What is Metatarsalgia?

You have five metatarsal bones in each foot of each of your toes. These bones make up your forefoot and prone to excess strain when doing activities.  While many of the activities can occur from more intense activities, it is also commonly seen in walkers and people on their feet all day at work.  Metatarsalgia can also result from shoes that don’t fit, foot deformities, arthritis, and other diseases.

What are the symptoms of metatarsalgia?

The pain of metatarsalgia usually starts slowly with time. It might feel a little better when you rest your foot and become worse when you stand, walk, or workout. Your foot might feel like:

• you’re walking with a marble or pebbles in your shoe
• you have a sharp burning or shooting pain in the ball of your foot
• your toes are numb or tingling

You might also find that your pain worsens when you:

• stand
• run
• walk barefoot
• participate in a high-impact sports activity

What causes metatarsalgia?

The most common reason for metatarsalgia is participating in sports activities that put pressure on the metatarsal bones at the front of your foot. These activities typically lead to overuse of the area. Running, for instance, includes putting consistent force on the ball of your foot. The irregular tension on your foot can increase inflammation in the metatarsal area. It can likewise aggravate the tendons, ligaments, and cartilage around the bone.  Forefoot runners are especially prone to metatarsalgia as they shift their weight to the front of the foot and away from the heel.

Other causes include:

• Shoes that don’t fit right: Your shoes may be too tight, squeezing your foot. Or your shoes might be too loose, making your foot slide back and forth.
  High heels shift weight to your metatarsal bones and tennis shoes without adequate padding and arch assistance can cause you to put more weight on the ball of your foot.
• Foot problems: High arches, a 2nd toe that is longer than your big toe, calluses on the bottom of your foot, bunions, and hammertoe can also contribute to metatarsalgia.
• Extra weight: Being overweight or obese puts more pressure on your feet and metatarsal location.
• Some diseases: Bursitis, arthritis, gout, Morton’s neuroma, and stress fractures in your toes and metatarsal bones can increase the stress on the ball of your foot.

How to treat and prevent metatarsalgia

The initial step in dealing with metatarsalgia is to determine the cause of the discomfort. If improper fitting shoes is the cause of the discomfort, the shoes need to be changed. Footwear developed with a high, wide toe box (toe area) and a rocker sole is ideal for dealing with metatarsalgia. The high, wide toe box enables the foot to expand while the rocker sole minimizes tension on the ball-of-the-foot.

Removing pressure on the ball-of-the-foot can be achieved by seeing your podiatrist. Orthotics developed to ease ball-of-foot pain generally feature a metatarsal pad. The orthotic is constructed with the pad positioned behind the ball-of-the-foot to alleviate pressure and rearrange weight from the painful location to more tolerant areas. Also, orthotics hold your arch stable and distribute your body weight evenly through your foot and not concentrated on the metatarsal bone. When orthotics are used with proper shoes, you should experience substantial relief.

If you have calluses on the ball of your foot, your podiatrist can trim them and this will relieve considerable pressure that may be causing your metatarsal pain.  Also, stretching a tight Achilles tendon can also relieve pressure from the ball of your foot.  If your natural fat pad has become thin on the ball of your foot, your podiatrist can help you with specialized pads to protect the fat pad area and add cushioning and shock absorption to the area.

Upon examination, you will likely have an x-ray to check for different potential causes of your pain.  If the pain continues, an MRI can be helpful to identify stress fractures, joint problems or other areas of high stress and inflammation. Your podiatrist can help you get rid of your pain and help you return to your activities.

For relief of your foot and ankle problems, contact Dr. Jairo Cruz today at Gentle Foot Care Clinic in Brandon and Zephyrhills.  

Author

Marc A Katz DPM Dr. Marc Katz is a podiatrist that previously practiced in South Tampa on Swann Ave with Dr. Jairo Cruz DPM. He works closely with Dr. Cruz to create educational materials to help patients and the community. Dr. Katz is recognized as a leader in the Tampa Podiatry community for over 23 years. Dr. Katz has extensive expertise in all areas of foot and ankle medicine and surgery and is Board-Certified. He was an early adopter and is a leader in Minimally-invasive procedures and Regenerative medicine in the podiatry community. Dr. Katz has had many articles published in podiatry journals discussing his procedures and techniques. In addition, Dr. Katz has advanced training in Functional and Holistic Medicine and Nutrition. He is one of a few podiatrists that has taken advanced courses in Prolotherapy, Neural Prolotherapy and Ozone Therapy. Please enjoy the content and I truly hope that you find great benefit. Dr. Katz can be reached at marckatz61@gmail.com For more information: https://marckatzdpm.com/