Metatarsalgia

Metatarsalgia, pronounce met-uh-tahr-SAL-juh, is a condition where the ball of the foot becomes painful and inflamed. The ball of the foot is the area of the foot just behind the toes. When experiencing metatarsalgia, the pain is described as burning, sharp or aching in the ball of the foot and the pain increases upon long periods of standing. Sometimes, metatarsalgia feels like having a pebble in the bottom of your shoe.

While painful, metatarsalgia is often treatable at home with ice and rest. If the pain in the ball of your foot persists for more than a few days, however, you should consider having an exam by a foot specialist to determine whether there might be a more serious cause for your foot pain.

Dr. Jeffery Kleis, DPM, is an award-winning podiatrist in Costa Mesa with more than 25 years of experience treating pain and disorders in feet and ankles. Dr. Kleis remains on the cutting edge of non-invasive techniques for treating foot, heel, and ankle pain through shock-wave, acoustic-wave, and laser therapy treatments.

For an evaluation of your metatarsalgia pain, call Dr. Kleis at (714) 760-4944 or book an appointment online.

What is Metatarsalgia?

Metatarsalgia is pain and inflammation in the ball of the foot, sometimes described as feeling like there’s a pebble in the sufferer’s shoe. Metatarsalgia is not a serious condition, though it may require treatment for relief. At-home treatments include ice and rest. If the pain from metatarsalgia is severe or lasts for more than a couple of days, a doctor’s exam may be necessary to rule out more serious conditions or determine if more aggressive treatment may be required for relief.

Metatarsalgia can be brought on by over-use or may be caused by a variety of factors, including intense training, abnormal foot shapes, deformities of the foot, being overweight, poor shoe choices, stress fractures, or Morton’s neuroma.

Intense Training – If a person engages in new activities or experiences a dramatic increase in the level of intensity of their training, it could cause stress on the ball of the foot. Runners are especially prone to foot injuries and may experience metatarsalgia after a significant increase in training level.
Foot Shape – Certain foot shapes are more prone to developing metatarsalgia. A high arch can place higher-than-normal pressure on the ball of the foot, causing irritation and inflammation. Also, having a second toe that is much longer than the first toe can change the pressure points of the foot, increasing pressure on the ball of the foot.
Foot Deformities – If your foot becomes misshapen, or has experienced deformities since birth, shoes may not fit correctly, placing greater-than-normal pressure on the ball of the foot, resulting in metatarsalgia.
Obesity – Carrying excess weight means higher pressure on the bottoms of your feet, including placing more pressure on the ball of your foot. Being overweight can result in several foot conditions, including metatarsalgia.
Poor Shoe Choices – Shoes that don’t fit properly or do not have sufficient room in the toe box can result in too much pressure on the ball of the foot, leading to metatarsalgia.
Stress Fractures – A stress fracture is a small break or crack in the bones of the foot. These fractures can be so tiny that they cause only mild discomfort but they may change the way you step, placing more pressure than you normally would on the ball of your foot. This abnormal gait can lead to metatarsalgia.
Morton’s Neuroma – Morton’s neuroma is a non-cancerous growth made up of fibrous tissues surrounding a nerve. This growth generally occurs between the third and fourth metatarsals. Morton’s neuroma causes symptoms very similar to metatarsalgia and also contributes to stress on the ball of the foot, leading to metatarsalgia.

Metatarsalgia Symptoms

The symptoms of metatarsalgia include pain, pain that gets worse when you stand, numbness or tingling in your toes, and feeling as if you have a pebble in your shoe.

Pain – The pain of metatarsalgia is described as a sharp or burning pain in the ball of the foot. The ball of the foot is the area just behind the toes.
Worsening Pain – Metatarsalgia pain will worsen after long periods of standing or running and it improves with rest.
Numbness or Tingling – Metatarsalgia is often described as a pain combined with numbness or tingling in the toes.
Pebble in the Shoe – Feelings of having a pebble in your shoe is a common complaint among individuals suffering from metatarsalgia. This symptom is also common to individuals suffering from Morton’s Neuroma.

Metatarsalgia Pain

Metatarsalgia can be quite painful. Fortunately, metatarsalgia pain is generally made much better with at-home treatments that include ice and rest. If your metatarsalgia pain does not improve with rest or is increasing and persistent for more than a few days, seek medical advice as other conditions may be contributing or to blame for your pain.

For an evaluation of your metatarsalgia pain, call Dr. Kleis at (714) 760-4944 or book an appointment online.

Metatarsalgia Treatment

Other conditions may cause symptoms similar to metatarsalgia. If your pain and discomfort do not subside with rest and at-home treatments, seek the advice of a podiatrist like Dr. Jeffery Kleis. Before prescribing treatment, Dr. Kleis will perform a complete evaluation of your foot pain and rule out any similar or contributing conditions. You may need an X-ray to rule out stress fractures or other problems.

Metatarsalgia treatment may include:

Rest – Often rest is often all that is required to heal metatarsalgia pain.
Ice – Ice can assist in reducing the inflammation-causing metatarsalgia pain.
Shoe Change – A change in shoe wear may result in reduced pressure on the metatarsal bones. Choose shoes with plenty of arch support and room in the toe box to relieve pressure on the ball of the foot.
Orthotic Inserts – Metatarsal pads or arch supports may be necessary for proper alignment and to relieve excess pressure on the ball of the foot.
Lifestyle Changes – If excess weight is contributing to your metatarsalgia, a change in diet and exercise may be required to achieve full relief.
NSAIDs – Over the counter anti-inflammatory medications can help relieve the pain and inflammation of metatarsalgia. These medications include ibuprofen, naproxen sodium, or aspirin.
Non-invasive Treatments – Shock-wave, acoustic-wave, or laser therapy treatments help treat metatarsalgia and other foot pain.
Surgery – In extreme cases, surgery may be required to treat the underlying foot formations that cause metatarsalgia. Only a doctor can determine whether you need surgery for metatarsalgia.

For an evaluation of your metatarsalgia pain and a complete treatment plan, call Dr. Kleis at (714) 760-4944 or book an appointment online.

Metatarsalgia Exercises

Maintaining good muscle tone and flexibility can help in relieving and preventing metatarsalgia. Exercises that assist in relieving metatarsalgia pain include stretching the calf muscles, Achilles tendons, ankles, and toes.

Calf Stretch – Standing arm’s length away from the wall, place your hands on the wall for balance. Step forward with one foot, as the back heel remains on the floor. Bend the front knee until you feel a stretch in the calf of the back leg. Hold the stretch for thirty to sixty seconds, then switch to the other leg. Repeat five times on each leg.
Achilles Tendon Stretch – Stand on a step with the backs of your heels hanging off the step. Hold onto the handrail for support. Allow your heels to lower until you feel a good stretch. Hold for several seconds before lifting your heels back up, level with the step. Repeat several times.
Ankle Extensions – Sit in a chair with the injured foot crossed over your knee. Hold your ankle with one hand and your toes with the other hand. Pull your toes backward toward you until it’s uncomfortable. Do not pull to point of causing pain. Hold for ten seconds and repeat.
Ankle Flex – Sit on a chair with the injured foot crossed over your knee. Hold your ankle with one hand and your toes with the other. Pull your toes forward toward your body until you feel the stretch. Do not pull to point of causing pain. Hold ten seconds and repeat.
Toe Scrunches – Stand with a towel under one foot. Slightly bend the leg that has the foot on the towel. Use your toes to pull the towel inward, scrunching the towel with your toes. Do three sets of fifteen scrunches per foot.

Strengthening exercises, including weight lifting, can help avoid injuries in the future.

Metatarsalgia Shoes

Choosing shoes that provide plenty of arch support and a roomy toe box is key to healing from and avoiding metatarsalgia. Sometimes, orthotic inserts can assist in providing support and avoiding excess pressure on the ball of the foot.

Metatarsalgia Surgery

In extreme cases, surgery may be required to treat the underlying foot formations that cause metatarsalgia. Only a doctor can determine whether you need surgery for metatarsalgia.