You’ve geared up for a walk outside, shoes tied, music at the ready, and boom—you’ve got that dreaded ball of foot pain again. Whether this is your first, or fifteenth time dealing with this, it sure is a pain.
This condition, also known more medically as Metatarsalgia, affects the area where the toes meet the rest of the foot (aka the ball of your foot.) There are many factors that can cause this problem over time, such as overuse, structural abnormalities, injury, and more. No doubt if you’re experiencing this, it’s frustrating, inconvenient, and uncomfortable. And if you’ve never had it, it’s best to be avoided.
Luckily, there are lots of effective measures to be taken that can alleviate, and even prevent, this situation. In this article, we’ll discuss common causes of this type of foot pain, and what you can do about it.
What are the symptoms of Metatarsalgia?
Shooting pain or burning pain
- Sharp/shooting pain, numbness, and/or tingling in the ball of your foot and/or in your toes
- Aching and/or burning pain in the ball of your foot
How can ball of foot pain be prevented?
Proper footwear
Wearing shoes that are supportive and fit your foot correctly is the first step in avoiding this condition. You’ll want to look for shoes with wide toe boxes, solid arch supports, and an overall comfortable design. This way, your body weight will be balanced across both feet, relieving uneven or excessive pressure on the ball of the foot.
Recovery Shoes are a great option to incorporate into your daily rotation. Ensuring that you have a reliable pair of running shoes and a proper pair of recovery shoes will keep your feet in great shape both during activities as well as after. Additionally, sometimes other foot support types can be worn while running or engaging in a high-impact activity, such as metatarsal pads.
Note: If you have foot problems, it’s best to avoid wearing high heels and narrow-fitting flats. These can squish and increase pressure on the big toe, second toe, and ball of the foot, causing pain and discomfort.
Engage in stretching and strengthening exercises
These kinds of exercises improve both the overall flexibility and strength of the foot, which in turn helps prevent metatarsalgia from arising in the first place. Often you can find helpful instructional videos online that can guide you through a set of exercises at varying levels, intensities, or lengths.
A physical therapist is also a great call. A PT can customize a stretching and strengthening program that will target your specific needs, both during your physio sessions as well as at home.
Be careful with high-impact activities
Activities that put major stress on your feet can increase the chances of you developing metatarsalgia. Running is a prime example, as it requires your feet to pound the pavement repeatedly. But who wants to stop jogging or running? No need to cut out a favorite way to exercise - simply approach these activities equipped with wisdom!
High-impact activities can be more seamlessly incorporated into your routine with the correct footwear, warm-ups, and ease-ins—after all, a gradual increase in duration and intensity can make the world of a difference!
Maintain a healthy weight
Putting extra pressure on your feet, particularly on the balls of your feet, can unfortunately lead to various foot problems over time, like metatarsalgia. Maintaining a healthy weight through regular exercise and healthy eating can help reduce the risk of pain, inflammation and swelling in your feet.
Regular foot care
Sometimes ball of foot pain can actually be associated with skin irritation or dryness. Making sure you’re cleaning and moisturizing your feet is a great way to prevent this from happening.
It’s also wise to periodically check your feet for any cuts, sores, redness or swelling to ensure all is well. If your foot looks and feels like it's in tip-top health, you may be somewhat less prone to other foot problems. Plus, quickly catching any changes in your foot health is a smart habit to develop, which goes equally for foot muscles, tendons, ligaments, bones and skin.
What are the common causes of Metatarsalgia?
Overuse
Tennis, running, dancing, jumping rope—these are all fun high-impact sports and are sure to have you breaking up a sweat in no time. But there can be repercussions to going over the limit.
A common way metatarsalgia can crop up is when the ball of the foot is repeatedly subjected to high stress and pressure. Overuse pain or injuries can also build up and worsen over a longer duration of repeated impact.
Ever returned from a night out on the town and immediately felt the burn? That’s because ill-fitting shoes and high heels can also cause overuse pain. These kinds of shoes are not meant to support or cushion your foot, so after prolonged periods your foot may pay the price with inflammation and swelling. Moderation helps!
Structural abnormalities
Certain foot deformities can lead to metatarsalgia. Whether these abnormalities are congenital or acquired over time, they can put someone at a higher risk of developing pain in their foot, including the ball of the foot.
Orthotics or specialized shoe inserts can help take pressure off isolated areas of a structurally abnormal foot, however more severe cases may require surgery to correct the abnormality.
A few abnormalities that can lead to or exacerbate metatarsalgia include:
- Hammertoes: This occurs when the second, third and/or fourth toe bones are bent at the middle joint. Since this is an unusual bone structure in the food, this condition can cause increased ball of foot pain.
- High arches: When the arch of the foot is set higher than it’s meant to, extra pressure is weighted on both the heels and the balls of the feet.
- Morton's neuroma: When the tissue surrounding the nerves leading to the toes becomes thickened, it causes pain and discomfort in the forefoot, particularly in the ball of the foot.
- Flat feet: When the arch of the foot is set at a lower position than it’s naturally meant to, the foot can roll inward, placing too much pressure on the inner heel and the balls of the feet.
Injury
Injury to the food can cause metatarsalgia, which can span from less severe to more severe. The two main categories of injuries are fractures, and sprains and bruises. These can be a result of falling or injuring your foot in other ways during activities.
Fractures
Stress fractures are micro-breaks or cracks in the bone that develop over time, which are commonly seen in athletes. A regular fracture is an immediate, traumatic injury resulting from impact.
Both of these types of fractures can lead to metatarsalgia, causing pain and swelling, particularly when bearing weight on the foot. Less severe fractures often respond well to immobilizing the foot, whereas severe cases may require surgical intervention to properly heal.
Sprains and bruises
Sprains and bruises often go hand in hand (aka if you have a sprain, you’ll usually also have bruising) and are comparatively minor injuries to fractures, but can still lead to metatarsalgia.
Sprains and bruises typically present as painful, swollen or tender in the specified area, affecting the blood vessels and ligaments. Often icing, resting and compression is enough to treat these issues, but a more intense sprain may also require physical therapy.
Medical conditions
Certain medical conditions can also cause metatarsalgia, such as:
- Arthritis: This includes osteoarthritis, rheumatoid arthritis, and gout, all of which cause joint inflammation, and can lead to pain and stiffness in many areas of the foot.
- Diabetes: This condition affects your body's ability to naturally produce insulin, and if mismanaged, can lead to foot nerve damage and circulatory problems.
Treatment options
Try to rest and ice
Keeping off that foot for a while can be your saving grace! Resting your feet by propping them up on your couch or chair is a great first measure. While resting and (preferably) elevating, you can also apply an ice pack (or a bag of ice cubes) to the affected area.
Since the ball of your foot is, of course, underneath your foot, using a tensor bandage to tie the ice pack to the foot will keep it secure. Just be sure not to ice directly, or for a prolonged period. Use a cloth as a skin barrier, and ice at approximately 15 minute intervals.
Wear proper footwear
Wearing proper footwear is key to preventing and treating metatarsalgia. Running shoes with a wide toe box and shock absorbing insoles can help distribute weight evenly across the foot and relieve pressure on the ball of the foot. Orthotic inserts may also be necessary for your condition.
Another form of essential footwear are Recovery Shoes. The best ones will have solid support, comfort and flexibility. These provide a great way for your feet and calves to restore and recover after engaging in high-impact sports.
Take necessary medications
OTC (over the counter) pain medications that do not require a prescription can help with short term pain alleviation. Medications that have acetaminophen or ibuprofen in them can reduce inflammation and relieve pain caused by metatarsalgia.
Over the counter medications, however, should still be taken with caution and care. Follow the instructions on the packet or bottle carefully and do not exceed the maximum dosage. If you have underlying medical conditions or are taking other medication or supplements, always consult your doctor first.
When to call a doctor
Aside from medication recommendations, there may be other reasons to consult a physician. If your pain has transitioned into severe foot pain, for example, you’ll want to seek the help of a physical therapist, or an orthopedic surgeon. Both professionals can help target and treat your metatarsal pain. The severity of your situation will dictate which treatment to seek out.
