Metatarsal Pain (Metatarsalgia)

Metatarsal Pain (Metatarsalgia)

| Metatarsal Pain (Met
Risk factors

Anyone can get metatarsalgia, although the following population is at a higher risk:
• runners and others who take part in high impact sports or spend more time on their forefoot
• People with high arches
• People with a second toe longer than their big toe
• People with foot deformities such as hammertoes and bunions
• Excess weight can also contribute to metatarsalgia.
• Having rheumatoid arthritis, osteoarthritis or gout


• Pain under the ball of the foot (Sharp, aching or burning). The pain may get worse when you stand, run or walk.
• Numbness or tingling in your toes
• The feeling of a pebble in your shoe
• May or may have bruising and swelling
• Symptoms can come on quickly or develop over time.

Its important to see a doctor as soon as you note these symptoms because untreated cases can lead to hammertoes, can cause you to limp and cause pain in other parts of the body, including the lower back and hip when you compensate and begin to walk abnormally.


You physiotherapist may recommend you use a metatarsal pad, a surgical shoe, or a shoe insert to offload the painful part of your foot. Athletic shoes or rocker soled shoes may be recommended.

Other helpful tips include:
• Picking shoes with good soles, a wide toe box and a lower heel
• Avoiding walking barefoot
• Soaking and using pumice stone on your feet to help remove calluses. Removing these calluses can help relieve pressure. People with diabetes should consult their physician first before doing this.
• Take an over-the-counter pain reliever. 

• Rest. Elevate your foot after standing or walking. You might need to avoid your favorite sport for a while, but you can stay fit with low-impact exercises, such as swimming or cycling.
• Once you're ready to walk or take load on your foot, wear proper shoes. Avoid too-tight or too-loose shoes and limit your wearing of high heels. Wear shoes appropriate to the sports you play.
• Use metatarsal pads. These off-the-shelf pads are placed in your shoes just ahead of the metatarsal bone to help deflect stress from the painful area.
• Consider arch supports. If insoles don't help, your physiotherapist might recommend arch supports to minimize stress on the bones and improve foot function
• Pain relief and apply ice packs to the affected area (pain-killers that contain anti-inflammatories to help reduce any swelling). Swelling can also be reduced by elevating feet.

• For symptomatic relief, an MT pad made of rubber or silicone can be applied. The pad reduces pressure under painful MT heads by spreading it to a larger area, improving functional ability.

• Calf-stretch
• Ankle Extension stretch
• Strengthening key muscles which can help in preventing metatarsalgia.
• Toe towel-scrunches: Stand barefooted, with one foot in front standing on a towel. Use your toes to scrunch up the towel, making sure that the rest of the foot does not leave the ground. Perform 3 sets of 15 scrunches per foot.
• Icing, ultrasound or interferential therapy may help to reduce pain and inflammation in the beginning stages of treatment as well

What is Metatarsalgia ?

Metatarsalgia is a condition that causes pain in the ball of the foot, specifically in the area where the metatarsal bones meet the toes. The pain can range from mild to severe and may be described as a burning or aching sensation.


Metatarsalgia is commonly caused by overuse or excessive pressure on the ball of the foot. Some common causes of metatarsalgia include:

  1. High-impact activities: Running, jumping, and other high-impact activities can place significant stress on the metatarsal bones, leading to inflammation and pain.

  2. Poorly fitting shoes: Shoes that are too tight or have a narrow toe box can compress the metatarsal bones and cause pain. High-heeled shoes can also increase pressure on the ball of the foot.

  3. Foot deformities: Conditions such as hammertoes, bunions, or fallen arches can alter the distribution of weight on the foot and increase pressure on the ball of the foot.

  4. Osteoarthritis: Osteoarthritis can cause the cushioning cartilage in the joints of the foot to break down, leading to pain and inflammation in the ball of the foot.

  5. Weight gain: Excess weight can put extra pressure on the feet and increase the risk of developing metatarsalgia.

  6. Stress fractures: Repetitive stress or trauma to the foot can lead to small fractures in the bones of the foot, including the metatarsals.

  7. Medical conditions: Certain medical conditions, such as diabetes or gout, can increase the risk of developing metatarsalgia.

It's important to identify and address the underlying cause of metatarsalgia to prevent further damage and relieve symptoms. A healthcare professional can help diagnose the cause of metatarsalgia and recommend appropriate treatment.


The treatment of metatarsalgia depends on the underlying cause and severity of the condition. Here are some common treatment options:

  1. Rest: Taking a break from activities that cause pain can help reduce inflammation and relieve symptoms.

  2. Ice: Applying ice to the affected area can help reduce swelling and relieve pain.

  3. Pain relief medications: Over-the-counter pain medications such as acetaminophen or ibuprofen can help reduce pain and inflammation.

  4. Shoe modifications: Wearing comfortable, well-fitting shoes with a wide toe box and adequate arch support can help alleviate pressure on the ball of the foot.

  5. Orthotic devices: Custom-made shoe inserts can provide cushioning and support to the foot, relieving pressure and reducing symptoms.

  6. Physical therapy: Stretching and strengthening exercises can help improve foot function and reduce pain.

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