What is Metatarsal Pain?
Metatarsal pain, or Metatarsalgia, is a common overuse injury described as pain in the forefoot associated with increased stress over the metatarsal head region. Metatarsalgia often is referred to as a symptom, rather than as a specific disease. Common causes of metatarsalgia include interdigital neuroma, metatarsophalangeal synovitis, avascular necrosis, sesamoiditis, and inflammatory arthritis; however, these causes often are diagnosed separately.

With this condition one or more of the metatarsal heads become painful and/or inflamed, usually due to excessive pressure over a long period of time. It is common to experience acute, recurrent, or chronic pain with this common foot condition. Ball of foot pain is often caused due to improper fitting footwear, most frequently in women’s dress shoes and other restrictive footwear. Footwear with a narrow toe box (toe area) causes the ball of foot area to be forced into a minimal amount of space. This can inhibit the walking process and lead to extreme discomfort in the forefoot.

What Causes Metatarsalgia?
There are a number of possible causes of metatarsalgia, including:

• Poorly fitting shoes
• A foot with a high arch (known medically as pes cavus)
• Arthritis
• Deformed or crooked toes
• Trauma, as caused by a car accident or sports injury
• Repeated stress, caused by frequent walking or standing on cement floors or repeated walking on a sloping surface

Treatment of Metatarsal Pain
Chronic pain on the bottom of the foot should be evaluated by a physician or specialist who fully understands the structures and mechanics of the foot.

X-rays are often used for evaluative purposes.

A common treatment for metatarsal pain is the use of a custom orthotic, or shoe insert, made to correct the deforming forces of the foot. A metatarsal pad is usually incorporated into the device to assure long-term support.

Other treatment measures include:

• Roomier or specially constructed shoes
• Resting and elevating the foot, as well as making changes in any activity that regularly stresses the foot
• Finding shoes with energy absorbing soles