What is Metatarsalgia?

Metatarsalgia is the name given to pain in the front part of your foot under the heads of your metatarsal bones (the ball of your foot). The metatarsals are the bones which connect your toes to the ankle bone and they support your full body weight when walking and running.

What causes it?

There are various causes of Metatarsalgia including:

• Badly fitting footwear – high-heeled or tight, restrictive shoes or boots. Shoes with a narrow toe box or high heels can force the ball of the foot into a small amount of space, which puts more pressure on that area.

• Being overweight – This can increase the pressure upon the foot.

• Age – Older people are more susceptible to metatarsalgia as the fat pad that protects the foot can thin with age, making them more likely to feel pain in the ball of their foot.

• Bone structure of the foot – Narrow, high-arched feet or flat feet can increase the chance of metatarsalgia. Hammer toes (where the toes are bent at the middle joint) and a bunion (bony swelling at the base of the toe) can also bring it on.

• High-impact sports – such as running or tennis, which puts extra pressure on the foot.

• Stress fractures in the foot – These occasionally occur in athletes or walkers and cause pain to come on rapidly.

What will happen if I leave it untreated?

If left untreated pain can spread to other parts of the foot. Patients can also adopt an abnormal gait pattern due to the avoidance of putting pressure onto the ball of the foot. Patients tend to limp or walk on the outside of their foot. Long term this can have an impact on both feet, the back, the knees and the hips.

What can help?

Simple measures can help to relieve the symptoms of metatarsalgia. 

These include:

• Resting with your feet elevated where possible.

• Wearing shoes that are well fitted, low-heeled and with a wide toe area.

• Painkillers such as paracetamol may help to relieve pain.

What are the treatment options?

Orthotic inserts for your shoes may help to relieve pain in your foot by reducing the pressure placed on the heads of your metatarsal bones.