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What Causes Metatarsal Foot Pain and How You Can Treat It

If you experience constant pain in the balls of your feet, you may suffer from a condition known as metatarsalgia. Metatarsalgia can affect everything you do. When your feet ache, you can’t give your all to your family, your work, or other activities embedded in your lifestyle. Metatarsal arch support and metatarsal pads may help ease your discomfort, as may other convenient remedies you can try at home.

What Is Metatarsalgia or Ball of Foot Pain?

Metatarsalgia (met-a-tar-sal-jee-a) is a condition that causes pain in the forefoot—or ball of foot—the area between your arch and toes. The five metatarsal bones transect the midsection of your foot, connecting your ankle bone to your toes. Also known as ball of foot pain or a stone bruise, the area under your toes can be a common source of pain because it supports your weight when standing, walking, or running.

Ball of Foot Pain Symptoms

Metatarsalgia is characterized by a painful inflammation that flares up in the ball-of-foot area between your toes and arch. The pain can manifest as a tingling or numbness, a sharp shooting or burning pain, or as if you’re walking with a small pebble in your shoe (that’s where the name “stone bruise” comes from). You may feel pain in a small area under your toes, or it could radiate across the whole width of the foot. Symptoms often begin gradually and get worse over time, and one or both feet may be affected.

Pain can increase just from simply flexing your feet, standing on your feet for long periods of time, or walking—especially if you walk barefoot on hardwood floors or cement pavement. High-impact exercise that include running or jumping can also make the pain worse. Pain may decrease when you rest or soak your feet.

Causes of Metatarsalgia

Increased pressure on the ball of the foot can result in metatarsalgia. Some common causes of this ball of foot pressure are:

  • Poor-fitting shoes including
    • High-heels over two inches, and pointy-toed shoes that force the toes and ball of the foot into a restricted amount of space.
    • Athletic shoes that are too loose or too tight: loose shoes cause the foot to slide and rub, which increases friction, while tight shoes squeeze the foot and increase pressure.
    • Ballet flats or flip-flops with very little shock absorbing padding or arch support
    • High-impact sports such as running or tennis put extra pressure on the balls of your feet, especially if you’re wearing the wrong shoe for the sport.
    • A recent weight gain or being significantly overweight can increase forefoot pressure. Metatarsalgia is also more common in older people, especially older women, and people with diabetes.
    • Narrow feet, flat feet, or high arches can increase the incidence of metatarsalgia.
    • Bone and joint conditions such as arthritis, gout, bunions, bursitis, Morton’s neuroma, hammer toes, and stress fractures can cause or aggravate metatarsalgia.

Morton’s Neuroma

Metatarsalgia can be also caused by a Morton’s neuroma, which is a thickening of the tissue that surrounds the nerve between the third and fourth toes. Morton’s neuroma usually develops in response to irritation, trauma, or excessive pressure on the nerve as it passes under the ligament connecting the metatarsals to the forefoot. Essentially, it’s a pinched nerve that can cause pain, numbness, and burning in the ball of the foot. However, not all Morton’s neuromas cause ball of foot pain. If you’re asymptomatic, you might not even know you have one without an X-ray of the foot.

Treatment and Prevention of Metatarsalgia

Staying off your feet, wearing footwear that puts less stress on your feet, and/or adding padding and arch support inside your shoes will relieve ball of foot pain. If you are a runner or do other high-impact sports or exercise routines, consider taking a break for a few days or weeks. Try low-impact activities like swimming or cycling until your pain subsides.

Home remedies for metatarsalgia

Common ways to treat metatarsalgia at home are:

  • Resting your feet. Get off your feet after any activity when you’ve been on them for a while. Put them up on an ottoman, or lie down on the couch and rest completely. Avoid activities such as running or jumping that make the pain worse. Soaking your feet can also bring relief.
  • Massaging your feet. Foot rubs feel good even when you don’t have metatarsalgia, but they’re also a great way to soothe your feet, release pressure, and relieve ball of foot pain. Massage your feet at the end of the day when you get in bed and in the morning before you get out of bed. Using aromatherapy oil or lotion while massaging your skin will moisturize rough skin and calluses too. Better yet, have someone else massage your feet!
  • Icing your foot. Wrap an ice pack (or a bag of frozen corn or peas) in a towel, put it in a basin, and place the ball of your foot and affected toes on top of it for about 10-20 minutes once or twice a day. Ice can help with the pain of inflammation common to metatarsalgia, but avoid heat, which is more for muscle or joint pain.
  • Taking anti-inflammatory medication. Take an over-the-counter pain reliever like ibuprofen or naproxen to temporarily relieve pain and inflammation in the ball of your foot.

Effective exercises to treat metatarsalgia

Daily toe and foot stretches are a great way to relieve pain, promote healing, and prevent metatarsalgia from coming back. Here are a few exercises:

Ankle cross

  • Sit with your feet on the floor and place one ankle across the opposite thigh, foot flexed slightly.
  • Using the hand on the same side, gently, but firmly, pull your toes back towards your shin until you feel a stretch along the arch.
  • Hold the stretch for 10-20 seconds and release for 10 seconds. Repeat 5-10 times, several times a day. Repeat with the other foot.
  • To ensure you have the right stretch position, gently run your opposite fingers across the sole of your foot; the fascia ligament should feel like a firm string along the arch. This is also a great stretch for plantar fasciitis.

Foot roll

  • Sit with both feet on the floor, hands loosely on your knees. Sit forward in a chair with your back straight and feet close to the chair. You can also do this standing, if that’s more comfortable.
  • Roll a tennis ball back and forth under the arch of your foot for 2-5 minutes. Rest. Switch sides and repeat with your other foot.
  • You can also do this stretch with a frozen water bottle (put a towel underneath the bottle to catch condensation)—the cold helps relieve metatarsalgia pain and inflammation.

Range of motion

  • Sit down so that your feet do not touch the floor.
  • Use your big toe to trace the letters of the alphabet in the air. Block print or script—your choice! Switch feet.
  • Keep the movement small, using just your foot and ankle, not your whole leg.

Best Shoes for Metatarsalgia

Whenever you look up what causes foot problems like metatarsalgia, you’ll find that high heels are front-and-center culprits. Similarly, when you look up treatments for ball of foot pain, you’ll find advice to not wear high heels—at least not heels over two inches, and particularly not heels with pointed toes. But many, if not most, women are going to be challenged by this dictum. And frankly, high heels aren’t the only “bad” shoes out there.

Contrary to popular opinion, wearing shoes like ballet flats or flip flops instead of high heels is not necessarily better for your feet. These shoes offer very little shock absorption or support, and wearing them to walk even short distances can create increased pressure on the ball of the foot causing or aggravating metatarsalgia. Wearing improper athletic shoes—like running shoes for hiking—and old athletic shoes can also make metatarsalgia worse.

The solution is to limit when and for how long you wear heels, buy high-quality casual and exercise shoes, and replace old, worn shoes regularly.Take advantage of over-the-counter inserts and insoles that provide extra padding and support for the ball of your foot (see below).

Metatarsal Pads and Inserts

Metatarsalgia pain usually lasts from a few days to a few weeks. If it doesn’t subside on its own or after some self-treatment, see a podiatrist or doctor. Your doctor may recommend you work with a physical therapist to exercise and strengthen your feet and legs or an occupational therapist to fit you with proper orthotics.

Extra padding and arch support can alleviate ball of foot pain and relieve the pressure of metatarsalgia. Over-the-counter orthotic inserts can help align the foot, provide extra cushioning, and absorb shock while walking. A gel pad under the ball of your foot can ease pain as well.

  • PROFOOT Toe Beds—These ball of foot gel pads cradle each toe plus the ball of foot. Featuring a raised toe bed that gently positions your toes to prevent the painful corns, foot fatigue, and callus formation that can often lead to metatarsalgia. They provide all-day comfort in all kinds of shoes for your toes and metatarsals.
  • PROFOOT Bottom of the Foot Cushion—This ball of foot gel cushion works as a shock absorber for metatarsalgia pressure, providing comfort and relief from ball of foot pain. Using PORON® technology to provide maximum comfort, this expertly designed orthotic absorbs shock and helps prevent calluses from forming on the bottom of the foot.
  • PROFOOT Triad Orthotic—These inserts provide 3-Zone support for heel, arch, and ball of foot. These three zones give shock absorption and relief to the balls of your feet, arches, and heels to protect your knees, legs, and back. Available in men and women’s sizes.