Metatarsalgia

Metatarsalgia is the name for pain in the ball of the foot.

It affects the metatarsals, the bones connecting the ankle bones to the toes. They're a common source of pain because they support your weight when you're standing, walking and running.

Metatarsalgia can have a number of different causes, including wearing unsupportive footwear, conditions such as arthritis, and doing high-impact sports.

It can be very uncomfortable and interfere with your normal activities, but will often improve with some simple self-help measures.

Symptoms of metatarsalgia

Metatarsalgia tends to develop gradually over time.

It may be felt in a small area of the foot, or across the whole width of it. One or both feet may be affected.

The pain of metatarsalgia is sometimes described as:

• a burning or aching sensation
• a shooting pain
• tingling or numbness in the toes
• a feeling like there's a small stone stuck under the foot

Metatarsalgia tends to be worse when you're standing, walking or running.

What causes metatarsalgia?

Metatarsalgia is usually the result of increased pressure on the ball of the foot.

Some common causes of metatarsalgia include:

• badly fitting footwear – high-heeled or restrictive shoes can force the ball of the foot into a small amount of space, which puts more pressure on that area
• high-impact sports – sports like running or tennis put extra pressure on the feet
• being overweight or obese – this can also increase the pressure on the feet
• an unusual bone structure in the feet – having narrow, high-arched or flat feet can increase the chances of metatarsalgia
• joint and foot conditions – including arthritis, gout, bunions, bursitis, Morton's neuroma, hammer toes,and stress fractures

Metatarsalgia is also more common in older people and people with diabetes.

Treating and preventing metatarsalgia

The following measures will often help improve metatarsalgia and stop it coming back:

• rest your feet – put your feet up regularly and avoid activities that make the pain worse; try low-impact activities such as cycling or swimming instead of sports that involve a lot of running or jumping
• use an ice pack – apply an ice pack to the affected area for about 20 minutes several times a day (a bag of frozen peas will also work); make sure you wrap it in a towel so it doesn't damage your skin
• change your footwear – try flat shoes that have plenty of room for your feet and have a well-cushioned sole; replace any worn out shoes as they could make things worse (read more about choosing sports shoes and trainers)
• use shock-absorbing pads or insoles – these can fit inside your shoes to help cushion your feet; they're available from pharmacies and sports shops, or can be bought online
• maintain a healthy weight – adopting a healthy, balanced diet and doing regular low-impact exercises can help you lose weight if you're overweight
• take paracetamol or ibuprofen to help relieve pain and swelling if necessary

Try these measures for a few weeks to see if your symptoms improve.

When to get medical advice

You can usually treat metatarsalgia at home without seeing your GP.

However, you should get medical advice if:

• the pain doesn't improve despite trying self-help measures
• the pain significantly interferes with your normal activities
• you develop sudden and very severe foot pain or a change in the shape of your foot – this could be a sign of a more serious problem that requires immediate treatment

Your GP can arrange a number of tests to check for any underlying problems, such as X-rays, scans or blood tests.

They can also refer you to a health professional that specialises in foot care, such as a podiatrist (also known as a chiropodist), physiotherapist, or foot and ankle surgeon.

These specialists may recommend additional treatments, such as custom-made insoles (orthotics), foot and ankle exercises, steroid injections or, in rare cases, surgery.