Metatarsalgia: Symptoms & Treatment

Metatarsalgia is a relatively common condition characterized by pain and swelling in the ball of the foot. Though often treatable without surgical intervention, it can cause a great deal of discomfort, and surgery may be indicated in certain cases.

If you are experiencing ongoing pain in the ball of your foot that is impacting your quality of life, metatarsalgia could be the reason. Below, we’ll explore its causes, diagnosis, and treatment options.

At Modern Orthopaedics of New Jersey, our world-class surgeons are highly experienced in treating all types of metatarsalgia. Contact us today to book a consultation and take the first step toward resolving your foot pain.

Anatomy of the Metatarsal Region

The metatarsal bones are the long bones that run from the middle of the foot to the toes. Their heads articulate with the proximal phalanges (toe bones), where the toes attach to the foot. Along with other bones and structures, the metatarsal bones help to form the arch of the foot and are crucial in supporting the body’s weight during standing, walking, or running activities.

The ball of the foot is the padded portion of the foot’s sole located under the heads of the metatarsal bones (between the toes and the arch). When you raise your heel to stand on tiptoe, you are standing on the ball of your foot.

Causes of Metatarsalgia

Metatarsalgia can have many different root causes, including foot deformities, overuse, injury, ligament tears (plantar plate) inflammation or other health issues, and poorly fitting footwear. Though the symptoms are similar regardless of the condition’s cause, metatarsalgia is categorized into three categories as follows:

Primary Metatarsalgia

Primary metatarsalgia results from conditions that affect the relationship between the metatarsals and other parts of the foot. These can include hammertoes, bunions, calluses, high arches, and more.

Secondary Metatarsalgia

Secondary metatarsalgia results from health conditions, habits, or activities that place increased pressure on the ball of the foot. These can include arthritis, obesity, Diabetes, and certain neurological disorders, as well as overuse (excessive running/jumping) or wearing unsupportive shoes.

Iatrogenic Metatarsalgia

Iatrogenic metatarsalgia occurs when a traumatic injury or complication related to a prior foot surgery causes changes to the alignment of the foot or big toe joint.

Can Metatarsalgia Be Prevented?

You may not be able to completely prevent metatarsalgia, but you can reduce your risk of being severely affected by the condition in the following ways:

• Select proper footwear (supportive, low heel, wide toe box sneakers).
• Wearing supportive functional orthotics with metatarsal pads.
• Avoid walking barefoot.
• Regularly remove calluses from the bottoms and sides of the feet.
• Maintain a healthy body weight.

Diagnosing Metatarsalgia

If you have one or more of the following symptoms, metatarsalgia may be suspected:

• Shooting pain in the ball of the foot (may worsen with weight bearing or walking/running)
• Swelling in the ball of the foot
• Numbness or tingling in the toes
• Feeling like you have a pebble in your shoe

To diagnose metatarsalgia, your doctor will ask you questions about your pain and perform a visual and manual examination of the affected foot. They will watch you walk and may order imaging tests such as X-rays, ultrasounds, or MRIs. Such tests can provide a clearer picture of what is causing your pain and help rule out other possible causes of the symptoms you are experiencing.

How Is Metatarsalgia Treated?

Metatarsalgia can often be effectively treated non-surgically with interventions such as customized orthotics, shockwave therapy, rest, icing, stretching, taking over-the-counter pain medications, and investing in comfortable, supportive shoes. Your doctor may also suggest shoe inserts such as arch supports or injections for pain relief.

If these methods are unsuccessful over time, surgery may be considered to realign the metatarsal bones. Some procedures require manipulating bone alignment while others require repair of ligaments. The surgical approach will depend on the specifics of your condition. Speak directly with your surgeon for more information.

Rehabilitation and Recovery

Metatarsalgia often improves or resolves on its own with nonsurgical treatment over a period of days, weeks, or months (depending on the severity of the condition). Recovery after metatarsalgia surgery usually takes somewhere between 1-6 months and may involve a period of walking in a special boot followed by physical therapy.

Frequently Asked Questions

What activities should be avoided with metatarsalgia?

If you have metatarsalgia, it is important to limit participation in high-impact sports and other activities that involve running and jumping. Also to be avoided are high heels and other poorly fitting shoes that put undue pressure on the balls of your feet.

How long does it take to recover from treatment?

Recovery after metatarsalgia surgery usually takes between 1-6 months, but the recovery period may be much quicker with nonsurgical treatment options.

What are the risks associated with metatarsalgia surgery?

Like most other orthopaedic surgery, risks are very low. Metatarsalgia surgery comes with risks such as infection, nerve damage, scarring, and bleeding. Speak with your surgeon for specifics.