Metatarsalgia... Tips on Management and Treatment

What is Metatarsalgia?

Metatarsalgia is a general term used by the medical community to describe pain in the front of the foot or the "ball of the foot". This problem is most common beneath the "metatarsal" head bones, hence its name.

What Causes Metatarsalgia?

This type of pain in the ball of the foot can have many causes. These may include:

  • Bone deformity;
  • Excessively malaligned feet causing abnormal pressure distribution;
  • Forefoot valgus and rigid 1st ray leading to callus formation;
  • Hypermobile 1st ray leading to abnormal forefoot pressure distributon
  • Muscle/ligament tears;
  • Synovitis;
  • Capsulitis;
  • Muscle strain or rupture;
  • Tearing in the plantar plate ligaments;
  • Neuromas
  • Calluses or corns; and
  • Arthritis
  • Improperly fitted footwear can also cause metatarsalgia or forefoot pain.

    As we age, the natural fat pad cushioning under the ball of the foot decreases in size which predisposes people to ball of foot pain. This is sometimes termed fat pad atrophy where the ball of the foot loses the natural cushioning provided by the fat pad.

    There are many other possible causes so it's important to diagnose the true cause so that an appropriate treatment plan can be devised.


    How is Metatarsalgia prevented?

    Prevention involves the use of properly fitted footwear which is appropriate for the type of activity. So don't try using work boots or hiking boots if you plan on running marathons. Different shoe designs exist for a reason. Often ladies can reduce ball of foot pain by simply wearing shoes with lower heels.

    Sometimes tight calf muscles and incorrect foot posture will cause ball of foot pain. In this situation prevention involves stretching exercises and the use of orthotic shoe inserts to control abnormal foot alignment.

    How is Metatarsalgia Treated?

    Treatment may include a combination of the following:

  • Review of footwear;
  • Reduction of skin lesions;
  • Strapping may be indicated;
  • Ball of foot cushions or gel pads may be advised for short term relief;
  • Medication review may be necessary if the cause is and inflammatory arthritis;
  • Foot mobilisation can be helpful;
  • Specific exercises can be used once the diagnosis is confirmed;
  • Orthotic shoe inserts to control any uneven pressure distributon are important and often helpful in the treatment of this type of foot condition.
  • What happens if this ball of foot pain is left untreated?

    In serious cases skin lesions can ulcerate and become infected. If there is underlying bone damage, permanent disability can occur. To cure metatarsalgia, one must first know exactly what is causing the foot problem.

    If pain persists consult your Podiatrist, Chiropodist or foot doctor. If detected early, you can cure this condition without surgery. If left too late, surgery may be required to achieve a satisfactory result.

    More information for metatarsalgia can be found at the following links:

    Metatarsalgia at WebMD

    Metatarsalgia at Mayo Clinic

    Posture Podiatry

    WARNING : This information is for educational purposes only and is not intended to replace professional podiatric advice. Treatment will vary between individuals depending upon your diagnosis and presenting complaint. An accurate diagnosis can only be made following personal consultation with a Podiatrist, your Doctor or your foot specialist.

    For more information on aching feet and many other foot pain, leg pain and back pain conditions please visit our Foot Pain Conditions page and click on the condition of interest to you.

    To find a Podiatrist or Foot Doctor near you visit our Find a Podiatrist page and click on your country.

    Still have a question about your foot problem, leg pain or you just need some footwear advice?

    Visit our Foot Problems page and ask us a question about your specific problem. We'll do our best to help.

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