Understanding Metatarsalgia

What is metatarsalgia?

Metatarsalgia is a broad term often used to describe pain and inflammation experienced in the ball of the foot. People with metatarsalgia may find that they tend to walk on the outside of the foot or on their heels in an effort to avoid putting any pressure on the ball of the foot that can result in pain and discomfort. Sometimes a callus may form in the area due to increased pressure and pain.

 

 

Symptoms of metatarsalgia

  • Throbbing, dull aching, a bruise like sensation in the ball of the foot with or without a feeling of pebble in your shoes

  • Sharp or shooting pain, numbness, tingling in the toes  

  • Pain generally worse when walking barefoot, particularly on hard floors such as concrete or tiles

  • Pain may be relieved with rest and use of good supportive footwear with forefoot cushioning

  • Often include inflammation of the capsule surrounding the joints in the ball of the foot (capsulitis) or lubricating fluid within the joint or tendons surrounding the joints (synovitis/bursitis)

 

 

What causes metatarsalgia?

Metatarsalgia can be caused by several factors:

  • Overloading of the metatarsals and surrounding structures caused by biomechanical problems such as high-arched feet, flat feet, bunions or lesser toe deformities. A high arch can put excessive pressure on the metatarsals, so can having a longer second toe.

  • Poorly fitting shoes. High heels can transfer extra weight or pressure to the forefoot. Shoes with narrow toe box and inadequate support as well as cushioning are another common cause of metatarsalgia.

  • Sudden trauma to the foot including hard landing on the ball of the foot with poor footwear and equipment.

  • Stress fractures. Small breaks in the metatarsals can be painful and can change the pressure distribution throughout the foot.

  • Intense training or activity / participate in high- impact sports that involve running and jumping.

  • Excess weight.

  • Fat pad atrophy.

  • Morton’s neuroma - a benign growth of fibrous tissue around the nerve can mimic symptoms similar to metatarsalgia and can contribute to metatarsal stress.

  • Inflammatory arthritis such as rheumatoid arthritis or gout.

 

 

What will happen if I left metatarsalgia untreated?

Metatarsalgia might lead to pain in other parts of the foot or elsewhere in the body, such as leg, knee, hip and lower back due to compensatory or avoidance, altered gait from foot pain.

 

 

Management of metatarsalgia

Effective management of metatarsalgia is achieved through proper diagnosis and early treatments. It is imperative to determine the root cause of the pressure on the foot and reduce the abnormal pressure on the feet as well as improving the abnormal leg and foot function. Metatarsalgia usually responds well to proper treatment and hence, surgery is rarely necessary. Contact your local podiatry today for proper metatarsalgia treatment

 

Some of the common treatment options for metatarsalgia include:

  • use of anti-inflammatory medications/gel

  • modification of weight-bearing activities

  • change in footwear/footwear modification

  • use of offloading paddings such as a metatarsal pad or forefoot cushioning

  • orthotic therapy

 

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