What is Metatarsalgia?

Also known as a stone bruise, Metatarsalgia is a type of inflammation and pain that is felt in the metatarsal, or ball of the foot. It usually occurs where the three middles toes attach to the ball of the foot, know as the metatarsal heads. Metatarsalgia is a common problem that affects the joints and bones of the metatarsals. Usually, the first metatarsal head is affected. It’s located at the ball of the foot right behind the big toe.

This condition is most common in people or athletes who participate in high-impact sports that included jumping and running. This type of physical activity puts them at a high risk of forefoot injury. Athletes who participate in track and field have the most traumatic force to the feet, however those who participate in tennis, baseball, football and soccer can also suffer from this.

What does Metatarsalgia feel like?

Pain at the end of one or more of the metatarsal bones is the main symptom of Metatarsalgia. The pain will usually get worse when walking or running. It’s also not uncommon to suffer from Metatarsalgia while having another inflammatory condition. The discomfort usually comes gradually rather than suddenly.

The symptoms can range from mildly painful to severe. It will become more noticeable while standing, running or walking. Many people describe the pain as a burning sensation, however others say it feels like shooting pain, tingling or numbness in their toes. Some describe it like walking on pebbles.

What causes Metatarsalgia?

There are many different causes of Metatarsalgia. Anything that puts too much stress on the ball of the foot puts you at risk. The most common causes are as follows:

  • Improper footwear – shoes that are too tight around the toes or that have high heels put additional pressure on the ball of the foot while it’s being forced into a tight space.
  • Being overweight – the excess weight puts strain on the feet.
  • Age – as you get older, the pad of fat that protects your feet gets thinner. As the foot has less protection from strain and impact, Metatarsalgia is more likely to develop.
  • Exercise – participating in high-impact running or sports increases the risk of developing this condition because of the large amounts of force placed on the feet.
  • Foot and toe shape – if you have a high arch or a longer second toe, this can add pressure to the metatarsals as well.

Preexisting medical conditions can also put you at risk. These include:

  • Bunions – this swollen, painful pump at the base of the big toe weakens the toe, which causes more stress to be placed on the ball of the foot. This condition is actually more common in women than men.
  • Arthritis – swollen joints in the feet or gout can also be a cause.
  • Fluid – a buildup of fluid in the foot results in excess pressure.
  • Morton’s neuroma – the fibrous growth of tissue of nerves between the metatarsal heads increases stress to the metatarsals.
  • Diabetes – this disease causes the small nerves in the foot to become irritated, causing Metatarsalgia.

How is Metatarsalgia treated?

There are various ways to treat Metatarsalgia. To ease the pain, apply ice to the area a few times a day for about 15-20 minutes. However, make sure the ice doesn’t touch the skin. Wrap the ice in a cloth before applying it. Anti-inflammatory medication, like ibuprofen, could help as well. Avoid high-impact sports or exercises that put an excessive amount of pressure on the feet. Swimming and cycling are great alternatives. Using orthotics can relocate the pressure felt on the forefoot, therefore improving function and providing protection. In more severe cases steroid injections or surgery may be recommended.

Are there ways to prevent Metatarsalgia?

Yes, there are. Always wear the proper footwear. It’s best to avoid high heels and shoes that are too small or tight. Make sure your shoes have adequate cushioning and support for your feet as well as a wider toe-box. Arch supports can also help prevent pain as well as relieve it. If you’re overweight, try losing a few pounds. Slimmer people have much less of a risk of developing this condition. Lastly, if you’re recovering from an injury make sure you comply with all of your doctor’s recommendations. Don’t return to strenuous activity until you are completely healed.

You don’t have to live with pain! Schedule an appointment on the Waukesha Foot Specialists website or give Drs. David Guhl and Amy Miller-Guhl a call at (262) 544-0700.


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