Metatarsalgia (Ball of the Foot Pain)

What is Metatarsalgia (Ball of the Foot Pain)?

Metatarsalgia, or ball of the foot pain, is very common and affects about 80% of people at some point. It includes several conditions that cause pain and inflammation around the bones and joints in the ball of the foot. Finding comfortable shoes can be difficult.

Common Conditions Causing Ball of the Foot Pain:

• Fat Pad Atrophy: Thinning of the fat pad under the ball of your foot, reducing shock absorption and causing pain.
• Capsulitis: Inflammation of the joint capsule, causing swelling and pain.
• Intermetatarsal Bursitis: Inflammation of the bursa between the joints, causing pain and swelling.
• Plantar Plate Injury: Damage to the ligaments under the joints, leading to pain and possible toe deformity.

The Fat Pad

The Joint Capsule

Bursitis

The Plantar Plate

Signs and Symptoms:

• Sharp, stabbing, burning, or tingling pain in the ball of the foot and toes
• Pain that worsens with weight-bearing activities and improves with rest
• Feeling like you’re walking on a pebble or lump
• Increased pain when walking barefoot on hard surfaces

Causes:

• Being overweight
• Age-related thinning of the fat pad
• Swelling in the feet
• High arches or flat feet
• Tight calf muscles
• Weak foot or leg muscles
• Unsuitable footwear (narrow or thin-soled shoes)
• Foot deformities (bunions, hammer toes)
• Inflammatory conditions (rheumatoid arthritis)
• Previous foot injuries
• Long periods of standing, walking, or running

How to Help with Metatarsalgia:

There is no quick fix, but you can manage the pain by making some changes:

• Rest and elevate your foot
• Apply an ice pack to the painful area for up to 20 minutes every 2-3 hours
• Wear shoes with cushioned heels and good arch support
• Use insoles in your shoes
• Do regular stretching and foot exercises
• Try low-impact exercises like swimming
• Lose weight if needed

Things to Avoid:

• Walking or standing for long periods
• Wearing high heels and tight, pointy shoes
• Wearing flip-flops or backless slippers
• Walking barefoot on hard surfaces

Choosing the Right Shoes:

Make sure your shoes fit well and are not too tight across the forefoot. Choose shoes with a deep and wide toe box. Avoid high heels, narrow, or pointed-toe shoes, and shoes with thin, hard soles. Shoes with laces or adjustable straps are best.

Padding:

Using padding on the bottom of your foot or in your shoe can help cushion and reduce pressure on the joints. These pads can be bought from a pharmacy or online.

Managing Pain:

Use a pain scale from 0-10 to identify your pain level, zero being no pain. Aim for pain to be manageable. If you experience severe pain, you might be overdoing it and should reduce your activity level.