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What is Metatarsalgia?

Metatarsalgia is the name given for a group of symptoms that includes pain and inflammation in the ball of the foot.  There are various different causes for these symptoms and as a result quite a few different treatments are available.  Pain will often be prominent in the ball of the foot, but may also be present on the bottom of the foot or on the sole, just before the toes.  Mostly the pain tends to gather in the metatarsal heads, but sometimes may just be experienced near the big toe.

One thing that does make this disorder stand out is the pain in the ball of the foot that occurs when walking, running, or carrying out any other weight-bearing activity.  Sharp or shooting pains in the toes are not uncommon either and may get worse as the toes become flexed.  The pain is sometimes accompanied by numbness or a tingling feeling.  If you suddenly notice a pain in your foot that seems to get worse when walking, standing, or flexing your toes, then you may have metatarsalgia.  Another key sign is increased pain when walking barefoot particularly on hard surfaces such as asphalt, concrete, tile, or marble.  Thankfully, it is a treatable disorder.

What causes it?

There are various factors that could lead to the onset of metatarsalgia, but all seem to have one thing in common:  an unnatural change in the dynamics of the foot.  This change creates the excess pressure on the foot.  Some of the most common causes of metatarsalgia are:

  • Ill-fitting shoes: Wearing footwear that’s too narrow can put an immense amount of pressure on the ball of the foot and as a result can cause metatarsalgia.
  • Certain foot shapes: According to podiatric physicians certain foot types contribute to metatarsalgia.  Those with a high-arched foot or longer than normal metatarsal bone can add pressure on the forefoot, causing pain and inflammation.
  • Arthritis, gout or various other inflammatory disorders can cause pain in the ball of your foot.
  • Overweight:  The more a person weighs the more pressure the foot has to cope with when a step is taken.  As we age the pads on our feet wear thin, providing us with less cushioning and more chance of getting pain in the ball of the foot.
  • Stress fractures of the toe bones can be extremely painful. Because of this the individual more often than not will have to change their stride and in doing so they put more pressure on the ball of the foot.
  • The big toe can become weak after contracting a bunion or arthritis and as a result causes extra pressure on the ball of the foot. This may also happen after a bunionectomy when the patient doesn’t allow themselves enough healing time.  They resume normal activities too soon, and as a result cause problems to the forefoot.
  • Claw toes/hammertoes: These shape toes can also cause stress on the ball of the foot as the metatarsals tend to press downward constantly.

What treatment options are available?

As with most conditions, the best form of treatment is to be proactive.  Maintain a healthy weight and ensure you wear shoes that are not too ill-fitting.  And stay away from high heels wherever possible too.  There are a number of different treatment options available that your physician may suggest depending on the severity of the disorder:

  • Wear suitable footwear
  • Rest: This involves elevating the feet after periods of standing or walking.  It’s also advised that applying an ice pack to the painful area for around 20 minutes is a good way to gain extra relief.
  • Shoe inserts: Orthotic inserts may be prescribed which are worn inside the shoe and help realign the foot.  Sometimes just using an insert from the drugstore can help too.
  • Maintain a healthy body weight
  • Painkillers or non-steroidal anti-inflammatory medications: These may be prescribed if your physician feels they will reduce your symptoms.  In severe cases, injectable steroids may be considered to treat the pain.
  • Exercising: The physician may give you a range of exercises for your feet to help regain movement and strength.

Metatarsalgia is preventable by controlling your weight and wearing appropriate footwear.  You also need to allow your foot time to heal after an injury to it.  If at any time you experience forefoot pain, ease off the exercise, get some rest and apply ice to the painful area.  If the pain gets worse then seek the help of a podiatric physician as soon as possible to avoid further injury.