Metatarsalgia is pain at the ball of your foot (area where your toes connect to the foot). It can be singularly or in multiple areas across your foot. The term is really nonspecific as it is derived from multiple conditions or pathology. Most common conditions are a capsulitis (inflammation of the soft tissue encapsulating the joint), a tendonitis, a neuroma or swollen nerve, bruised bone or even thinning of the fat pad about the area. Lesser common pathology would be a stress fracture, bone tumors or systemic conditions such as rheumatoid arthritis.
Causes of Metatarsalgia:
Most commonly, the cause is too much pressure on the metatarsal heads, usually from abnormal biomechanics. Faulty footwear can contribute as well. If there is a callous on the ball of the foot, then a biomechanical fault does exist. Therefore, it is best to seek professional help, especially if it is on the 2nd toe area.
The second toe area is of significant concern as the 2nd metatarsal is the most common area to get a stress fracture. Also, this area is subject to deterioration of the ligament and capsule on the base of the toe. If damaged, it can lead to a disfigured 2nd hammertoe- even occurring overnight! This condition is known as 2nd MPJ syndrome.
The reason for it is mechanical. The first metatarsal (where the big toe connects) is significantly thicker than the other metatarsals. This is because it is suppose to bear up to 60% of your weight during gait. If an imbalance of the feet is present, it can lead to the weight being transferred to the 2nd metatarsal. This leads to deterioration and possible fracture of the 2nd. A truly functional type of foot orthoses can usually control this.
Symptoms of Metatarsalgia
Symptoms may be an aching, dull to a burning pain. There can also be tingling or shooting pain about the area and into the toes.
Treating Ball of Foot Pain
Sometimes simple metatarsal pads or gel may help, even soft soled foot wear or an over the counter foot orthotic. With shoes, look for a shoe that curves up at the toes so as you can roll off your foot faster when bending occurs at the area. Also, look for a softer sole and a toe box that does not “Crunch” your toes together. If there is a callous, then a custom molded orthotic is typically best in order to ideally redistribute the pressures about the area. Metatarsalgia rarely requires surgery.