Metatarsalgia is a term used to describe pain and inflammation in the metatarsal region of the foot, or the "ball" of the foot. This type of pain is common among active individuals and tends to affect people who wear ill-fitting footwear on a daily basis.

Though metatarsalgia is not usually indicative of a serious problem, it can interfere with daily activities. Conservative treatments can help relieve metatarsalgia symptoms; in most cases, a change in footwear can ease the pain.

Causes of metatarsalgia

Metatarsalgia develops when something alters the normal function of the foot, causing excessive pressure on the ball of the foot. The pain can result from any number of sources, including the following: 

  • Age - As you age, the fat pads in your feet tend to thin out, increasing the risk of metatarsalgia. 
  • Foot shape - High arches can lead to increased pressure placed on the ball of the foot. 
  • Improper footwear - Women who wear shoes with high heels and narrow toe boxes often suffer from pain in the ball of the foot. This type of restrictive footwear forces the ball of foot into a compressed space and can alter the way we walk, leading to inflammation. 
  • Intense physical activity - Anyone who participates in high-impact athletics, particularly running, is at risk for metatarsalgia. 
  • Other foot conditions - Everything from arthritis to a foot fracture can cause changes in the way you walk. Anything that alters your step can compromise the mechanics of the feet and cause pain in the ball of your foot. 
  • Weight - The more weight that is brought down on the feet during physical activities, the greater the pressure on the feet. Maintaining a healthy body weight can help reduce pressure on the feet.

Metatarsalgia symptoms

Metatarsalgia symptoms can develop suddenly (especially if you have become more active) or over time. Pain can be centralized in the metatarsal heads, which are the areas just before the second, third, and fourth toes, or pain may be localized in the area near the big toe.

Symptoms of metatarsalgia include:

  • General pain in the ball of the foot when bearing weight.
  • Shooting pain in the "ball" when the foot is flexed.
  • Shooting pain, tingling, or numbness in the toes.

Some people with metatarsalgia describe the condition as a feeling that they are walking over pebbles. Metatarsalgia may also feel like a bruise to the ball of the foot.

Treatment of metatarsalgia

Treatment of metatarsalgia will depend on the cause of the pain. If improper footwear is leading to pain and inflammation, treatment may be as simple as switching to shoes with a wide toe box. It is also helpful to be proactive; losing weight can reduce pressure on the ball of the foot and ease metatarsal pain.

Your doctor will make treatment recommendations based on the severity of your condition. Recommendations may include: 

  • Arch supports. 
  • Metatarsal pads or bandages. 
  • Over-the-counter pain relievers. 
  • Rest and ice.
  • Shoe inserts.

If you are experiencing recurrent pain in the ball of the foot, consult a physician. Your doctor can help determine the source of the pain and rule out more serious foot conditions.

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