Metatarsalgia is a painful inflammation of the ball of the foot caused by overuse from high-impact sports, ill-fitting shoes that put pressure on the metatarsal bones, or underlying foot issues. Symptoms include pain in the ball of the foot that gets worse with activity. Treatment focuses on rest, orthotics, pads and changes to activities and footwear. For most cases, conservative care relieves pain, but surgery may be needed in severe cases to realign bones causing persistent pain.

1. Metatarsalgia
Discuss by: Dolan Jay Salturio

2. Contents
What is metatarsalgia?
What are the symptoms of metatarsalgia?
What causes metatarsalgia?
Who’s at risk?
How is metatarsalgia diagnosed?
How is it treated?
What’s the outlook?
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3. What is metatarsalgia?
Metatarsalgia is a painful inflammation in the ball of your foot. The ball of
your foot is the area between your toes and your arch. Metatarsalgia is
named for the five metatarsal bones in the midsection of your feet that
connect to your toes.
Metatarsalgia commonly occurs from overuse injuries in sports that involve
running and jumping. It can also result from shoes that don’t fit, foot
abnormalities, or arthritis and other diseases.
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6. What are the symptoms of
metatarsalgia?
The pain of metatarsalgia usually begins gradually over time. It may improve
when you rest your foot and get worse when you stand, walk, or exercise.
Your foot may feel like:
•you’re walking with a marble or pebbles in your shoe
•you have a sharp burning or shooting pain in the ball of your foot
•your toes are numb or tingling
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7. What are the symptoms of
metatarsalgia?
You may also notice that your pain gets worse when you:
•stand
•run
•walk barefoot
•participate in a high-impact sports activity
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9. What causes metatarsalgia?
The most frequent cause of metatarsalgia is participating in sports activities
that put pressure on the metatarsal bones at the front of your foot. These
activities often lead to overuse of the area. Running, for example, involves
putting constant force on the ball of your foot. The abnormal stress on your
foot can increase inflammation in the metatarsal area. It can also irritate the
tendons, ligaments, and cartilage around the bone.
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10. Other causes include:
•Shoes that don’t fit right: Your shoes may be too tight,
squeezing your foot. Or your shoes may be too loose, making
your foot slide back and forth.
•High heels or sneakers without adequate padding and arch
support: These shoes can cause you to put more weight on
the ball of your foot.
•Foot abnormalities: High arches, a second toe that is longer
than your big toe, calluses on the bottom of your
foot, bunions, and hammer toe can contribute to
metatarsalgia.
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11. •Extra weight: Being overweight or obese puts more
pressure on your feet and metatarsal area.
•Some diseases: Bursitis, arthritis, gout, Morton’s neuroma,
and small stress fractures in your toes and metatarsal bones
can increase the stress on the ball of your foot.
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12. Who’s at risk?
People who play high-impact sports that involve running and jumping
have a greater risk of metatarsalgia. Also at greater risk are athletes
who wear shoes with spikes or shoes without good support.
Other people who have a greater risk of metatarsalgia include:
•older people
•women who wear high heels
•people who wear ill-fitting shoes
•people who have inflammatory arthritis or foot deformities
•people who are overweight or obese
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13. How is metatarsalgia diagnosed?
If your pain in the metatarsal area persists for a few days after
resting your feet or changing your footwear, it’s best to see a
doctor.
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14. Your doctor will examine your foot and ask you to walk so they 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 the pain, you may have other tests. These may include:
•an X-ray to rule out a stress fracture
•a blood test to check for uric acid, which is an indication of gout
•an ultrasound test to look at soft tissue problems like bursitis or
neuromas, which may contribute to metatarsalgia
•magnetic resonance imaging (MRI) to look for evidence of arthritis
and possible injuries
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15. How is it treated?
Treatment for metatarsalgia depends on the cause and severity
of your pain. Usually, conservative measures like staying off of
your feet, changing your footwear, and using an orthotic pad in
your shoe will relieve the pain.
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16. At-home remedies include:
•resting your foot
•icing your foot a few times per day, 20 minutes at a time
•elevating your foot after activity
•taking an over-the-counter pain reliever to help with pain
and inflammation
•losing weight if you’re overweight
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17. You may also be able to ease pain and prevent recurrence
by replacing your shoes with a well-fitting pair with good
support. You should also avoid wearing high-heeled shoes. A
break from high-impact sports or exercise routines should
also help. For exercise, try swimming or cycling, which are
low impact.
Your doctor may recommend you work with a physical
therapist. They can give you range-of-motion exercises and
exercises that strengthen surrounding muscles. The therapist
can also help correct your gait, if necessary.
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18. An occupational therapist may also be able to help. They can fit
you with custom orthotics, such as a metatarsal pad or arch
support. One small study Trusted Source found that custom-
made sandals with a metatarsal pad had the best results in
increasing walking time and distance without pain.
If your pain persists after trying conservative treatment
measures, you may be a candidate for surgery to realign your
metatarsal bones.
If left untreated, pain can cause you to alter your gait, which may
affect your hips, lower back, and legs.
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20. What’s the outlook?
Most metatarsalgia eases with conservative measures and
properly fitting footwear. Early diagnosis and treatment usually
gives you a good prognosis. In some cases, you may need
surgery to treat the underlying cause of the pain.
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21. Thank you!