Metatarsalgia is a common foot disorder marked by pain and inflammation in the ball of your foot. You may experience metatarsalgia if you're physically active and you participate in activities that involve running and jumping. Or, you may develop metatarsalgia by wearing ill-fitting shoes. There are other causes as well. Although generally not serious, metatarsalgia can sideline you. Fortunately, conservative treatments, such as ice and rest, can often relieve metatarsalgia symptoms. And proper footwear, along with shock absorbing insoles or arch supports, may be all you need to prevent or minimize future problems with metatarsalgia.


In each foot, five metatarsal bones run from your arch to your toe joints. The first metatarsal is shorter and thicker than the other four bones, which are usually similar in size. During the push-off phase when you walk, jump or run, your body weight is transferred to your toes and metatarsals. The first and second metatarsal bones take the brunt of this force due to the anatomy of the first and seconf metatarsals.

Most metatarsalgia problems develop when something changes in the way biomechanics of the foot, affecting how your weight is distributed. This can put excess pressure on the metatarsals, leading to inflammation and pain, especially in the metatarsal heads, the rounded ends of the bones that connect with your toes.

Sometimes a single factor can lead to metatarsalgia. More often, several factors are involved, including:

Intense training or activity. Runners are at risk of metatarsalgia, primarily because the front of your foot absorbs significant force when you run. But anyone who participates in a high-impact sport is also at risk, especially if your shoes are ill-fitting or are worn out.

Certain foot types. A high arch can put extra pressure on the metatarsals. So can having a second toe that's longer than the big toe, which causes more weight than normal to be shifted to the second metatarsal head.

Hammertoe. This foot problem can develop when high heels or too-small shoes prevent your toes from lying flat. As a result, one of your toes, usually the second, curls downward because of a bend in the middle toe joint. This contraction depresses the metatarsal heads.

Bunion. This is a swollen, painful bump at the base of your big toe. Sometimes the tendency to develop bunions is inherited, but the problem can also result from wearing high heels or too-small shoes. Bunions are much more common in women than in men. A bunion can weaken your big toe, putting extra stress on the ball of your foot. Surgery to correct a bunion can also lead to metatarsalgia if you don't rest long enough for your foot to heal completely.
Excess weight. Because most of your body weight transfers to your forefoot when you move, extra pounds mean more pressure on your metatarsals. Losing weight may reduce or eliminate symptoms of metatarsalgia.
Poorly fitting shoes. High heels, which transfer extra weight to the front of your foot, are a common cause of metatarsalgia in women. Shoes with a narrow toe box or athletic shoes that lack support and padding also can contribute to metatarsal problems.

Stress fractures. Small breaks in the metatarsals or toe bones can be painful and change the way you put weight on your foot.
Morton's neuroma. This benign growth of fibrous tissue around a nerve usually occurs between the third and fourth metatarsal heads. It causes symptoms that are similar to metatarsalgia and can also contribute to metatarsal stress. Morton's neuroma frequently results from wearing high heels or too-tight shoes that put pressure on your toes. It can also develop after high-impact activities such as jogging and aerobics.


Symptoms of metatarsalgia may include:

Sharp, aching or burning pain in the ball of your foot, the part of the sole just behind your toes
Pain in the area around your second, third or fourth toe or, only near your big toe
Pain that gets worse when you stand, walk or run and improves when you rest
Sharp or shooting pain in your toes
Numbness or tingling in your toes
Pain that worsens when you flex your feet
A feeling in your feet as if you're walking with a rock in your shoe
Increased pain when you're walking barefoot, especially on a hard surface

Sometimes the symptoms of metatarsalgia develop suddenly — especially if you have recently increased your usual amount of running, jumping or other high-impact exercise, but metatarsalgia problems usually develop over time.


Conservative measures usually relieve the pain of metatarsalgia. You may also try:

Rest. Protect your foot from further injury by not stressing it. You may need to avoid your favorite sport for a while, but you can stay fit with low-impact exercises, such as swimming or cycling. Continue with stretching and lower body strength training as your pain permits.

Ice the affected area. Apply ice packs to the affected area for about 20 minutes at a time, several times a day. To protect your skin, wrap the ice packs in a thin towel.

Wear proper shoes. Your doctor may recommend a shoe that's especially suited for your foot type, your stride and your particular sport.

Custom Orthotics. These are often made of cork, plastic, rubber or a gel-like substance, they fit inside your shoes to help cushion shock and support the arch. This often relieves pressure on the metatarsal heads, decreasing the pain of metatarsalgia..Rigid arch supports are made of a firm material such as plastic or carbon fiber. They're designed to control motion in two major foot joints below your ankles. Semirigid arch supports are made of softer materials such as leather and cork reinforced by silicone. Arch supports designed to treat metatarsalgia may include metatarsal pads, too.

Use metatarsal pads. These off-the-shelf pads are placed in your shoes just ahead of the metatarsal bone to help deflect stress away from the painful area.
If conservative treatments fail in treating metatarsalgia, in rare cases surgery to realign the metatarsal bones may be an option. If you suspect you have metatarsalgia, we recommend a consultation with a Podiatrist/Orthopedist. Please click here for a list of Kalamazoo and Battle Creek area providers.