Metatarsalgia is the medical name for pain in the ball of the foot. It is a combination of pain and inflammation localized in the ball of the foot. It is termed an overuse injury. However, bony structure of the foot, mechanics, footwear and fat pad deterioration can contribute to the condition. It’s often thought of as a symptom of other conditions, rather than as a specific disease.
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Symptoms
The pain felt is localized to the ball of the foot. If it is shooting or migrating elsewhere, you likely do not have metatarsalgia. It is important to note though that metatarsalgia pain can be sharp, dull, or present as a burning feeling. You may even feel like you’re stepping on a pebble. The pain is typically worse when you are active or barefoot. Finally, you may feel tingling or numbness in your toes but this is rare.
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Causes
The heads of the five metatarsal foot bones are present in the ball of the foot and are related to the pressure and pain felt. As we age, the fat pad under the ball of the foot wears thin and the pressure of the bones on the ground are felt more. Repetitive training, high impact sports, aging, high heels and the absence of orthotics can create/contribute to metatarsalgia.
Other causative factors are mechanical such as:
• A short first metatarsal bone or a long second metatarsal bone
• Prominent metatarsal heads
• Tight toe extensors (muscles)
• Weak toe flexors (muscles)
• Hammertoe deformity
• Hypermobile first foot bone
• Excessive pronation
• Shoes that do not fit
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Treatment
While over-the-counter anti-inflammatory medications, such as Ibuprofen, can be helpful, they are not a long-term solution. Evaluation by a Footcare Clinician, such as a Canadian Certified Pedorthist or Registered Chiropodist is an important first step. They can determine if the pain in the ball of your foot is related to your lifestyle, mechanics and/or a structural or soft tissue issue, such as callusing, corns or fat pad atrophy. Treatment options include debridement of any corns or calluses if present, and orthotics to offload the ball of the foot. A modification can be added to orthotics or shoes, called a metatarsal pad, which works to elevate the heads of the metatarsal bones and take the pressure off the area. Additionally, choosing properly fitted footwear, ideally with cushioning, and possibly a rocker bottom sole can help! Visit BioPed today to be assessed and understand which treatment would best suit your needs!
