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What is metatarsalgia?

Metatarsalgia is a general term describing pain at the midfoot, often at the metatarsals. It is often considered to be a symptom of other injuries or conditions, as opposed to a condition in itself. Because the ball of the foot and the metatarsals take a lot of pressure with every step, metatarsalgia is a relatively common foot problem. Luckily, this also means that it’s very treatable.

What causes metatarsalgia?

There are many causes of metatarsalgia. Often, there is a biomechanical problem that puts stress on the metatarsal bones at the ball of the foot. Other causes include:

  • Systemic diseases such as diabetes
  • Joint degeneration from arthritis
  • Irregularities in bone size or shape, such as an enlarged metatarsal head
  • Other conditions in the feet such as hammertoes or claw toes
  • Any skin conditions affecting the bottom of the foot that alter the weight distribution on the met heads, such as calluses
  • Fat pad atrophy, which reduces the cushioning beneath the met heads
  • High-impact activities that overload and stress the metatarsals
  • Poor footwear that cramps the feet and causes changes in the position of the bones, place greater pressure on the metatarsals or offer little support or cushioning to the midfoot and metatarsals
  • Increased weight
  • General biomechanical problems that result in excessive stress or pressure at the ball of the foot or the loss of the transmetatarsal arch of the foot

What does it feel like?

You may experience:

  • Pain in the ball of the foot or through the midfoot 
  • Pain that ranges from a dull ache to a sharp, stabbing pain
  • A bruised or swollen sensation
  • Symptoms are typically exacerbated by walking
  • Swelling may or may not be present

How is it treated?

The treatment of metatarsalgia must address its specific cause. We identify the cause through a tailored biomechanical assessment, which will examine everything from the biomechanics and alignment of your feet and legs to pressure testing, muscle strength testing, footwear assessment, gait analysis and more.

PRICE (protection, rest, ice, compression and elevation) can help relieve the painful symptoms, but to treat metatarsalgia, we need to address the cause, so it doesn’t become an ongoing issue. To achieve this, treatment may include:

  • Orthotics to correct alignment issues in the feet and legs and offload pressure away from painful metatarsals
  • Assessing footwear to ensure it is helping and not hindering your recovery
  • Increasing cushioning beneath the ball of the foot
  • Strengthening and stretching if the cause may be related to tight or musculature in the feet
  • Dry needling to improvement movement in the foot

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