Metatarsalgia – What is it and How Can I Fix It?

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What is Metatarsalgia?

Metatarsalgia is a term used to describe painful forefoot conditions in the metatarsal region, or the area often referred to as the ball of the foot. Your foot has five bones that run from the mid arch to your toe joints. They are called metatarsal bones. You may experience pain when the soft tissues around the heads of the metatarsal bones become inflamed. It usually occurs around the 2nd, 3rd, and 4th metatarsal heads, at the ball of the foot, and can affect the bones and joints.

What are the Symptoms of Metatarsalgia?

Pain, burning and discomfort under the ball of the foot are all signs. This pain could be experienced when you are standing, walking or running. Sharp or shooting pain in your toes, or numbness and tingling in your toes can also be symptoms. It is not uncommon for metatarsalgia to cause intense or long term chronic pain.

What Causes Metatarsalgia?

Metatarsalgia is often aggravated as the metatarsal heads become inflamed due to excessive pressure over a long period of time. Some causes include intense activity, physical foot types such as high arches or pronated feet, arthritis, fat pad deterioration (this can happen with age), and excessive weight.

Footwear can also be a problem. The narrow toe area you will find in a women’s dress shoe forces the ball of the foot area to be squished into the shoe and the toes and metatarsals to be compressed. This leads to an altered walking process, more forefoot pressure, and can cause forefoot pain. In addition, wearing high heels, or using inappropriate footwear for specific physical activities can be a cause.

How Do You Treat Metatarsalgia?

One of the most effective treatments are foot orthotics (arch supports). Foot orthotics designed for metatarsalgia generally have a pad behind the ball of the foot called a metatarsal pad or metatarsal bar pad. They work to distribute weight away from the painful metatarsals to other areas of the foot. Metatarsal cushions or pads placed in the shoes may also be helpful to reduce pain associated with metatarsalgia, but they do not help correct underlying alignment problems the way foot orthotics do, and are usually not as effective.

Properly fitting footwear can also be a treatment for metatarsalgia. Footwear designed with a wide toe area and rocker sole is best to accommodate the forefoot. A rocker sole is curved so the foot rocks forward as the weight moves forward. The wide toe area enables the foot to spread out while the rocker sole works to decrease the stress on the forefoot and alleviate symptoms.

Injections sometimes help alleviate metatarsalgia pain, and occasionally surgery will be recommended, but less invasive treatments like orthotic arch supports should be tried first. Using orthotic arch supports after surgery or injection can also prevent recurrence of the problem. When looking for orthotic arch supports for this condition, make sure they are designed specifically for metatarsalgia or forefoot pain.


write by Samuel Plummer

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