Metatarsalgia is a common overuse injury described as pain in the front part of the foot (forefoot). It is associated with increased stress over the heads of your metatarsal bones (the ball of your foot). Metatarsalgia commonly occurs in the area where the second, third and fourth toes meet the ball of the foot (the metatarsal heads).
Metatarsalgia causes pain in the ball of your foot that can be worsened by walking or running. There may be a burning or aching sensation in the ball of the foot and some people compare the sensation to 'walking on pebbles'. The intensity of the pain varies greatly from mild to severe. Shooting pains in the toes, tingling or numbness around the toes, and worsening pain when standing or moving are all common symptoms of metatarsalgia. Symptoms usually develop gradually over a period of months rather than coming on all of a sudden.
There are a number of different causes of metatarsalgia, anything that adds extra strain or pressure to the ball of the foot can lead to problems. Poorly fitting footwear such as narrow, high heeled shoes which force the foot into a small space can cause the condition. Certain foot shapes are more likely to suffer with metatarsalgia, for example, a narrow, high arched foot where pressure is great on the front part of the foot. Athletes who take part in high-impact sports which involve running or jumping have an increases risk of developing forefoot problems. Being overweight also increases pressure on the foot. As we age the protective 'fat pad' that sits over our metatarsal heads for protection begins to displace and thin, leaving the bones more exposed to pressure. Metatarsalgia is often associated and is a symptom of; hammer toes, Mortons' neuroma and osteoarthritis of the feet.
If you have metatarsalgia then you require an assessment with a podiatrist. Depending on how quickly symptoms have appeared will determine the appropriate treatment. Reducing levels of pressure over the area is key and often avoiding certain types of activity for a period of time is necessary.
Wearing inappropriate footwear and continuing with high-impact sports will worsen symptoms. Avoiding the activity that places high pressure on the forefoot is very important.
Continued high pressure on the forefoot may lead to stress fractures of the metatarsals.
Orthotics can be provided to improve the function of the foot and redistribute pressure to protect the ball of the foot. Cushioning silicone gel insoles may also provide relief. Advice regarding appropriate footwear with good shock absorption is important.
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