Metatarsalgia - Pain in ball of foot

Metatarsalgia denotes a foot condition characterized by pain and inflammation of the joints and bones of the ball of the foot – that area just before the toes, also called the metatarsal region.

Most patients experience pain in the second, third and fourth metatarsal heads, but there are some cases of pain the big toe’s metatarsal heads.

During walking, jumping, or running, a big percentage of your body weight transfers to the toes and therefore to the metatarsals. The metatarsal bones of the big toes together with the second and third metatarsals take the burden of weight transfer. Excessive pressure (common during athletic activities) sometimes leads to pain and swelling.

Metatarsalgia is not a very serious foot condition, but it can significantly affect foot movement. Athletes in high-impact sports such as basketball may find it very hard to jump and land because of metatarsalgia, for example.

Fortunately, metatarsalgia treatment is quite simple – in most cases, rest and some therapy are enough. Metatarsalgia surgery may be required of more sever cases.

 

What are the symptoms of metatarsalgia?

Patients with metatarsalgia usually experience a sharp, often ‘burning’ pain on the sole behind the toes, or ‘balls’ of the feet. The pain usually worsens when the patient stands, walks or runs or when the affected foot is flexed. The pain usually eases down with rest. Some patients also experience toe numbness.

Most of these symptoms manifest abruptly, but it usually takes weeks for metatarsalgia to develop.

 

What are the causes of metatarsalgia?

One or a combination of many factors can cause metatarsalgia.

Among the most common is over-training or over-activity. Studies show that runners – who tend to put excessive pressure on their metatarsals when playing – develop metatarsalgia more than others do. Intensive, extended training puts an abnormal amount of stress on the balls of the feet, often causing irritation and eventually, inflammation.

A high arch, an abnormally long second toe, and other such structural factors can also cause metatarsalgia. People with hammertoes , those who wear high heels (which prevent the toes from relaxing flat), and those who are overweight are also more prone to metatarsalgia because their conditions tend to put more pressure on the balls of the feet.

The risk of developing metatarsalgia also appears to go higher as a patient grown older. This is because the fat pads on the metatarsals thin out as a person ages, diminishing the ability of the metatarsal bones to protect themselves.

 

Tests and Diagnoses

Most doctors require a patient to undergo an x-ray in order to rule out other foot problems which cause symptoms similar to those of metatarsalgia. Most doctors also ask about a patient’s lifestyle, exercising habits, activity levels, etc.

 

How to treat metatarsalgia?

Most metatarsalgia cases only require conservative treatment.

Metatarsalgia treatment can be as simple as applying ice packs to the affected area several times during the first day, for example – in most cases, this can already significantly reduce swelling and ease pain. Rest is another simple but effective form of metatarsalgia treatment. By keeping stress off the balls of the feet, inflammation and pain are reduced. Athletes who need to still keep active even during recuperation period are usually advised to temporarily switch to low impact exercises like swimming.

In some cases, doctors may prescribe nonsteroidal anti-inflammatory medication like ibuprofen. These drugs aid in lessening pain and swelling. Doctors may also prescribe specially-designed orthotics to minimize pressure. Shock-absorbing insoles are also great in cushioning the balls of the feet.

When conservative metatarsalgia treatment options fail, the doctor may recommend metatarsalgia surgery. During surgery, the metatarsal bones are realigned.