Metatarsalgia is a general term used to describe pain and inflammation in the metatarsal region of the foot, more commonly referred to as the ball-of-the-foot. This is a common foot disorder that can affect the bones and joints at the ball-of-the-foot. Metatarsalgia is often located under the 2nd, 3rd, and 4th metatarsal heads-the rounded ends of the bones that connect to your toe bones, or more isolated at the first metatarsal head near the great toe joint.
Most metatarsal problems develop when something changes in the way one’s foot normally works (mechanics), affecting how one’s weight is distributed. This can put excess pressure on the metatarsals, leading to inflammation and pain, especially in the metatarsal heads.
Sometimes a single factor can lead to metatarsalgia. More often, several factors are involved, including:
Intense training or activity. Runners are at risk of metatarsalgia, primarily because the front of your foot absorbs significant force when you run. During the push-off phase when one jumps or runs, one’s body weight is transferred to one’s toes and metatarsals. The first and second metatarsal bones take the brunt of this force. This condition commonly occurs when performing high impact activities especially if one’s shoes are ill fitting or are worn out.
At Gotham Footcare we initially treat our patients with non-surgical treatments to alleviate one’s symptoms of pain and inflammation. Conservative measures usually relieve the pain of metatarsalgia in the majority of our patients. Initial treatment first consists of determining the cause of the pain. An x-ray of one’s foot will be taken to determine any abnormal position of one or more metatarsals or to rule out a stress fracture or other foot problem.
If improper fitting footwear is the culprit, the footwear must be changed. Footwear designed with a high, wide toe box and a rocker sole is ideal for treating metatarsalgia. The high, wide toe box allows the foot to spread out while the rocker sole reduces stress on the ball-of-the-foot. Unloading pressure to the ball-of-the-foot can be accomplished with a variety of foot care products including Orthotics designed to relieve ball-of-foot pain usually feature a metatarsal pad.
At Gotham Footcare we use cutting edge technology to construct our custom orthotic devices. Our orthotics constructed by laser scanning one’s feet to fabricate a custom device with padding placed behind the ball-of-the-foot to relieve pressure and redistribute weight from the painful area to more tolerant areas. Rigid arch supports are made of a firm material such as plastic or carbon fiber. They're designed to control motion in two major foot joints below your ankles. Semi-rigid arch supports are made of softer materials such as leather and cork reinforced by silicone. Arch supports designed to treat metatarsalgia may include metatarsal pads, too.
Other products we recommend include gel metatarsal cushions and metatarsal bandages. Resting, icing, use of oral anti-inflammatories, topical anti-inflammatories, and cortisone injections may also be recommended.
If conservative treatments fail, in rare cases surgery to realign the metatarsal bones may be an option. If you're considering foot surgery, we will discuss with you the risks, benefits, and expected outcomes of surgery.