What is metatarsalgia?
Metatarsalgia is a general term used to describe pain and inflammation in the ball of the foot. Particularly, this is pain around the metatarsal heads—the bones just before your toes. While it’s not necessarily a condition in itself, it signals an underlying problem in foot structure, biomechanics, or lifestyle.
The pain feels like or is often described as:
- A sharp, burning, or aching sensation in the front part of your foot
- The feeling of walking on a pebble
- Numbness or tingling in the toes
What causes this foot pain?
Metatarsalgia can develop from a variety of factors, including:
1. Overuse and high-impact activities
Runners, jumpers, and dancers often put repetitive stress on the forefoot. Ultimately, the large forces going through the area can affect the tissues leading to inflammation and pain
2. Improper footwear
Wearing high heels or tight shoes can shift your body weight forward onto the metatarsals or cause extra compression through those bones. As a result, consistently wearing these types of footwear can overload that area of the foot. Also, a lack of cushioning or arch support can be a common culprit in foot pain
3. Foot shape
Furthermore, people with high arches or other foot shapes like hammer toe, bunions, or a second toe longer than the big toe are more prone to metatarsalgia due to uneven weight distribution
4. Excess body weight
More weight means more pressure on the feet, causing increased strain over time
5. Aging
As we age, the fat pad that cushions the ball of the foot naturally thins, reducing shock absorption and increasing vulnerability
What are the symptoms of metatarsalgia?
Metatarsalgia may have some or all of the following complaints:
- Pain location is the ball of the foot
- The pain improves with rest and worsens with standing, walking, or running
- Swelling or bruising around the ball of the foot
- Feels like having a pebble in your shoe
- Numbness or tingling in your toes
If these symptoms persist, it’s a good idea to consult a health care professional like a podiatrist (a doctor that specializes in foot care or a physiotherapist to have the issue evaluated and treated.
What is the treatment for it?
Physical therapy management and care from a podiatrist is usually the first step in conservative care. These can include treatments such as:
1. Education
- Activity modifications: Stopping high-impact exercise, alternatives include exercises in a pool, swimming, running or cycling
- Footwear advice: Using supportive shoes to prevent reinjury
- Advice on pain management: Ice, elevation, and NSAIDs for pain/swelling
2. Orthoses/orthotics
- Metatarsal Pads: Rubber/silicone pads placed just behind the metatarsal heads can reduce pressure on the area. Subsequently, they can reduce irritation in the area
- Forefoot cushions/metatarsal bars: Similarly to the pads, they help redistribute pressure in the foot
- Insoles:
- Accommodative: Redistribute pressure
- Functional: Control abnormal foot mechanics that are causing
3. Stretching
The areas of focus include the calves, Achilles, and other muscles around the ankles or toes. Key exercises include:
- Wall calf stretch
- Step-down Achilles stretch
- Seated ankle flexion/extension
Ultimately, the aim is to improves flexibility and mobility in the area and surrounding areas while reducing pain.
4. Strengthening
Different exercises may be used to builds foot strength, improve arch support, and increase muscle endurance. A common exercise used to improve intrinsic foot muscle (small muscles in the feet) strength is:
- Toe towel scrunches: 3 sets of 15 reps/foot.
5. Modalities and pain relief techniques
Ice, ultrasound, interferential therapy may be used to help manage pain and swelling. In some cases: taping is a very helpful strategy that provides pain relief.
Surgical Options
Unfortunately, conservative care does not achieve satisfactory results with everybody. Surgery is typically a last resort and considered only when conservative treatments fail. In this case, it might involve realigning bones or correcting deformities that are contributing to the midfoot pain.
Can metatarsalgia be prevented?
Prevention starts with foot awareness and smart lifestyle choices:
- Wear well-fitting shoes with adequate support
- Maintain a healthy weight to reduce foot pressure
- Watch out for large increases in activity such as starting a new sport or increasing the amount you play.
- Stretch and strengthen your foot muscles regularly
- Replace athletic shoes often—don’t wait until they’re worn out
Looking for help with foot pain?
Look for PhysioNow! We are leading health care providers with service across the GTA from Burlington, Oakville, Mississauga to Etobicoke. Our experienced practitioners offer their expertise in many different areas including Physiotherapy, Massage Therapy, Manual Osteopathy, Athletic Therapy and more! Get help with your pain today! Contact us to book your first assessment and treatment with PhysioNow!
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