Metatarsalgia is the general term used to describe forefoot pain in the area of the metatarsal bones.  The pain usually occurs at the ball of the foot, otherwise known as the metatarsal phalangeal joints.  Examples of related forefoot conditions include – bunions (hallux valgus), Morton’s syndrome (short 1st toe), Morton’s neuroma (pinched nerve) and metatarsal fractures.


The most common symptoms associated with metatarsalgia include:

  • Tenderness and / or burning at the ball of the foot.
  • Sensation of walking on a pebble.
  • Sharp or shooting pain.
  • Painful callous under a metatarsal head
  • Pain with toe-off when walking.

The most common causes of metatarsalgia include:

  • Overuse caused by prolonged standing or walking.
  • Quick ‘start and stop’ sports.
  • Diseases such as arthritis, diabetes, osteoporosis and other bone/joint diseases.
  • Higher heels or pointed toed shoes.

Orthotics (Orthoses) – Must be prescribed by a physician

Custom made orthotics support the skeleton, muscles and fascia in the correct position. Orthotics are a long-term solution to prevent reoccurrence by controlling and / or correcting the mechanics that cause the problem. Orthoses for metatarsalgia should include:

  • Prominent metatarsal pad or bar to lift and separate metatarsal heads – positioned in the hollow just behind the balls of the joints.
  • Soft forefoot material to cushion metatarsal heads.
  • Hollowing out the orthotic under prominent metatarsal heads to reduce pressure.



Footwear including therapeutic and orthopaedic shoes are integral to the treatment process. Certified Pedorthists are trained to fit patients with appropriate footwear. BioPed offers many types of footwear into which an orthotic device may be placed or worn alone. Footwear for metatarsalgia may have any of the following characteristics:

  • Footwear with a cushioned sole.
  • Forefoot rocker sole – a must for chronic forefoot conditions. Off-the-shelf therapeutic footwear with a rocker can minimize the metatarsal joint bending and plantar pressure.

Modifications to footwear are also available at the discretion of the Pedorthist.