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An individual with metatarsalgia experiences foot pain. The areas of the metatarsal region of the foot affected include the:

  • Ball of the foot
  • Toes
  • Arch and center of the foot

What are the causes?

It is best to take a close look at the metatarsal region of the foot. Starting at the top of any of the toes, trace it down to the middle of the foot. When past the toe bone, you can trace the metatarsal bone. There are 5 metatarsal bones attached to the toe bones that help with walking, standing and running by distributing the body weight evenly to maintain balance.

There are 5 metatarsal bones attached to the toe bones that help with walking, standing and running by distributing the body weight evenly to maintain balance.

Once the metatarsal bones are inflamed, injured, or abnormal, there is intense pain in the ball of the foot. The usual causes of metatarsalgia include the following:

  • Irregularities with the bone from hereditary predisposition, injuries or diseases such as arthritis
  • Hammertoes which affects the distribution of weight across the foot
  • Thinning out or shifting of the fatty tissue of the foot pad. This fatty tissue on the ball of the foot is responsible for absorbing shock, but it wears out as one starts to age.
  • High arch or flat feet where both places irregular pressure across the metatarsals

There are also certain conditions that can aggravate the foot pain such as:

  • Obesity which places excess pressure to the feet
  • Diabetes can lead to diabetic neuropathy which is described as nerve-related foot pain
  • Neuromas are enlarged nerves that can affect the metatarsal region
  • Severe calluses and skin lesions can crush the metatarsals
  • Injury or damage to the metatarsal bones such as a stress fracture

Are there any serious issues with metatarsalgia?

The individual should also be aware of some daily activities and footwear options that can worsen metatarsalgia such as:

  • Using ill-fitting footwear such as those with constricted toe boxes
  • Engaging in intense sports especially those that strenuously work the balls of the feet such as jogging


There are certain measures that can be used to manage metatarsalgia. Remember that surgery can significantly affect the feet for 6-12 months which is why these are initially tried.

  • Stretching of the Achilles tendon and strengthening of the foot muscles reduces the pressure placed on the forefeet.
  • Utilize supports for the metatarsals such as arch supports, metatarsal padding, shock-absorbing shoe inserts and insoles, orthotics and wearing properly fitting, supportive footwear
  • Reduce any strenuous activities that places excess weight on the feet such as jumping or jogging
  • Avoid wearing high-heeled shoes
  • Anti-inflammatory medications such as naproxen or ibuprofen
  • Cold therapy

In case these measures fail to work and metatarsalgia persists, surgery might be considered. Surgical intervention might be the only option to fix a bone irregularity. For severe cases, metatarsalgia might require the cutting and removal of a region of the bone.

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