Metatarsalgia

What Is Metatarsalgia?

Metatarsalgia is a term that describes pain and inflammation in the metatarsal area (the area between the arches and toes on the bottom of our feet). We commonly refer to this area as the “balls” of our feet. The metatarsal bones are the five bones at the base of our toes.  They connect the toes to the rest of the foot, and absorb our body weight when we walk or stand.

Metatarsalgia is an umbrella term that can involve a variety of syndromes and conditions which cause pain at the ball of the foot. Examples include: Metatarso-phalangeal joint stress syndrome, neuroma, stress fracture, capsulitis, or bursitis in the ball of the foot.  

A foot specialist can help you identify the underlying cause of your metatarsalgia, and the best course of treatment.

What Are The Symptoms of Metatarsalgia?

Metatarsalgia is characterized by pain at the balls of the feet. The pain can be described as sharp, a dull ache, or a burning sensation.  It often worsens with exercise and weight-bearing activities, and improves with rest.  The pain is often felt during the “toe-off” stage of walking, which is the motion of putting weight onto our toes as we lift our foot off the ground to propel us forward.

What Causes Metatarsalgia?

Metatarsalgia is an umbrella term that describes the symptoms produced by other conditions; it is not necessarily a condition in and of itself.  Therefore, the source of metatarsalgia will vary depending on the condition that causes it.

Some conditions that cause Metatarsalgia include:

• Metatarso-phalangeal joint stress syndrome
• Morton’s neuroma
• Stress Fracture
• Bursitis in the ball of the foot
• Foot deformities such as high arches, flatfoot, hammertoes and bunions
• Arthritis affecting the feet
• Gout

This list is not exhaustive.

How Do You Treat Metatarsalgia?

Treatment options for metatarsalgia depend on its underlying cause.  Usually rest will improve symptoms; however too much rest can also weaken the affected muscles and ligaments, which will make the condition worse in the long run.  Therefore, effective management of metatarsalgia often involves a combination of the following:

• Proper footwear, over the counter insoles and/or padding:  This will offset the load and strain on the metatarsal region of the foot.  By alleviating the load on the forefoot, it essentially mimics the effects of rest, while still allowing you to conduct your daily activities.
• Stretching and Strengthening Exercises: The Achilles tendon and calf muscles should be regularly stretched and strengthened.  Strong muscles and ligaments improve body mechanics and help to properly distribute weight so that the forefoot doesn’t get overburdened.  This also improves our feet’s resilience to our daily activities and makes them less injury-prone. Check out these great stretches and exercises you can do at home to help alleviate your foot pain: They are quick, easy and many can be done at home while sitting or laying down.  
• Custom orthotics:  These accomplish two important goals – they reduce pressure on the forefoot while improving biomechanical function to prevent further pain.  The chiropodists at our foot clinic can assess and fit you for custom orthotics.  

An assessment with a foot specialist can help determine the underlying cause of your metatarsalgia and the best course of treatment.  

We also have a curated selection of supportive footwear available at our online shop (coming soon) and foot clinic.  The knowledgeable staff and foot specialists at our clinic can help you find the solution that works best for you and your unique physiology.

What Can Put Me At Risk For Metatarsalgia?

The following risk factors can make you more prone to developing metatarsalgia:

• Ill-fitting footwear: This is one of the biggest culprits behind metatarsalgia.   Persistently wearing high heels or shoes that are too tight can exert a compression force on the ball of the foot, ultimately causing foot pain and a variety of foot issues.
• Shoes that are worn out or do not properly support our biomechanics:  Even the best of shoes wear out over time, and when they do, they fail to properly support our biomechanics and the structures in our feet.  This can then strain the muscles and ligaments in our feet, which can lead to metatarsalgia.
• Pronation
• High arches: High arches increase the pressure placed on the forefoot.
• Bunions: Having a deviated big toe exerts increased pressure on the 2nd and 3rd toes, which can lead to metatarsalgia
• Clawed toes and hammertoes: Clawed toes disrupt the foot’s biomechanics when we weight-bear, resulting in increased pressure at the ball of the foot.
• Tight calves: Tight calves pull on the joints in the feet and ankles, which then trickles down to the connected muscles and ligaments.  Our body then compensates by redistributing our weight onto the front of the fo
• Obesity:  The metatarsal joints at the base of our toes absorb most of our bodyweight when we walk.  Weight gain increases the load placed on these structures, which can lead to metatarsalgia

How Can I Prevent Metatarsalgia?

The following can prevent or reduce your risk of developing metatarsalgia:

• Wear proper-fitting footwear: Footwear that encourages healthy biomechanics and proper weight distribution is critical for preventing metatarsalgia. It’s important to find shoes that properly suit your foot’s unique physiology while giving you the support you need to accomplish your daily activities pain-free.  
• Restrict high heels: High heels are a common culprit behind foot pain and various medical conditions.  Restricting high heels to special occasions can go a long way toward preventing metatarsalgia. For those times you feel you must wear heels, you can check out our specially curated selection of foot-friendly high heels at our online shop (coming soon) or in person at our foot clinic.
• Supportive insoles:  The knowledgeable staff at our foot clinic can help you find the right insoles that support and pad the balls of your feet.  
• Custom orthotics:  These will redistribute pressure evenly along the bottom of the foot and correct any abnormalities in your gait, which in turn alleviates excess strain placed on the forefoot.  Orthotics can also be placed into your existing footwear.  A chiropodist at our foot clinic can fit you for custom orthotics – no referral necessary.
• Metatarsal pads and arch supports:  These help cushion and support the metatarsal region and arches of our feet.  These are available at our foot clinic and online foot shop (coming soon).
• Regular physical activity:  Staying active and keeping our joints and muscles strong goes a long way toward preventing foot pain: The stronger the muscles in our feet and legs are, the more equipped they are to withstand the burdens of our activities.
• Warm up and cool down before and after exercise:  Warming up before exercise improves our muscles’ elasticity and increases blood flow to our muscles, which helps them withstand exercise.  Since muscles tighten when they’re exerted (i.e.: during exercise), cooling down afterwards helps relax and restore our muscles to their ideal condition.  One way to do this is by stretching. You can check out our stretching series for ways you can reduce your risk of injury and developing metatarsalgia, along with other kinds of foot pain.  

We have an array of pads, insoles and supportive footwear available at our online shop (coming soon) and in our foot clinic.  Our knowledgeable staff can help you find supportive footwear options that work best for you.