What Is Metatarsalgia?
Metatarsalgia is a condition characterized by pain and inflammation in the ball of the foot. Metatarsals are the bones that connect the toes to the ankles, and people with metatarsalgia experience its symptoms in the padding right under the toes. This is the part of the foot that endures most of the pressure when a person is standing or in motion. The pain usually goes away as the feet are relieved of this pressure but comes right back once the activity is resumed.
Seeing a podiatrist as soon as possible is the best way to handle ball of foot pain, which can lead to hammertoes (bent toes), limping, and back and hip pain as the body develops an abnormal walk to compensate for metatarsalgia.
Causes and Risk Factors of Metatarsalgia
Metatarsalgia occurs when metatarsal heads are continually pressed against one another, such as during certain activities, causing the toe nerves between them to swell and become painful. Each time weight is exerted on the foot, the condition worsens, which means both the inflammation and the pain increase.
Metatarsalgia can be a symptom of many preexisting conditions, such as diabetes, rheumatoid arthritis, obesity, and Freiberg disease (metatarsal tissue death caused by low oxygen supply in the area). However, it is still mostly a result of day-to-day activities that put tremendous pressure on the foot. Sports like tennis, soccer, and track and field, for example, are notorious for being extremely traumatic to the forefoot, oftentimes even causing injuries to athletes.
In some cases, simply wearing inappropriate footwear, such as stilettos, can cause metatarsalgia, along with factors like age, which tends to thin the pad of fat that protects the foot, and having high-arched feet. Sometimes, a big toe that’s shorter than the second toe, a stiff ankle, tiny breaks in the toe bones, or even bunions can add stress on the forefoot, hence causing metatarsalgia.
Symptoms of Metatarsalgia
Ball of the foot pain is the hallmark symptom of metatarsalgia, which usually intensifies when a person stands, walks or runs, or flexes the toes. The sensation, which usually develops over a period of months instead of abruptly, is often described as a sharp, aching or burning foot pain.
In a similar condition known as Morton’s neuroma, or interdigital neuroma, the same sensation is felt but with the addition of pins and needles foot pain, as well as the feeling of standing on a pebble. In athletes, metatarsalgia is often accompanied by bursitis, another inflammatory condition felt as widespread pain across both the forefoot and the midfoot.
The treatment for metatarsalgia may include a comprehensive set of interventions designed for every stage of the condition. In the acute phase, this usually includes cold compress, application of a pressure bandage, and keeping the foot weight-free for the first 24 hours. This is then followed by range of motion (ROM) and ultrasound treatments as prescribed by a podiatrist, who may also recommend the use of metatarsal pads and other orthotic devices, as well as a change in footwear.
The recovery phase consists of two types of therapy: physical and recreational. Physical therapy is generally focused on restoring the patient’s normal mechanical functions and eliminating the pressure in the affected area. As soon as pain and inflammation resolve, certain strengthening exercises will be prescribed. In recreational therapy, alternate conditioning and training routines that promote healing, such as swimming, may be recommended.
Lastly, in the maintenance phase, physical therapy will include using an orthotic device to keep force away from the affected foot, along with self-mobilization exercises. In severe cases, surgery may be required to realign the metatarsal bones.
To manage the pain, nonsteroidal anti-inflammatory drugs (NSAIDs) such as naproxen or ibuprofen may be prescribed, although they provide no more than a quick fix to the problem — so it is best to have a trained podiatrist evaluate your condition.
Preventing metatarsalgia can be as simple as eliminating the cause, such as a certain medical condition, high-impact activities that overuse the foot, or wearing the wrong footwear. If the cause is age or genetics, the condition can be managed with orthotics, metatarsal pads, and other devices deemed appropriate by a foot pain doctor.
Get in Touch with a Podiatrist for Metatarsalgia
Metatarsalgia is highly treatable, especially when addressed early by a podiatrist. Talk to our St. Louis foot doctors at Missouri Foot and Ankle to get you started on the path to healthy, pain-free feet. Contact us today!