WHAT IS METATARSALGIA?

Pain in the ball of the foot is often called Metatarsalgia, usually giving the individual the feeling they are “walking on pebbles”. Other people may feel a more diffuse vague pain, ache or burning/tingling or numbness. Metatarsalgia may affect the ball of the foot as well as around only one or two toes.

WHAT CAUSES BALL OF THE FOOT PAIN?

Common examples are:

• Morton’s Neuroma (video below)
• Capsulitis (video below)
• Flat feet or high arched feet
• Bunions
• Achilles tendinopathy
• Inappropriate footwear

A bunion or arthritis in the big toe can place increased pressure onto the ball of the foot which can lead to Metatarsalgia.

An irritated nerve in the ball of the foot (interdigital neuroma or Morton’s Neuroma) or near the ankle (tarsal tunnel syndrome) may lead to pain within the ball of the foot.

Some individuals, commonly runners, may suffer with stress fractures of the metatarsal bones as repetitive trauma can compromise the integrity of these bones.

Arthritis, gout or inflammation of the joints in the ball of the foot (metatarso-phalangeal joints) may also lead to pain within the region.

 MORTON’S NEUROMA

CAPSULITIS

WHAT IS THE TREATMENT FOR PAIN IN THE BALL OF THE FOOT?

• If you have a high-arched or flat foot, your podiatrist may advise an insole or custom orthotic to reduce stress on the areas of pain.
• Your Podiatrist may inject steroid into the region to reduce the inflammatory process caused by the problem, which often relieves the pain.
• Infrared multi-shot video gait analysis can be undertaken to establish what motion during walking or running is over stressing the affected structures and from this an insole or custom made orthotic may be designed and prescribed.
• Your podiatrist will advise you about weight loss, activity modification and appropriate footwear.
• If you have an ankle problem or tension within the Achilles tendon a physiotherapist can advise on exercises for this. Stretching the Achilles tendon and plantar fascia is very effective general treatment for many patients and your Podiatrist can make the appropriate in-house referral.

WHEN SHOULD I OBTAIN PROFESSIONAL ADVICE?

If none of these simple measures help your pain it is worth consulting a podiatrist for an examination and appropriate treatment.

DO I NEED AN OPERATION?

The great majority of people with metatarsalgia will be helped by the measures outlined above. In a few people an operation may help:

• Release or removal of an irritated nerve
• Straightening of hammer or claw toes
• Reconstructing or shortening prominent joints or bones