Metatarsalgia | Causes, Symptoms & Treatment

Metatarsalgia is a problem which affects the ball of the foot, and is caused by inflammation of the bones and joints at the base of the toes, where the metatarsal bones meet with the phalanges of the toes. In most cases, sufferers only feel pain in the second to fourth metatarsal heads. On rare occasions the big toes are also affected, although pain in that location is more often than not caused by sesamoiditis rather than metatarsalgia, especially if there is no pain behind the lesser toes.

Metatarsalgia Causes

The condition is commonly associated with overuse, with the balls of the feet suffering from excessive exercise, with running, jumping and hiking commonly leading to its development. Any activity which places a strain on the balls of the feet can potentially lead to metatarsalgia, and any footwear which does not effectively cushion the balls of the feet, or increases the forces acting on the metatarsal heads can make its development more likely. The burning in the balls of the feet which immediately follows a night in high heels is a warning sign that metatarsalgia may be just around the corner.
There are many factors which can lead to the development of metatarsalgia, with obesity being a common cause due to the increased forces acting on the balls of the feet. Metatarsalgia is sometimes linked to other foot problems, where the body weight is moved more onto the balls of the foot, such as when experiencing heel pain from conditions such as heel spurs or plantar fasciitis or from foot deformities such as hammer toes, mallet toes and bunions. Sufferers of Morton’s Neuroma and stress fractures can also develop this problem for the same reason.

Metatarsalgia Symptoms

Like all other skeletal disorders pain is most obvious symptom. Most commonly, the pain is described as a burning or sharp pain felt in the ball of the foot immediately behind the toes, although it can present as a dull ache or sensitivity in the balls of the feet. The pain is usually at its worst during weight bearing activity such as walking, running jumping or simply standing, with it easing during rest. Oftentimes, the pain radiates to other nearby areas such as the toes and midfoot. The problem can be located behind one or all of the lesser toes.
Some people also experience numbness and a tingling sensation related to the involvement of nearby nerves, with swelling sometimes accompanying the pain. Whilst excessive activity is a common cause, poor quality footwear such as old worn shoes, or fashionable footwear with little to no cushioning is often to blame.

Metatarsalgia is rarely a sudden onset condition, with the pain developing over a period of time. Sudden onset pain in the balls of the feet could well indicate a stress fracture.

Metatarsalgia Treatment

The primary goal of treatment is to ease the pain. Doctors will most likely prescribe pain killers, with non-steroidal anti-inflammatory drugs (NSAIDs) usually sufficient with accompanying rest. In most instances ice packs and cold compression can relieve the discomfort associated with metatarsalgia and will ease any swelling. Applying an ice pack to the affected area will promote constriction of the blood vessels to reduce the inflammation. Compression will also help in minimizing the swelling, restricting any fluid buildup.
The use of shock-absorbing insoles is also helpful in cushioning the balls of the feet, with metatarsal pads commonly used to ease the pressure when walking.

Since metatarsalgia is simply a name given to this type of pain in the balls of the feet, a consultation with a doctor will involve tests to ascertain the actual cause of the pain and whether other conditions exist which have led to the inflammation in the balls of the feet.