Metatarsalgia

When somebody comes in complaining about foot pain, the first question we’ll probably ask is, “where?” Feet are complicated structures (fully one quarter of the bones in your body are found from the ankles down!) and pain can occur in many different locations, for many different reasons. When the pain radiates from the ball of your feet, it’s known as metatarsalgia.

Metatarsalgia is not really a condition in and of itself. It’s really more a set of symptoms which may arise from any number of underlying conditions or injuries. It gets its name from the metatarsal bones (located toward the front of the feet) and the suffix –algia, which means pain.

Common Symptoms of Metatarsalgia

The unifying symptom of all metatarsalgia conditions is, of course, pain in the balls of the feet—that is, on the front part of the foot, just behind your toes. The discomfort usually gets worse during extended periods of standing, walking, or athletic activity. Depending on the underlying problem, you may also feel shooting, tingling, or numbness in your toes, or feel like you have a pebble or bunched-up sock in your shoe that you can’t get rid of.

Causes and Risk Factors

In a very general sense, the most common overarching cause of metatarsal pain is soft tissue overuse injury. With overuse injuries, there usually isn’t a single underlying explanation for the pain, but rather some combination of contributing factors that produce symptoms that gradually worsen over time. Possible factors include:

• Intense athletic training, particularly in sports or activities that require a lot of running and/or jumping on hard surfaces.
• Shoes that don’t fit properly, are too narrow in the toe box, or don’t provide the right type of support for your foot shape and chosen activity.
• Inherited foot structures that place additional stress on the balls of the feet, such as high arches, a tight Achilles tendon, or an abnormally long second toe, or acquired foot deformities such as hammertoes or bunions.

Besides soft tissue damage from overuse, other potential causes of ball of foot pain include:

• Stress fractures, a more serious form of overuse injury in which thin cracks develop in bones.
• Morton’s neuroma, a non-cancerous tumor of thickened nerve tissue that can cause pain by pushing on a nearby nerve when you stand or walk.
• Arthritic joints, particularly inflammatory conditions such as rheumatoid arthritis (RA) or gout.

Treating Metatarsalgia

At the Kansas Foot Center, we know there is no one-size fits-all approach to treating ball of foot pain. A thorough examination, using any relevant diagnostic technologies, will be used to determine a personalized care approach that we believe will provide the greatest benefit for your unique situation and be the best fit for your needs.

That said, in most cases of metatarsalgia, conservative remedies are usually the first step, and sometimes may be all you need to relieve your discomfort. Such measures typically include things like rest, ice, gentle stretches, switching to better-fitting and better-cushioned shoes, and changing up your exercise routine to feature more low-impact activities.

For chronic metatarsalgia that does not respond to self-care, our office provides more advanced (but still non-surgical!) treatment options, such as:

• Shockwave therapy, which uses electronic pulses similar to sound waves to stimulate healing.
• MLS laser therapy, which uses specific wavelengths of light to stimulate healing.
• Custom orthotics, which are specially made using a digital scan of your feet. They are inserted into your shoes to accommodate structural foot problems and provide any extra cushioning or support you need.

In rare cases—typically only when conservative options have already been tried or are not recommended—we may consider surgical treatment.

Don’t suffer through ball of foot pain, especially if it’s keeping you from living an active life! You have many treatment options available to you. To schedule an appointment with the Kansas Foot Center and see how we can help, give us a call today at 866.222.5177.