Metatarsalgia is defined as a painful foot condition in the metatarsal region of the foot, located just before the toes, commonly referred to as the ball-of-the-foot. Metatarsalgia is a common foot disorder that can affect the bones and joints at the ball-of-the-foot.

The term is derived from the name of the bones in this part of the foot .i.e. the metatarsals. These are the long bones at the base of each toe. The metatarsal bones run through the forefoot from the arch in the mid-foot to the base of the toe joints.

A few associated conditions of metatarsalgia include:

i) Neuromas

ii) Sesamoiditis

iii) Exposed Bone Ends

Symptoms of Metatarsalgia

The key symptom of metatarsalgia is a sharp, aching or burning pain in the ball of the foot .i.e. the part of the sole just behind your toes. The pain may be felt in the area around the second, third and fourth toes or only near the big toe.

A few main other symptoms of metatarsalgia include:

· Pain that worsens when you stand, flex your feet, walk or run and improves when you rest

· Sharp or shooting pain in the toes

· Tingling or numbness or tingling in the toes

· A feeling in your feet as if you’ve been walking on pebbles

· Increased pain when walking barefoot, especially on a hard surface

· Pain that is aggravated when dorsiflexing toes

· Callousing under 2/3/4th toes

Causes of Metatarsalgia

The most prominent cause of metatarsalgia is excess strain or pressure being placed on the ball of the foot. Some of the other causes are:

· Narrow high arched feet

· Flat feet

· Improper footwear

· Incorrect posture during movement

· Trauma, such as from a car accident

· Deformed or crooked toes

· Strained arches – excessive pronation or supination

· Skin irritation

· Nerve disorders

· Rheumatoid arthritis

· Stress fractures

· Fluid accumulation in foot

· Muscle fatigue

· Overweight or obesity


The first step in the treatment of metatarsalgia is to identify the cause and work on the same. Other specific lines of treatment include:

· Medications, such as NSAIDS (Advil, Motrin)

· Orthotics or metatarsal pads, which fit inside the shoes and help minimize stress and improve foot function. These are usually prescribed by a doctor and can be custom-made from a plaster cast of your foot.

· Shock-absorbing insoles, which are cushioned inserts that fit inside your shoes to help cushion shock.

· X-ray or ultrasounf guided injections of the joints with local anaesthetic and corticosteroid

· Surgery for realignment of the metatarsal bones is advised if all other measures fail and especially if you have a bunion deformity.

Self Care

Self-care measures are known to be of great help in the condition of metatarsalgia. Here we list a few main home care guidelines for this condition:

· Wear well-fitting footwear, with moderate heel height and a wide toe-box

· Cut down running and extended walking to rest the foot

· Massage the area with ice

· Stretch your calf muscles