What is Metatarsalgia?

Unlike most people who can't wait to arrive home at night and kick of their shoes, people with metatarsalgia experience pain when they walk in socks and bare feet. Metatarsalgia is a condition that is symptomized by burning or sharp pain and inflammation around the affected area. The condition affects the individual bones that exist in the foot, otherwise referred to as metatarsal heads. The first metatarsal head exists behind the toe, is the most commonly affected area. However, the complication can impact various other areas such as the foot, toes, and more.

Other signs associated with the complication include numbness in toes, pain during movement, and infections. The patients with Metatarsalgia might feel like they have a “heavy and lump sum” item in the foot. The condition commonly appears a single or several calluses that exist on the ball of the foot – which looks like a plantar wart.

Metatarsalgia can affect both males and females. The condition relates to continuous stress that occurs on the structure of the foot. Usually, people who engage in intense physical activity such as running are prone to the complication. More so, the condition also commonly relates to a single cause, but other contributing factors are also common. For instance, wearing tight footwear is known to be a contributor of metatarsalgia. More often than not, the condition could've been prevented by wearing roomy footwear instead.

Contributing Factors

Caused by many different factors, Metatarsalgia is likely to affect any person, regardless of their age. The common risk factors associated with the foot health complication include:

Foot Physiology

The feet are responsible for accommodating the entire weight of your body when standing. Furthermore, there is a transfer of force between the ground and the feet when performing simple movements such as walking.

The first and second metatarsal heads are exposed to the most force during the transfer of energy. Usually, the force that these components have to accommodate increases during an intense activity such as running. As such, athletes that engage in such activities are highly likely to expose metatarsals to increased levels of stress. The increased stress level can lead to issues such as inflammation and pain.

An individual that is prone to the condition due to a compromised shape of the foot might also experience metatarsalgia complications. More so, the symptoms might increase when engaging in high impact sports.

Physical Activity

Intense training and physical activity that exposes the feet to strain is a leading cause of metatarsalgia. A person who engages in high sports is highly likely of experiencing damage to the structure to the metatarsals, which will cause pain. Even more, putting on shoes that are not comfortable increase the risk of pain and injury. Typically, runners rely on the front section of the foot to absorb force during movement. However, such an activity can affect the foot and expose it to increase stress.

For example, an individual that is predisposed to the condition due to abnormal foot shape commonly experiences the onset of metatarsalgia symptoms following participation in high-impact sporting activities.

Deformities and the Shape of the Foot

The natural structure and shape of some feet cause the metatarsals to experience increased pressure. These individuals are at a high risk of experiencing pain as the body is not able to handle such weight. For instance, an individual with a higher foot arch than usual, or a longer second toe than the big toe, can experience such pain. Furthermore, foot deformities such as hammertoe, bunions, and claw foot can also cause metatarsalgia. Find a description of these complications below:

  • Clawfoot, otherwise referred to as pes cavus, is a condition where one has a high arch of the foot. The condition is inherited and also associated with neurological health complications.
  • Hammertoe consists of an unusual positioning of the three joints that exist in the toes. Such a misalignment causes the toes to resemble the structure of a claw or hammer. The condition occurs due to many issues and can place increased stress on the foot.
  • Bunions otherwise referred to as hallux valgus, is a deformity that occurs at the base of the big toe. The complication places intense stress on the ball of the foot and might lead to pain during walking.
  • Hammertoe involves abnormal position of all three joint in one of the toes, such that the shape resembles a hammer or claw. This can result from several factors and causes increased stress on the foot.
  • Also, previous fractures to the structure of the metatarsal can compromise the structure of the foot and natural weight distribution. Such an issue can place increased stress on the metatarsal, which often leads to pain. Even more, a stiff ankle or Achilles tendon can also have adverse effects on weight distribution.

Health Complications

Morton`s neuroma is a health complication that involves the development of fibrous tissue in the foot nerves. Usually, it occurs in at the third or fourth metatarsal heads. The condition occurs as a result of intense physical activities or wearing tight shoes. That said, Morton’s neuroma also relates to additional signs such as numbness, and tingling in the toes. Other related complications include:

  • Arthritis – a joint health complication that affects the functionality and strength of the bones. Usually, the condition worsens with age.
  • Gout – an inflammatory form of arthritis, that occurs in individuals who have excessive uric acid levels. The acid leads to the formation of need like crystals that can cause severe pain.
  • Diabetes – is a health complication that occurs when your blood sugar increases significantly or becomes excessive. Diabetes also affects metabolism and the physical strength of bones.
  • Freiberg`s disease – otherwise referred to as Freiberg infarction, this is a form of necrosis that affects the metatarsal bones in the foot. While the condition often affects the second metatarsal, it can affect all metatarsals.

Other Risk Factors

Being overweight or having an excessive weight BMI can also lead to metatarsalgia. An excess weight places increased stress on the foot and metatarsals, with every movement. Such an issue can lead to pain in the foot over time. More so, wearing tight shoes that affect the natural distribution of weight in the body can cause metatarsalgia. Putting on high heeled shoes is also a risk factor for women.

Symptoms and Diagnosis

The first sign of metatarsalgia is when you experience pain in the foot, which can compromise both feet. Usually, the pain comes up gradually and increases through time. However, it can also come about suddenly due to an injury. The details of the pain can change, and sometimes compromise a small section of the foot. Some people commonly experience the condition as a “pebble stuck in the foot,” with issues such as aching.

The diagnosis process often involves evaluating the symptoms reported by the individual. However, additional investigation is required if the pain persists, or does not resolve with the conventional forms of treatment. The tests might include x-ray imaging, blood tests, and other scans as well.


If the pain persists for several days, then consider visiting a podiatrist for additional advice. Various issues can lead to symptoms similar to metatarsalgia. In some cases, the podiatrist might even perform a gait analysis to identify sections of the foot that are prone to pressure. Other tests include X-ray or MRI to evaluate the presence of damage in the foot. Imaging will also allow the doctor to distinguish the condition from Morton`s Neuroma.

Rest and Recovery

The first step in controlling the pain relating to Metatarsalgia is to ensure the footrests and gets adequate time for recovery. For instance, if tight office shoes or high-intensity sports are the cause of the condition, - then consider cutting down on the activity. For physical enthusiasts that have to engage in some exercise, there are several low impact sports such as swimming to consider. More so, it is also vital for the person to ensure that the feet get adequate rest. Being able to allow the entire body to rest, also promotes cell healing and flow of blood to the affected area. Using cold therapy and elevating the affected area can also be beneficial.

Pads and Orthotics

Using pads and insoles in the shoes also plays a significant role in absorbing the shock during motion. More so, the insoles help to cushion the feet, and this helps in the treatment process. It also helps to reduce any likelihood of future injury. A podiatrist might also provide a custom orthotic device that will help relieve the discomfort associated with the condition. Usually, the orthotic helps to ease the pressure on the metatarsal region, thus encouraging optimal healing. More so, the orthotics can also be beneficial for individuals who have feet with a high arch. This is because the orthotics help to prevent the arch from collapsing, while simultaneously relieving pain on the metatarsals.

Medical Management

Pharmacological management is also beneficial in reducing the pain in the short term. Using analgesic medicines such as Tylenol or Non-Steroidal Anti Inflammatory Drugs (NSAIDs), are useful for pain relief. Laser therapy is also a contemporary form of treatment for people with metatarsalgia. The process involves the use of lasers to target the affected area, thus providing many benefits. These include pain relief, anti-inflammatory effects, and effects against edema in the tissues. The photons in the laser energy, target deep tissue, thereby accelerating healing and cell reproduction. Once the inflammation reduces, consider using basic physical therapy techniques to control the inflammation. For the more severe cases, steroid injections might be recommended.

NB: While most cases of metatarsalgia are simple to manage using these methods, others might require specialized techniques. A podiatrist might recommend the use of corticosteroid injections to regulate the pain, or surgery as a secondary solution.

Can Metatarsalgia be Prevented?

Some of the causes of metatarsalgia cannot be prevented - for example, metatarsalgia due to claw foot (pes cavus). However, there are some things that may help to prevent some of the other causes. These include:

  • Ensuring that shoes are well fitted, low-heeled, and have a wide toe area. This may help to prevent some causes of metatarsalgia, including Morton's neuroma.
  • Ensuring that you wear properly fitted footwear when running or doing sports with high impact on the feet.
  • Controlling your health and bodyweight. Being able to regulate your physical and mental health will benefit your ability to regulate the occurrence of metatarsalgia.
  • Regulating your blood sugar levels, and diabetes health complications also contributes towards your bone and muscle health.
  • Various home remedies are available that you can consider before going to a podiatrist of foot physician. The conventional techniques for controlling the problem include wearing proper shoes, avoiding pressure around the affected area, rest, and applying ice. More so, consuming anti-inflammatory medications such as ibuprofen and naproxen are also highly beneficial.

Physical Exercises for Metatarsalgia

Plantar Sling Strengthener

Use an exercise band tied in a loop and place it on a desk leg. Position the arch of your right foot at the edge of the band loop. Now, work against the band resistance, by stretching the band away from your body several times. Ensure that you repeat the same exercise for both of your legs. Change your body position by facing the opposite direction you hard started the practice in during the workout.

Arch Strengtheners

This exercise involves two different main techniques. They include:

  • Pick up a marble by using your toes, and maintain this position for a few minutes, and then release. Start with any side, as you work your way through all the toes. Repeat the process for a few times.
  • Put a washcloth on a clean floor and pick it up using your toes. Maintain this position for a few minutes and then release. Repeat this process for a few times as well.


When it comes to managing metatarsalgia, you must practice proper foot care techniques. Even more so, being able to identify the condition early enough can help you avoid complicated foot medical procedures. Both men and women are prone to the condition, particularly those that wear ill-fitting footwear. Your doctor may perform tests to distinguish the condition from other similar conditions such as Morton`s Neuroma. With proper care, you can easily eliminate the condition and prevent any future chances of its remittance.

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About the Author

Hi, I’m Brian Bradshaw. I’m a super duper mega hiking enthusiast, with a love for everything that has to do with outdoors, hiking, gear, footwear and more.

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