What is metatarsalgia?

Metatarsalgia is a painful inflammation in the ball of your foot. The ball of your foot is the area between your feet and your arch.
Metatarsal is the name given to the five metatarsal bones in the middle of your feet that connect to your toes.

Metatarsalgia usually occurs from excessive injuries in sports that include running and jumping. It can also be caused by unsuitable shoes, foot disorders or arthritis and other diseases.

What are the symptoms of metatarsalgia?

The pain of metatarsalgia usually starts gradually over time. It can get better when you support your leg and worse when you stand, walk or exercise. Your foot may feel like:

• You walk on marble or pebbles in your shoe
• You have severe pain when burning or in the dark
• Your fingers are numb or tingling

You may also notice that your pain gets worse when:

• You are at a standstill
• You are on the run
• You walk barefoot
• Participate in high-impact sports activities

What causes metatarsalgia?

The most common cause of metatarsalgia is engaging in sports activities that put pressure on the metatarsal bones in the front of your foot.
These activities often lead to overuse of the area.
Running, for example, involves the constant strength of the ball of your foot. Abnormal stress on your foot can increase inflammation in the metatarsal area. It can also irritate the tendons, ligaments and cartilage around the bones.

Other causes include:

• Shoes that do not fit properly: Your shoes can be too tight, pressing your foot. Or your shoes may be too loose, causing your foot to slip forward.
• High heels or sneakers without adequate support and arch support: These shoes can make you put more weight on the ball of your foot.
• Foot Irregularities: High arches, a second toe larger than your big toe, calluses on the bottom of your foot, bunnies and toe hammer can all contribute to metatarsalgia.
• Extra weight: Being overweight or obese puts more strain on your legs and metatarsal area.
• Some diseases: Bursitis, arthritis, gout, Morton’s neuroma and small stress fractures in the toes and metatarsals can increase the stress on your ball.

Who is most at risk?

People who play high-impact sports that include running and jumping have a higher risk of metatarsalgia. Also at greater risk are athletes who wear toe shoes or shoes without good support.

Other people at higher risk for metatarsalgia include:

• Older people
• Women wearing high heels
• Women wearing high heels
• People who have inflammatory arthritis or deformities in the legs
• People who are overweight or obese

How is metatarsalgia diagnosed?

If your pain in the metatarsal area persists for a few days after resting your feet or changing your shoes, it is best to see a doctor.

Your doctor will examine your foot and ask you to walk so that he can observe your gait. They will also ask you questions about your activities and when the pain started. If your doctor suspects other causes of pain, you may have other tests. These may include:

• An x-ray to rule out a stress fracture
• Blood test for uric acid test, which is a sign of gout
• An ultrasound test to look for soft tissue problems, such as bursitis or neuromas, which may contribute to metatarsalgia
• Magnetic resonance imaging (MRI) to look for signs of arthritis and possible injuries

How is it treated?

Treatment for metatarsalgia depends on the cause and severity of your pain. Usually, conservative measures such as staying away from your feet, changing your shoes and using a orthostatic pad on your shoe will relieve the pain.

Home remedies include:

• Rest your foot
• Put ice on your foot several times a day, 20 minutes at a time
• Lifting your leg after an activity
• Taking a painkiller to help with pain and inflammation
• Lose weight if you are overweight
• You may also be able to relieve pain and prevent recurrence by replacing your shoes with a well-fitting pair with good support. You should also avoid wearing high heels.
• A break from sports activities or exercise routines should also help. For exercise, try low-impact swimming or cycling.

Your doctor may recommend that you work with a physiotherapist. They can offer range of motion exercises and exercises that strengthen the surrounding muscles. The therapist can also help you correct your gait, if necessary.

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