Few foot complaints seem as bizarrely precise as that one occurring exactly where the toes meet the rest of your foot. Metatarsalgia is the technical word for that pain in the foot’s ball, and it can strike anyone from runners to office workers to retirees. The pain doesn’t usually start with a crushing step off the curb.
Instead it develops gradually, often after a fresh pair of shoes, a sudden mileage increase, or years of standing on concrete and tile. Fortunately, for most people, the condition resolves with some straightforward, commonsensical tweaks.
What Is Metatarsalgia?
Pain and inflammation in the ball of the foot (metatarsals) – a group of five long bones in the foot that connect the midfoot with the toes. It’s not a diagnosis but a sign or symptom, like a headache or backache, so many different conditions can cause it; that’s why two people with the same metatarsal pain may require very different treatment. The one thing all causes have in common is overload – excessive pressure being applied to the heads of the metatarsals for an extended period of time.
Common Symptoms
The pain is usually aching or burning, may be stabbing at times and is usually located under the ball of the foot. It is typically worse when walking on the toes or on a hard surface with bare feet or when you flex your toes. You may notice swelling and a feeling of tingling in the toes, with a ‘walking on a stone’ or ‘lumpy sock’ sort of feeling.
Who Is Most at Risk?
Joggers and athletes who leap from all of the time thrust their forefeet all of the time. So do footwear, foot form, age, and physique. As we grow older, our pure fat cushioning beneath our forefeet reduces, and extra weight has a major impression on the drive of each step.
Structural modifications similar to bunions, a excessive arch, or a protracted second metatarsal can result in further pressure on a single level.
Causes and Conditions Linked to Metatarsalgia
And there are just four root causes: too much pressure, joint inflammation or inflammation of the surrounding tissue, nerve irritation, or impact injury to the bone. Usually many of these occur in combination. A tight calf, a new activity, and a shoe that is too thin all combine to create one sore forefoot.
Footwear, Activity, and Foot Structure
High heels lead to the load being borne primarily on the ball of the foot, and pointy shoes tend to crowd the metatarsals. Sleek soles with minimal cushioning provide little shock absorption on the street. The shape of the foot also affects risk.
Those with high arches may load the forefoot, while someone with flat feet may have an abnormal distribution of pressure across the metatarsals. Limited ankle flexibility or tight calves mean shock absorption becomes increasingly challenging. And finally there is that abrupt increase in activity, a couch-to-5K plan embarked on with too much enthusiasm.
Related Conditions
Since the symptom is so non-specific, other disorders can simulate this.