Metatarsalgia is a common foot condition that causes pain and inflammation in the ball of the foot, usually under the metatarsal bones. Metatarsalgia is common due to the heavy weight the ball of your foot bears with every step. When one foot is off the ground, the other supports your entire body weight. This condition often affects people who engage in high-impact activities, but it can also develop due to other factors such as improper footwear or foot structure. If you're dealing with discomfort in the ball of your foot, understanding metatarsalgia and how to treat it is essential for finding relief and preventing future issues.
What is Metatarsalgia?
Metatarsalgia refers to pain in the metatarsal region—the area just before the toes, commonly referred to as the "ball" of the foot. The pain can vary from a dull ache to a sharp, burning sensation and may be worsened by walking, running, or standing for long periods. People with metatarsalgia often describe the pain as though they are stepping on a pebble or rock.
While metatarsalgia is not a condition on its own, it is often the result of other foot issues that put pressure on the metatarsals.
Causes of Metatarsalgia
There are several causes and risk factors that can lead to metatarsalgia, including:
- Foot Structure: Individuals with high arches, flat feet, or an uneven metatarsal length may experience increased pressure on the ball of the foot.
- Improper Footwear: Wearing shoes that lack support, cushioning, or have narrow toe boxes (i.e. particularly high heel shoes) can contribute to the development of metatarsalgia.
- High-Impact Activities: Running, jumping, or sports that involve repetitive foot impact can cause strain on the metatarsal region.
- Overweight: Excess weight places additional pressure on the feet, increasing the risk of metatarsal pain.
- Foot Conditions: Conditions such as bunions, hammertoes, or arthritis can cause changes in foot mechanics, leading to metatarsal pain.
- Aging: As you age, the protective fat pads in the ball of your foot naturally thin out, which can lead to metatarsalgia.
Symptoms of Metatarsalgia
The symptoms of metatarsalgia can vary but generally include:
- Pain in the ball of the foot that worsens with activity and walking barefoot on hard surfaces.
- Aching, burning or sharp sensation under the metatarsal bones.
- Numbness or tingling in the toes.
- Feeling as if you are stepping on a pebble.
- Swelling or bruising in the ball of the foot.
These symptoms may come on gradually or develop suddenly, particularly after intense physical activity.
Left untreated, metatarsalgia might lead to pain in other parts of the same or opposite foot and pain elsewhere in the body, such as the lower back or hip, due to altered gait from foot pain.
Treatment for Metatarsalgia
Here are some effective treatments for relieving your initial symptoms of metatarsalgia at home:
1. Rest and Ice
Resting your feet and applying ice packs to the affected area can help reduce inflammation and alleviate pain. Try to avoid activities that put stress on your feet while they heal.
2. Footwear Changes
Wearing shoes with good arch support, a wide toe box, and extra cushioning in the forefoot can relieve pressure on the metatarsal bones. Avoid high heels and shoes with narrow fronts, which can worsen the pain. Keep your feet supported in good shoes, even inside the home. This can help reduce the stress on the damaged, painful area, and help reduce your symptoms.
3. Use Orthotics
Orthotic inserts can provide extra support and cushioning to the ball of your foot, redistributing pressure and relieving pain. Custom orthotics or over-the-counter metatarsal pads can also be beneficial.
EB Emily Braidwood Medigel Insoles
Silipos Metatarsal Cushions and Pads
4. Stretching and Strengthening Exercises
Stretching and strengthening exercises for your feet can improve flexibility and reduce tension. It’s important to note that any stretch you do should never feel painful. Tension or tightness is fine, but pain is not. If you feel any pain, cease the action immediately.
- calves & Achilles tendon: tightness in your calf muscles and your Achilles tendon can have a direct impact on the pressure on your forefoot with every step. Keeping the calves stretched and flexible can help reduce this overloading and help prevent the recurrence of metatarsalgia in the future.
- big toes: When your big toe is stiff and has reduced mobility, it can lead to extra pressure being placed on your lesser four toes. This can contribute to the development of metatarsalgia.
Fasciitis Fighter Exercise Devices
5. Pain Relief
Over-the-counter anti-inflammatory medications such as ibuprofen can help manage pain and reduce swelling in the short term. Be sure to follow the recommended dosage and consult a healthcare professional if the pain persists.
6. See a Podiatrist
If the pain continues despite at-home treatments, it’s important to consult a podiatrist. An experienced podiatrist will know what metatarsalgia treatment is needed following a thorough gait analysis and examination. Metatarsalgia recovery time will vary depending on the diagnosis but normally gradual improvement commences in line with the appropriate treatment.
In rare cases, metatarsalgia surgery may be considered, however, this is rarely required and only after all conservative treatment options have been exhausted.
Prevention Tips
To prevent metatarsalgia from developing or recurring, follow these simple tips:
- Wear proper footwear with adequate support and cushioning.
- Replace shoes regularly if you engage in high-impact activities.
- Maintain a healthy weight to reduce pressure on your feet.
- Incorporate stretching exercises into your routine to improve flexibility (including calf stretch, Achilles stretch, Big Toe stretch).
- Use orthotic insoles for additional arch and forefoot support.
If you're struggling with metatarsalgia or looking for footcare solutions, check out our Metatarsalgia Collection for products designed to provide relief and support for the balls of your feet.
FAQS About Metatarsalgia
Is metatarsalgia related to other foot conditions like Morton’s neuroma?
Yes, metatarsalgia and Morton’s neuroma can sometimes be related. Morton’s neuroma involves a thickening of the tissue around the nerves between the toes, which can contribute to pain in the ball of the foot, similar to metatarsalgia.
What is the difference between a stress fracture and metatarsalgia?A stress fracture describes tiny micro-cracks in a bone that occur for the same reasons as metatarsalgia - repetitive overloading. Metatarsalgia can include a stress fracture under its umbrella of forefoot pain, but it can also include many other tissue and joint injuries.
Can metatarsalgia affect only one foot?
Yes, metatarsalgia can affect just one foot, although it’s common for both feet to experience discomfort. It often depends on the underlying cause, such as uneven weight distribution, a foot injury, or the way you walk.
Why is metatarsalgia common in cyclists?
Metatarsalgia is often seen in cyclists, especially those who wear carbon fibre cycling shoes. These shoes are popular for their stiffness but can increase peak plantar pressures in the forefoot by 19%. Your podiatrist can help you make adjustments to continue cycling during recovery. Consider using orthotics like the COBRA SemiPro Cycling Orthotics for added support.
Why is metatarsalgia common in runners?
Running puts significant strain on the metatarsals, particularly for forefoot runners. Depending on your symptoms, it’s often recommended to reduce your running distance, opt for softer surfaces, or switch temporarily to low-impact activities to allow for recovery. Consider using Formthotics Sports insoles.
Why long does metatarsalgia last?
Recovery time depends on the severity of your pain and the specific structures affected. Since metatarsalgia covers a broad range of conditions, healing can take anywhere from weeks to months. After an assessment, your podiatrist will provide a clearer timeframe based on the cause and severity of your condition.
Can metatarsalgia occur without physical activity?
Yes, while high-impact activities often cause metatarsalgia, it can also occur in people who are sedentary or have certain foot conditions (such as flat feet or high arches) that put extra pressure on the metatarsals even without intense physical activity.
How does aging affect metatarsalgia?
As you age, the fat pads on the soles of your feet naturally thin, reducing the cushioning between your bones and the ground. This makes you more susceptible to metatarsalgia, especially if combined with other factors like poor footwear or foot deformities.
Can wearing high heels cause metatarsalgia?
Yes, wearing high heels shifts your body weight onto the ball of your foot, which can lead to metatarsalgia over time. High heels place increased pressure on the metatarsal bones, making pain in this area more likely.
Is metatarsalgia linked to poor circulation?
While poor circulation itself doesn’t directly cause metatarsalgia, conditions such as diabetes or vascular issues that affect blood flow can contribute to foot pain and worsen symptoms of metatarsalgia.
Can custom orthotics cure metatarsalgia?
Custom orthotics can significantly reduce the symptoms of metatarsalgia by providing proper arch support and redistributing pressure across the foot. However, they may not completely cure the condition, especially if the underlying cause (such as improper footwear or weight issues) isn’t addressed.
Can metatarsalgia lead to long-term complications if untreated?
If left untreated, metatarsalgia can lead to further foot complications, such as the development of bunions, hammertoes, or chronic pain. It may also affect your gait, leading to issues in other areas like the ankles, knees, or hips.
Does weather affect metatarsalgia pain?
Some people with metatarsalgia report that their pain worsens in cold or damp weather, as lower temperatures can make tissues stiffer and exacerbate joint pain. However, this is not the case for everyone.
Can metatarsalgia be treated with physical therapy?
Physical therapy can be an effective treatment for metatarsalgia. Therapists can guide you through exercises that improve foot strength, flexibility, and alignment, helping to relieve pain and prevent future issues.