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Metatarsalgia

What is it?

Metatarsalgia is a term used to describe pain in the ball of the foot.  It may involve a small area or most of the width of your foot.  It can affect both feet at the same time.  The pain of metatarsalgia can be described as a burning or aching sensation, a sharp shooting pain or the feeling that you are walking on pebbles.  The pain tends to be worse when you are standing, walking or running.

A number of different conditions can cause metatarsalgia.  For example a bunion or arthritis of the big toe can put extra pressure on the ball of the foot. This can also happen after an operation on the big toe such as bunion correction surgery. Being overweight, wearing high-heels or shoes with thin poor quality soles, high impact sports such as running or having high arched feet can all increase the pressure on the ball of the foot. Having tight calf muscles and Achilles tendons can causes more pressure on the front of the foot.

Metatarsalgia can also be complicated by other toe deformities, such as hammer toe or claw toe.

How to manage it

The first step to treating Metatarsalgia is identifying things that are contributing to the pain.  There are simple things that can be done to help with your symptoms.  These are:

Weight loss

Losing weight will reduce the amount of pressure generally through the feet

Modifying footwear

A changed in footwear is often a good way to improve symptoms. Wearing flatter shoes, wearing wider shoes that have plenty of room for your feet or wearing well-padded shoes will reduce the pressure through the balls of your feet

See the footwear section for further advice.

Insoles or Orthotics

There are a number of different insoles available, online or in shops, to provide support and comfort. Insoles are inserted into the shoe. An insole with a metatarsal dome shaped pad can help to reduce the pressure under the ball of your foot.

Here is an example of an insole with a metatarsal dome built in to the insole.

These insoles are widely available online and in a number of shops, please speak with a health care professional if you need any advice.

Modifying activities

Avoid activities that make your pain worse as much as you can. Try low impact activities such as cycling and swimming instead of higher impact activities such as running

Rest

It is important to remember that rest can be a key part of your treatment. For example, putting your feet up after periods of prolonged standing or walking can help to reduce your pain and ease your recovery

Exercises

Regular stretching exercises for your calves will help to reduce the pressure on the front of your foot.

Stand in a walking position with the leg to be stretched straight behind you and the other leg bent in front of you. Take support from a wall or chair.

Lean your body forwards and down until you feel the stretching in the calf of the straight leg. 

Hold approx.  30 secs. relax. Stretch the other leg. Repeat 3 times.

Stand in a walking position with the leg to be stretched behind you. Hold on to a support.

Bend the leg to be stretched and let the weight of your body stretch your calf without lifting the heel off the floor.

Hold approx.  30 secs. – relax. Repeat 3 times.

Select ‘Exercises to stretch tight Gastrocnemius muscles’ and ‘Stretches for tight Soleus muscles’ for a video of the exercises.

It is important to do both these exercises.

Usually a combination of improving your muscle flexibility and wearing orthotics in your shoes considerably reduces your pain.

If symptoms are not manageable please discuss your GP for further advice.

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