Metatarsalgia: Causes and Possible Treatments
Find out more about this common foot issue and how to treat it
Metatarsalgia (met-uh-tahr-SAL-juh) a mouthful of a name for a common but painful problem. Metatarsalgia refers to a common overuse injury and describes inflammation and ball of foot pain in the metatarsal region of the foot which is the area just before the toes.
- Metatarsalgia is a common overuse injury that causes ball of foot pain in the metatarsal region of the foot, primarily at the end of one or more of the metatarsal bones.
- There are many potential causes of metatarsalgia, including high levels of activity, being overweight, age, weak toe flexors, tight toe muscles, and ill-fitting footwear.
- Treatment for metatarsalgia includes applying ice, taking over-the-counter anti-inflammatory medication, avoiding high-impact sports, using fitted insoles, metatarsal pads, and shock-absorbing shoes, exercising the ankle and stretching the Achilles tendon, and changing to better-fitting shoes with a broad toe box.
Symptoms and Causes
The primary symptom of metatarsalgia is a pain at the end of one or more of the metatarsal bones, where the middle three toes meets the ball of the foot. The pain will usually become more pronounced when walking, running, or doing high-impact sports. Athletes will often suffer from this condition which can then lead to other problems if not addressed. Most often, the symptoms begin to show up over a period of several months, rather than all at once. The initial problem may be created by a particularly rough impact, but the long term effects will not be known until much later.
The foot can be injured during many different kinds of activities, especially sports. As with many other overuse injuries, the condition may be the result of an alteration in normal biomechanics that then causes abnormal weight distribution (such as favoring a certain side, or overcompensating for another injury). Persistent use and stress can also cause chronic irritation in your feet.
Because it is a general description for a certain type of pain, there are many causes of metatarsalgia. Some conditions may predispose you to forefoot problems. High arches, hammertoes, or a long second metatarsal bone are some of these conditions. If not already predisposed, the following factors can cause excessive localized pressure over the forefoot:
- High level of activity
- Being overweight
- Weak toe flexors
- Tight toe muscles
- Hypermobile first foot bone
- A tight Achilles tendon
- Excessive pronation (side-to-side movement of the foot when running or walking)
- Ill-fitting footwear
Treatment and Recovery
When you see a physician for a diagnosis, they will probably check a few different things. They will begin by examining your foot and then asking a bit about your lifestyle: your hobbies, how active you are, what kinds of daily activities you have in your routine, where the pain is, and what aggravates it. Then they may ask you to do a “gait test”. Your gait, or the way that you walk and how you plant your foot, can actually say a lot about where the trouble is and what is causing it. They may ask you to walk on a special treadmill that can tell them how you distribute your weight and where any pain points could be. If more information is needed, the physician may ask you to do some imaging tests (such as an MRI or x-ray) or blood tests to check for a possible underlying condition. Once you have a sure diagnosis of metatarsalgia, which is not life threatening in any way, you will be directed to try a few things to ease discomfort and avoid further injury. Here are some tips on how to reduce pain from metatarsalgia:
- Apply ice to the area several times a day each time for approximately 15-20 minutes. Wrap the ice in something to protect your skin – do not let the ice touch the skin.
- Take over the counter anti-inflammatory medicines such as ibuprofen, this will reduce the inflammation and relieve the pain.
- Avoid high impact sports and exercise that puts pressure on the feet. Try something lighter on the feet, such as swimming or cycling.
- Try to keep pressure off the feet, when resting try putting your feet up.
- Be sure to exercise your ankle and keep stretching the Achilles tendon to strengthen your feet and help it to support the bones in your feet.
- Use fitted insoles (orthotics) as these will reallocate pressure, improve foot function and guard the ball of your foot.
- Use metatarsal pads as they reduce pressure from the metatarsal bones.
- Use shock absorbing shoes to relieve pressure when walking.
- Shoes with foot arch support may be recommended by your doctor if fitted insoles were not effective. There are various sizes which can be bought over the counter, or you can have ones custom made to fit your foot. With KURUSOLE™ technology, you can have a custom fit without the hassle. The advanced foam insole will shape to your foot using your own body heat as you walk, and give you a completely personalized fit without the extra cost and time of getting a custom insole made.
- Change to better fitting shoes with a broad toe box to give your toes room to flex and move as you walk. Cramped toes can lead to a flurry of problems, including metatarsalgia.
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