Metatarsalgia

What is metatarsalgia?

Metatarsalgia refers to a group of conditions which cause pain in the ball of the foot. This can include: 

  • Capsulitis – This condition causes damage and inflammation of the joint capsule, commonly affecting the second toe joint. Pain and swelling will be present on the underside of the joint where the metatarsal meets the toe in the ball of the foot (metatarsal-phalangeal joint).
  • Morton’s neuroma – This is where thickened tissue develops around the nerve running between the long metatarsal bones on the foot – commonly the 3rd and 4th metatarsals. Shooting, stabbing, burning pain can be experienced, along with numbness and swelling.
  • Bursitis – This condition occurs when the fluid-filled sacs (bursa) that cushion the joints of the ball of the foot become painful and swollen.
  • Turf toe – This is characterised by damage to the ligaments running under the big toe. You will experience pain, swelling and tenderness. This can be exacerbated when bending the toe.#


What causes metatarsalgia?

Pain on the ball of the foot is often caused by too much pressure placed on the ball of the foot. However, there are other factors that can increase your risk of developing metatarsalgia:

  • Wearing inappropriate footwear – This could refer to shoes that are too small or tight, increasing the amount of pressure on the forefoot or those which lack the right amount of cushioning to protect the ball of the foot.
  • Excessive use of the foot, whether that’s standing for too long, walking long distances or engaging in sports activities.
  • Foot deformities causing secondary effects e.g. toe deformities. 
  • Altered foot biomechanics (how the foot functions and moves).

Can metatarsalgia be treated?

There are various steps you can take to manage metatarsalgia. These include both metatarsalgia treatments for when you are already experiencing the condition, and preventative measures to reduce the likelihood of the pain returning. For example:

Do ✓

  • Wear supportive footwear with a spacious toe box.  
  • Rest. If symptoms are stemming from over-using your joints from intensive sports or similar activities, give your feet adequate rest and allow them to recover. In the long term, consider reducing the intensity of your activities to minimise the risk of the pain returning.
  • Use protective insoles such as ZeroSole Impact or ZeroSole Flex to reduce pressure at the ball of the foot. This can help to manage pain and inflammation.
  • Use at home pain management methods such as ice packs or heat pads to ease the discomfort while you recover.
  • Try gently stretching and moving the foot, ankle and toes to maintain flexibility and mobility. This can help to limit pain from stiffness due to not moving as usual.
  • Take painkillers and anti-inflammatories (seek medical advice first).
  • Seek treatment for any underlying foot conditions such as toe deformities or old injuries.

 

Don’t X

  • Do not wear tight, shallow shoes or shoes that are too small. This will increase pressure and compression at the ball of the foot, exacerbating metatarsalgia.
  • Don’t continue playing high intensity sport  without giving your feet time to recover.
  • Do not stand or walk around for long periods of time.

Consult your GP or a healthcare professional about metatarsalgia if:

  • The pain or inflammation persists after two weeks despite making the above changes. 
  • Your pain prevents you from carrying on with your usual everyday activities.
  • The pain worsens or keeps returning.
  • You feel any tingling sensations or numbness in your foot.
  • You have diabetes as well as metatarsalgia. Diabetes can make foot conditions more serious.


It’s important to check for other problems that might be causing the pain, such as a broken toe. If your GP is satisfied that it is metatarsalgia, they may refer you to a podiatrist who will be able to advise you on further treatment options.

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