Understanding Metatarsalgia

Understanding Metatarsalgia


What is Metatarsalgia?

Metatarsalgia is often the diagnosis for the pain that is felt around the ball of one’s foot.

The pain and inflammation are localized to the end of the long bones in the midfoot, called the metatarsals.

What Are The Symptoms?

The primary complaint about metatarsalgia is pain around the ball of the foot when weight-bearing.

Individuals can describe their symptoms as achy, sharp or even a burning-type pain; a bruised feeling on the ball of the foot is also a very common complaint. Some individuals also report the sensation of a small pebble in their shoe when walking.

Walking barefoot is usually more aggravating than when wearing a shoe, and the pain usually worsens the more one is on their feet. Rest and non-weight-bearing positions usually allow the pain to subside.

What Causes Metatarsalgia?

There are numerous potential underlying causes of metatarsalgia. Some of the most common are listed below:

Individuals that take part in running or high impact, jumping sports have a higher frequency of metatarsalgia, as significant force is required to be absorbed through the ball of the foot.

  • A sudden increase in training intensity
  • Individuals with a cavus (high arched) foot or other foot deformities
  • Tight lower extremity musculature (primarily calf muscle)
  • Poorly fit or worn out shoes
  • Excessive wearing of high heels
  • Overweight individuals
  • Co-existing medical conditions such as rheumatoid arthritis or gout


What Is The Treatment For Metatarsalgia?

Metatarsalgia is usually treated through a conservative approach. The most common treatment strategies are listed below, and it is usually a combination of these tactics that help one fully recover from metatarsalgia.

  • Rest from the aggravating activity
  • Anti-inflammatory management through ice or medication
  • Minimizing time spent in bare feet (especially on hard surfaces)
  • Ensuring proper footwear
  • Orthotics
  • Inserting a metatarsal pad in your shoe
  • Ensuring proper flexibility of lower extremity muscle groups (especially the calf musculature)
  • Weight loss
  • Managing other medical conditions


Differential Diagnosis?

When assessing one for metatarsalgia there are other foot conditions that should be ruled out, the most common being Morton’s Neuroma or a stress fracture.

Please consult with your healthcare provider if you wish to discuss your metatarsalgia symptoms further.

Teresa Agar, MScPT, BHKin
Registered Physiotherapist

Trailside Physio – Coquitlam Clinic


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