Metatarsalgia (Ball of Foot Pain)

What is Metatarsalgia?

Metatarsalgia is a general term for pain affecting the ball of the foot.

The discomfort is usually felt beneath the metatarsal heads, which are the prominent areas just behind the toes that take significant pressure during standing, walking and running.

What Does Metatarsalgia Feel Like?

Symptoms may include:

• aching or burning pain in the ball of the foot
• tenderness beneath one or more toe joints
• discomfort when walking or running
• pain that becomes worse when barefoot on hard surfaces
• the feeling of walking on a pebble or something beneath the foot

Symptoms may develop gradually and can vary depending on activity and footwear.

What Causes Ball of Foot Pain?

Metatarsalgia can develop when excessive pressure is placed through the forefoot.

Contributing factors may include:

• increased walking, running or sporting activity
• poorly fitting footwear
• high-heeled shoes
• changes in foot shape or biomechanics
• reduced cushioning beneath the forefoot
• toe deformities
• bunions
• arthritis
• other conditions affecting the joints or soft tissues of the forefoot

Because several different conditions can produce pain in this area, identifying the actual source of the pain is important.

How Can a Podiatrist Help?

A podiatrist can assess the painful area and look at how pressure is distributed through the foot.

Depending on the cause, management may include:

• footwear advice
• reducing pressure beneath the painful area
• padding or cushioning
• activity modification
• orthotics where appropriate
• exercises or stretching
• advice about gradually returning to activity
• referral for imaging or further assessment where required

The aim is to reduce painful loading while addressing factors that may be contributing to the problem.

When Should Ball of Foot Pain Be Assessed?

Ball-of-foot pain should be assessed if it persists, becomes worse or begins to interfere with walking, exercise or normal footwear.

Sudden severe pain, significant swelling or pain following an injury should also be professionally assessed.

Getting the Right Diagnosis

“Metatarsalgia” describes an area of pain rather than one single disease.

Conditions such as Morton’s neuroma, sesamoid problems, arthritis and toe-joint disorders can sometimes produce similar symptoms.

A podiatry assessment can help identify the likely source of the pain and guide an appropriate treatment plan.