefoot on hard surfaces.
• Pads. A metatarsal pad or surgical shoe will help offload the painful part of your foot.
• Take an over-the-counter pain reliever such as ibuprofen, naproxen sodium, or aspirin to reduce pain and inflammation.
• Wear arch supports. If pads or insoles don’t help, consider trying arch supports to minimize stress on the metatarsal bones and improve function. You can buy these over the counter, or they can be custom fitted.

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Author: Kelly Rocheleau, MPT, CSCS