You are some athlete, an overweight middle-aged woman or someone practising high impact exercises or activities. Now, you have been experiencing trouble walking and this pain in your forefoot. Ever wonder, why does the ball of my foot hurt so bad?

One of the most common causes of foot pain and inflammation around the world is the metatarsal pain or Metatarsalgia. According to an estimate, Metatarsalgia is around eight times more common than any other foot complications.

The following section provides a thorough understanding of metatarsal foot pain, its causes, symptoms, and risk factors. Moreover, you will find the most comprehensive guide to cure Metatarsalgia – the 11 ways to treat Metatarsalgia.

Metatarsalgia Definition

The term ‘Metatarsalgia’ is derived from two words, i.e. ‘Metatarsals’ – long bones in the foot and ‘Algos’ – pain (Greek Origin). Hence, Metatarsalgia is a painful condition affecting the metatarsal region of the foot.

Stone Bruise is a more common or informal term for Metatarsalgia. 

The metatarsal region or ball of the foot consists of five bones, the metatarsals, at the base of toes. These metatarsal bones are supposed to bear the entire body pressure while walking, running or practicing high impact activities.

However, a disturbance in the specific array or arrangement of metatarsal bones, owing to a foot injury or any other reason, may lead to Metatarsalgia of the foot.

The affected joints and bones in the metatarsal region can lead to consequences, ranging from mild to severe cases.

Susceptible Population

Metatarsalgia is an overuse injury or inflammation in the ball of the foot. Therefore, the athletic population is most vulnerable to Metatarsalgia, as evident through a study conducted in the United States.

Athletes, especially those involved in high impact sports like jumping and running, may experience a foot injury, resulting in Metatarsalgia.

Moreover, field runners and other athletes, including football, soccer, tennis and baseball players may also experience high pressure or strain on their feet.

In addition to athletes, the middle-aged and overweight females are also prone to metatarsal foot pain; however, the condition is not gender-specific.

Who is at Greater Risk to Develop the Metatarsalgia?

As already stated, Metatarsalgia is common among athletes involved in high impact sports. Middle-aged and overweight females are also at the risk of developing metatarsal pain. Following are the common risk factors leading to Metatarsalgia;

• Athletes – fast and high impact activities are putting a strain on the foot.
• Middle Aged Overweight Females – Thinning of fatty tissue under the ball of the foot and high body weight, putting extra strain on the feet.
• High Foot Arch – Overpronation and extra strain on the ball and heel of the foot.
• Smaller Big Toe in Comparison to Second Toe – Pressure in the ball of the foot.
• Foot Deformities in People – Bunions, Achilles tendonitis, and Hammertoe.
• Inappropriate Shoes – Tight-fitting shoes, especially at the toe area and high heels, putting significant strain.
• Bone Conditions – Osteoarthritis, Gouty arthritis, and Rheumatoid arthritis.
• Systemic Diseases – Diabetes, leading to nerve- type pain in the foot.
• Skin Lesions or Calluses on Foot – Uneven weight distribution.
• Morton’s Neuroma – Metatarsal stress from fibrous tissue growing between 3^rd and 4^th metatarsal heads.
• Foot Muscle Complications – Weak toe flexors and tight toe extensors.
• Experiencing Metatarsal Fracture Symptoms – Fractures or small breaks in the metatarsals.

Metatarsalgia Causes

A physical strain on the foot is probably the most common cause of metatarsal foot pain. This strain may result from physical over activity or high impact sports.

Other causes may include tight-fitting shoes or foot injuries occurring in the displacement of metatarsal bones.

The metatarsal bones get pressed with adjacent bones, resulting in pain and swelling as the nerves between them also get inflamed. Following is a more detailed explanation of how the Metatarsalgia develops;

1. Metatarsophalangeal Joint Pain – caused by a misalignment in joint surfaces, flexor plate tearing, foot deformities, joint dislocation, and cartilage wears out.
2. Synovial Impingement – from misaligned joints, a condition called ‘osteoarthritic synovitis’.
3. 2nd Metatarsalgia affected – Overpronation causing dislocation of 1^st ray (with the first metatarsal). 
4. Foot Deformities such as hammertoe and capsulitis may develop.
5. Metatarsal Fat Pad Affected – Cushioning halted between metatarsals and interdigital nerves, causing Interdigital Neuralgia Or Morton Neuroma.
6. Adventitial Calluses and Bursae Build-up – To add cushioning
7. High Sub-Metatarsal Head Pressure – Metatarsal pain or Metatarsalgia thus initiated.

Metatarsalgia Symptoms

The metatarsal foot pain or Metatarsalgia may be identified through the following common symptoms:

• Pain while walking, especially in the ball of the foot – the metatarsal area.
• Bruising, swelling and inflammation of the foot.
• Burning and sharp pain in the ball of the foot, worsening with activity.
• Tingling and numbness in the toes.
• The uncomfortable feeling while wearing socks or shoes, such as a pebble under the feet.
• A diffuse forefoot and midfoot pain like bursitis, an inflammatory condition.

Metatarsalgia Complications

If you are experiencing the symptoms mentioned above, you should immediately reach out to a medical practitioner and get a thorough check-up done.

If Metatarsalgia is left undiagnosed, consequently untreated, the following complications may result;

• Pain in other parts of the foot or opposite foot.
• Foot deformities, such as hammertoes.
• Pain in various body parts, especially weight-bearing parts such as hips and lower back.

Getting appropriate and timely treatment can, therefore, prevent you from these complications. Metatarsalgia recovery time also depends on this factor.

If you do not consult your physician early enough, you might have reached a chronic Metatarsalgia stage. Therefore, recovery time will also be different and prolonged as compared to early treatment.

Metatarsalgia Diagnosis

Your physician may require a brief medical history and answers to a set of questions. As, Metatarsalgia may result from various conditions, pinpointing the exact cause is probably the first step.

To assess the precise cause, your doctor may require an X-ray, ultrasound or MRI. These tests may help to rule out any bone fractures and determine the metatarsophalangeal joint. Typically, the purpose of different tests may be:

• Evaluating the exact point of inflammation – Bone Scan.
• Pointing any bone fracture or deformities – X-ray.
• Identifying conditions such a Morton Neuroma or Bursitis – Ultrasound.
• Detecting the cause of pain in midfoot and metatarsal regions – MRI.

The right diagnosis will ultimately help your doctor to suggest the right treatment option. 11 Ways to Treat Metatarsalgia – presents some of these most effective treatment options.

Metatarsalgia Treatment

Treatment for Metatarsalgia is generally grouped into the following two categories;

Conservative or Non-Surgical Treatment

These treatment options are the safest approaches to counter the metatarsal pain. Including non-surgical treatments are physical therapy options, shoe adjustments, and some home remedies. The ‘11 Ways to Treat Metatarsalgia’ covers the non-surgical treatment options.

Surgical Treatment

When all the non-surgical approaches fail to counter the metatarsal foot pain, the last option is Metatarsalgia surgery.

The surgery involves a realignment of metatarsal bones. Metatarsalgia surgery should only be conducted when none of the non-surgical Metatarsalgia cure is useful.

The following section provides the 11 Ways to Treat Metatarsalgia – best and most effective non-surgical approaches, including home remedies;

11 Ways to Treat Metatarsalgia

1. Give Rest to Your Feet

Metatarsalgia is most often an overuse injury. Therefore, giving rest to your feet is beneficial to get rid of pain and inflammation. Moreover, resting prevents any further damage to your feet, especially the metatarsal bones and nerves.

Even if you have to move around, stand or walk, make sure you rest your feet afterward. Resting does not mean to stop all activity; however, you must avoid high impact activities such as sports, running and jogging.

2. Icing the Affected Area

By applying ice onto the affected area, the inflammation can significantly help alleviate the burning sensation, swelling, and pain at feet. Ice helps to remove the redness and pain by numbing the area, thereby providing immediate relief.

You may apply the ice directly, an ice pack or ice wrapped in a towel. Make sure you ice the painful area for not more than 20 minutes at a time. Repeat this simple remedy at least 2 to 3 times daily.

3. Compression

Compression may help to remove the inflammation. You can use an elastic, flexible foot bandage for the purpose.

4. Elevation

The elevation is probably the most soothing remedy. You need to adjust your blood circulation at feet by elevating them.

This remedy helps to remove the pressure of blood from feet and also the swelling. You can put some small stool under your feet while sitting or a pillow or cushion when lying on a bed.

All these four remedies are customarily grouped as the “RICE – Rest, Ice, Compression and Elevation”.

This set of 4 simple home remedies is probably the most recommended as the first-line treatment of Metatarsalgia at home.

5. Pain Relieving Medication

Over the counter pain relievers (OTC) are recommended for acute and chronic pain management.

Some best-advised pain-relievers include; Ibuprofen (Advil, Motrin IB, others), Voltaren, aspirin (paracetamol) and naproxen sodium (Aleve).

Moreover, Non-steroidal Anti-Inflammatory Drugs (NSAIDs) can help to get rid of the pain and inflammation.

However, medication is only a short-term remedy and not recommended for long-term usage.

Also, make sure not to take two or more pain relievers at a time unless prescribed by your doctor. Acetaminophen (Tylenol) containing medications should be avoided as they may harm your health over time.

6. Massaging Essential Oils

Massaging the affected area with oils can help relieve inflammation and soothe your feet. You can use any of the following three oils for massage:

• Eucalyptus oil – Anti-inflammatory and analgesic in nature, aiding to relieve the pain and swelling.

• Peppermint oil – Strong anti-inflammatory compound, Menthol. It also helps relieve pain, swelling, and redness in the foot.

• Coconut oil – it contains medium-chain fatty acids, having analgesic, anti-inflammatory, and antimicrobial properties. Thereby helping to relieve the pain and tissue inflammation.

7. Metatarsalgia Orthotics

Specially designed orthotics for Metatarsalgia are available to help take off the pressure from the ball of the foot. Your doctor may recommend one, or you can get yourself the best foot orthosis.

These devices may serve to provide long-term relief to your feet, aiding in proper blood circulation. Moreover, these devices can help correct improper arch and overpronation.

Following are some of the best and most recommended orthopedic devices to treat Metatarsalgia;

• Metatarsal pads, Metatarsalgia gel pads or Metatarsal domes help to relieve forefoot pressure and pain.
• Rigid orthoses, external shoe bars, carbon fiber plates, and rocker soles. These devices are particularly useful when 1^st metatarsophalangeal joint is affected, especially its motion restricted. Also beneficial for patients with Morton neuroma.
• Metatarsalgia Bar is used in case of chronic symptoms, especially for athletes who have to run, etc. These metatarsal bars can be placed inside the shoe.
• Insoles for Metatarsalgia or the Metatarsalgia insoles may be extremely helpful in relieving the metatarsal foot pain.
• Metatarsalgia arch support help to alleviate metatarsal stress. Some recommended insoles are; berry Superfeet (female-specific), orange Superfeet (male-specific), DMP Superfeet, or Alimed Antishock insoles.
• Silicone gel metatarsal cushion (with toe loop) can help relieve metatarsal pain.

8. Shoes for Metatarsalgia – Supportive Footwear:

Improper footwear might be the actual cause of your metatarsal pain. Especially wearing high heels in routine, tight-fitting or too loose shoes may cause the initial misalignment of metatarsal bones.

Appropriate footwear can, therefore, help remove the excess pressure and weight from your forefoot area.

You may find yourself some of the specially designed and supportive shoes for your Metatarsalgia.

What type of shoe is best for Metatarsalgia?

Metatarsalgia best shoes are shaped and designed to include Metatarsalgia support and usually come with a specific type of inbuilt Metatarsalgia insert.

• Shoes with “Rocker” sole modification are best for the initial restoration of range of motion (ROM). These include Sketchers Shape-ups or MBT shoes.
• Athletes should make sure to wear appropriate shoes as they practice some high impact sports.
• The best running shoes for Metatarsalgia pain have sufficient cushioning and rubber soles or heels that help as a shock absorber.

9. Physical Therapy

Physical therapy aims to correct the metatarsal alignment and achieve normal biomechanics.

– Initial or Acute Phase Therapy

The initial phase involves relief of pressure, inflammation and swelling from the feet.

Proceeded by some passive range of motion (ROM) exercises to restore foot activity.

In some cases, Ultrasound treatment may also be provided to relieve the inflammation.

– Metatarsalgia Exercises

It is vital to take adequate rest; however, specific simple foot exercises and stretches can strengthen the muscles and treat the condition.

Your physical therapist may recommend some exercises for Metatarsalgia. These simple exercises help to restore dynamic muscle control at the foot.

In most cases, the stretching of Achilles tendon contributes to remove inflammation and get rid of the pain altogether. Therefore, Achille tendon and ankle exercises are suggested to treat Metatarsalgia.

Following are some of these proven foot exercises recommended to ger rid of Metatarsalgia;

• Stretching the Ankle Joint Up and Down

To perform this exercise:

• You will require to sit on a chair, but your feet should not be touching the floor. (Perform this exercise barefoot).
• Next, you should stretch the ankle joint downwards, as much as possible, holding the position for a few seconds.
• Now, reverse the direction of the stretch and move your ankle in an upward position in the same way and hold for few seconds again.
• Repeat this up and down ankle stretch for 12 to 15 times and then give your feet rest.
• Note: You can also modify the exercise in the way, as shown in the animated image above.

• Rotating the Ankle Joint

To perform this stretch:

• Sit comfortably on the floor, stretching your legs in the forward direction. Also, perform this exercise barefoot.
• Now, you should move your ankle joint in a clockwise motion 10 times.
• Proceed the clockwise rotation exercise with an opposite or anti-clockwise rotation, also for 10 times.

• Toes Walk

• You simply need to stand straight on the floor, without wearing any shoes or socks.
• Now, slowly lift your heels and stand on your toes, holding the position.
• Next, take a small round of your room, walking on your toes.
• Repeat this exercise 5 times and then relax.

– Recreational Therapy

Sometimes your muscles need conditioning or training to restore to normal form. Physical conditioning may be achieved by swimming as it does not halt the healing process.

10. Callus Removal

The callus build-up is common in the case of Metatarsalgia. The removal of callus can help alleviate metatarsal pain and remove forefoot pressure.

Generally, there are two methods to get rid of the callus;

• Shaving Callus Off

The doctor can help shave off the callus, providing immediate but temporary relief to metatarsal pain.

The process should be conducted with extreme care to avoid bleeding from debridement. During this process, some chemicals or acids may also be used.

• Pumice Stone to Remove Callus

You can also remove the callus at home, soaking and using a pumice stone. However, diabetic patients must consult their medical physician to discuss their case in detail.

11. Steroid Injection

In certain severe cases, your doctor may prescribe or administer steroidal injections for relieving the pain and inflammation.  However, steroids have side effects, and this treatment can not be used for a long-term basis.

Moreover, immunocompromised cases where an individual is already suffering from another disease, i.e. diabetes or the elderly, cannot take this treatment.

Steroid or Cortisone shots are only advised as the last source of relief from Metatarsalgia. These may be extremely effective for patients with the interdigital neuroma, having the nerve block.

Important Tip:

Probably, the best advice is to avoid Metatarsalgia causes. This includes precautionary measures such as wearing appropriate shoes or avoiding overactivity or controlling health conditions.

The kind of treatment depends on the degree of metatarsal deformation or severity. Always consult your physician to receive the best advice and thorough checkup.

In some cases, controlling of related conditions can help control Metatarsalgia. For instance, you must control your blood sugar if you are a diabetic patient or your weight if you are obese. Also, getting rid of foot deformities like hammertoe can help alleviate metatarsal pain altogether.

Common Queries or Frequently Asked Questions Regarding Metatarsalgia

How do I treat Metatarsalgia? Or How do you get rid of a ball of foot pain?

‘11 Ways to Treat Metatarsalgia’ is a comprehensive guide to treat Metatarsalgia. You can opt for the treatment option depending on your Metatarsalgia degree.

How long does it take for Metatarsalgia to go away?

Metatarsalgia healing time depends on various factors. Firstly, your degree of damage to the foot already resulting from metatarsal misalignment.

Secondly, your treatment option and care. For appropriate treatment, receive a proper diagnosis.

What does Metatarsalgia feel like?

You can read about the symptoms of Metatarsalgia given in this article.

What shoes are best for Metatarsalgia?

Metatarsalgia best shoes are specifically designed to fix the condition. You can find the best shoe option under Metatarsalgia Treatment.

Does Metatarsalgia ever go away?

Yes, you can always get the treatment for Metatarsalgia.

Is metatarsalgia curable? Or Can metatarsalgia be cured?

Yes, Metatarsalgia can be cured. However, in extreme cases, you might need to undergo Metatarsalgia surgery.

Metatarsalgia can reoccur even after the surgery; therefore, it is always advisable to take precautionary measures. Using supportive footwear is probably the best precaution for Metatarsalgia.

Can Metatarsalgia go away on its own?

No, if you do not take precautions, the Metatarsalgia may worsen up overtime.

Does Metatarsalgia show up on X-Ray?

An X-Ray can help to pinpoint bone deformities and fracture, serving as a critical tool in diagnosis.

Can flip flops cause Metatarsalgia?

Yes, wearing loose shoes can be a reason for Metatarsalgia. You should always wear proper fit shoes, nor too tight or too loose.

Will a cortisone shot help Metatarsalgia?

Yes, cortisone shot or steroid injection is useful but only recommended for extreme cases. This is not a long-term treatment option and may only be used to provide instant relief.

What is the best insole for Metatarsalgia?

Insoles for Metatarsalgia or the Metatarsalgia insoles may be extremely helpful in relieving the metatarsal foot pain.

Metatarsalgia arch support (insoles) helps to alleviate metatarsal stress. Some recommended insoles are; berry Superfeet (female-specific), orange Superfeet (male-specific), DMP Superfeet, or Alimed Antishock insoles

What kind of doctor treats Metatarsalgia?

You may consult either a bone specialist or foot specialist, i.e. orthopedist or podiatrist.

Want to know about other foot problems? check out the links below:

• Everything You Need to Know about Pes Cavus
• 11 Ways to Get Rid of Shin Splints – An Easy Guide
• Pes Planus (Flatfoot) – Symptoms, Treatment, and Shoes
• How to Buy Best Shoes for Foot Pain | Guide 2019
• Best Women’s Shoes for Plantar Fasciitis 2019
• How to Cure Plantar Fasciitis in one week at home?
• What is Hallux Valgus (Bunion)? Symptoms, Causes, and Treatment