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Disease: Metatarsalgia Metatarsalgia
Category: Bones, joints, muscles diseases
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Disease Definition:

Inflammation and pain in the ball of the foot are the things that mark metatarsalgia condition.

If a person’s feet are impacted by jumping and running and he/she is physically active, it might mean that he/she has metatarsalgia. Wearing ill-fitting shoes may cause metatarsalgia, in addition to other factors.

Metatarsalgia can sideline a person although it is not serious in general. The good thing is that metatarsalgia symptoms can be often relieved by conservative treatments like rest and ice. To minimize or prevent future problems with metatarsalgia, proper footwear together with shock absorbing insoles or arch supports may be all one needs.

Work Group:

Prepared by: Scientific Section

Symptoms, Causes


The following may be included in the symptoms of metatarsalgia:


  • A feeling in the feet as if one is walking with a pebble in the shoe
  • Pain only near the big toe or in the area around the second, third or fourth toes
  • Increased pain when walking barefoot, especially on a hard surface
  • Pain that improves when resting and gets worse when standing, walking or running  
  • Burning, sharp or aching pain
  • Pain in the ball of the foot which is the part of the sole just behind the toes
  • Tingling or numbness in the toes
  • Pain that worsens when the feet are flexed
  • Sharp or shooting pain in the toes

The symptoms of this condition develop suddenly sometimes in case the person has recently increased the usual amount of jumping, running or other high-impact exercise in particular; however, problems usually develop over time.

Medical care is needed, but not in all foot problems, like after a long day of standing or a punishing workout, feet simply ache sometimes. However, any case of foot pain that lasts more than a few days shouldn't be ignored. So, if a person experiences a burning pain in the ball of the foot that doesn't improve after changing the shoes and modifying the activities, he/she should seek medical treatment.


Five metatarsal bones run from the arch to the toe joints in each foot. The first metatarsal is shorter and thicker than the other four bones that are usually similar in size. The body weight is transferred to the toes and metatarsals during the push-off phase when one runs, jumps or walks. The brunt of this force is received by the first and second metatarsal bones.

When the impact load or the mechanics of the foot affect the way the weight of a person is distributed, most metatarsal problems develop. Inflammation and pain in particular in the metatarsal head, which is the rounded ends of the bones that connect with the toe bones, may be caused by the excess pressure on the metatarsals.

A single factor can sometimes lead to metatarsalgia. But several factors are involved more often, some of which are:

Certain foot shapes:
The metatarsals can be overly pressured by high arch. Additionally, 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, can put extra pressure on the metatarsals as well.

The painful, swollen bump at the base of the big toe is called a bunion. Though wearing high heels or too-small shoes may be the cause of the problem, the tendency to develop bunions is usually inherited. Bunions are much more common in women. Putting extra stress on the ball of the foot, a bunion can weaken the big toe. If the patient doesn't rest enough after surgery, the surgery to correct a bunion can lead to metatarsalgia as well.

Intense training or activity:
Primarily because the front of the foot absorbs significant force when running, runners are at risk of metatarsalgia. However, if the shoes are ill-fitting or are worn out, anyone who participates in a high-impact sport can also be at risk.

Morton's neuroma:
Usually between the third and fourth metatarsal heads, this noncancerous growth of fibrous tissue occurs around a nerve. It can lead to metatarsal stress as well and cause symptoms that are similar to metatarsalgia. Usually, wearing too-tight shoes or high heels that put pressure on the toes causes Morton's neuroma. After high-impact activities such as aerobics and jogging, Morton’s neuroma may also develop.

Excess weight:
Extra pounds mean more pressure on the metatarsals because most of the body weight transfers to the forefoot when one moves. Symptoms of metatarsalgia may be reduced or eliminated by losing weight.

When high heels or too-small shoes prevent the toes from lying flat, this foot problem can develop. Because of a bend in the middle toe joint, one of the toes, usually the second, curls downward. The metatarsal heads are depressed by this contraction.

Ill fitting shoes:
The common cause of metatarsalgia in women is high heels that cause more weight to be transferred to the front of the foot. Athletic shoes or shoes with a narrow toe box that lack support and padding can also lead to metatarsal problems.

Stress fractures:
The small breaks in the toe bones or metatarsals can be painful and change the way one puts weight on his/her foot.



Metatarsalgia may lead to the following if it's left untreated:


  • Pain elsewhere in the body, such as the low back or hip, due to limping (altered gait) from foot pain
  • Pain in other parts of the same or opposite foot


The pain of metatarsalgia is usually relieved by conservative measures:

Wearing proper shoes:
A shoe that's especially suited for the patient's stride, particular sport and foot type may be recommended.

Taking an over-the-counter pain reliever:
To reduce inflammation and pain, one can try acetylsalicylic acid , ibuprofen or naproxen.

By not stressing the foot, one should protect it from further injury. One can stay fit with low-impact exercises, such as cycling and swimming, though one may need to avoid his/her favorite sport for a while. As the pain permits, one can continue with lower body strength training and stretching.

Icing the affected area:
For about 20 minutes at a time several times a day, the patient can apply ice packs to the affected area. He/she can wrap the ice packs in a thin towel to protect the skin.

Using metatarsal pads:
To help deflect stress away from the painful area, these off-the-shelf pads are placed in the shoes just ahead of the metatarsal bone.

Considering arch supports:
To improve foot function and minimize stress on the metatarsal bones, arch supports may be recommended if insoles don't help. Off-the-shelf arch supports can be fitted immediately because they come in various sizes. More durable arch supports can be custom-made from a plaster cast of the foot.

Rigid arch supports are made of a firm material like carbon fiber or plastic. To control motion in two major foot joints below the ankles, these arch supports are designed. Semirigid arch supports are made of softer materials like cork reinforced by silicone and leather. Metatarsal pads are included in the arch supports that are designed to treat metatarsalgia.

Trying shock-absorbing insoles:
To help cushion shock, these off-the-shelf shoe inserts often made of plastic, rubber, cork or a gel-like substance, fit inside the shoes.

Surgery to realign the metatarsal bones may be an option if conservative treatments fail. However, the patient should discuss the benefits and risks with the doctor if he/she is considering foot surgery.


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