Metatarsalgia: Causes, Symptoms & Treatment
by Melinda Burris

What Is Metatarsalgia?

A common foot disorder, Metatarsalgia refers to pain in the forefoot or ball of the foot. Although often spoken of by lay people in terms of a diagnosis, metatarsalgia is not a specific condition; it is more a reference to where the source of trauma or pain is located, across the front of the foot affecting the metatarsal bones that lie behind the toes in the area across the plantar forefoot. However, it is frequently accompanied by deformity of the first and fifth rays, as well as the toes.¹

Metatarsalgia involves pain in the ball of the foot. It stems from problems with the long metatarsal bones. There are five metatarsal bones in all, one that extends from each toe to the ankle. Athletes, particularly runners and others who participate in high-impact sports that take a high toll on the feet are often prone to metatarsalgia. Other causes of pain in this area are traumas caused by an injury which can result in bone fractures or dislocation. Overuse can lead to long-term and painful conditions including arthritis. Other causes of pain in this area are present from birth such as being born with high arches or other types of unusual bone structure.² Other sources of metatarsalgia can be self-inflicted.

Common examples include wearing inappropriate footwear. This is especially important for hurdlers and sprinters. Coach McGill has often emphasized the importance of wearing shoes that fit properly and provide appropriate support as this is essential for maintaining good health, avoiding over-taxing your body, and prolonging your athletic career as long as possible.
Another crucial element often emphasized in this magazine is eating properly so your body has the fuel it needs to perform at optimum levels. Maintaining a balanced diet so your body weight stays at an appropriate level keeps you from placing too much pressure on your joints and other body parts, which can make it a struggle for your frame to carry the load and perform the motions required for your chosen sport.^1,2.

You also want to choose substance over style when it comes to high heels, shoes with a pointed toe, or that are too tight. Instead, you want to opt for shoes that give plenty of support and cushioning as well as adequate room in the toe box to avoid compressing the front section of the foot and toes — both on and off the track.²

Home Remedies and Exercises That Can Help Alleviate the Pain Associated with Metatarsalgia

Generally, simple home remedies aimed at easing the pain and discomfort associated with metatarsalgia are effective.²

Apply ice or a cold compress to the inflamed area for approximately 20 minutes every two to three hours to alleviate swelling.²
You can also use gravity by keeping your feet raised above your heart to keep fluid from building and causing additional swelling. By keeping your feet elevated this way, excess fluid is naturally circulated back toward the heart.
Stay off your feet as much as possible as standing for extended periods will only aggravate the injured area.²
An over-the-counter (OTC) non-steroidal anti-inflammatory medication may help manage the pain.²
You may find using metatarsal pads (readily available online or at your neighborhood drug store) helpful.²
Arch supports may prove helpful if you can’t avoid being off your feet long enough for your feet to fully heal. These are available through retailers. Custom orthotics can be made for you and purchased from an orthopedist. If the pain persists, you should see an orthopedist to have x-rays done and determine if surgical or other medical intervention is necessary. Do not ignore metatarsal pain or put off treatment! Doing so can cause more serious and even permanent damage and the pain that comes with it.

Simple Exercises to Improve and Maintain Good Foot Health

There are several easy exercises you can do for a few minutes each day that will improve your foot health and increase and maintain your mobility and comfort levels for your daily routine, whether it’s just walking or standing for extended periods or if you enjoy workouts like running or cycling that are known to give your entire body, including your feet a thorough workout! Here are a few simple foot exercises you can try:

Walking in the sand barefoot causes your feet and toes to naturally stretch. The resistance of the sand also strengthens the foot muscles and is great for working the calf muscles.³

Simply find an area with sand. If you live near a beach or desert, this will be easy to do. If you don’t live in one of these locations, go to a local park, recreation center, or YMCA that has a volleyball court.³
Remove your shoes and socks.³
Take a walk in the sand.³
Remember, walking in the sand is more tiresome than walking on level ground, so if you take a walk along the beach or in the desert, take note of the time and turn around before you’ve gone too far, bearing in mind you have the return route left to take. Be sure to take plenty of water with you as well to stay hydrated.

Tennis Ball Curl

Take a seat on a flat-backed chair.^2,3
Make sure you are sitting up straight, and both your feet are resting flat on the floor.³
Place a tennis ball under your right foot and use the muscles of the foot to roll it back and forth.^2,3
Repeat the exercise using your left foot.^2,3
Do this exercise at least two times each day to reduce tightness and cramping in your feet.^2,3

Achilles Stretch

Stand straight, facing the back of a straight-backed chair. ^2,3
Place your hands on the top of the chair for support.^2,3
Put your right foot slightly behind your left to get a good stretch.^2,3
As you bend your knees, push the heel of your back foot down into the floor until you feel the resistance of a nice stretch from your Achilles tendon to your calf muscle.^2,3
Hold each stretch for 30 seconds and do a set of three.^2,3
Relax a moment, switch feet, then place your left foot behind your right, repeating the exercise and again holding each stretch for 30 seconds and repeating 3 times.^2,3

We’ve all had days when our feet hurt for one reason or another, a pair of shoes that fit badly, overuse due to standing or working out too long—whatever the reason, when your feet hurt, you seem to hurt all over! It’s difficult to concentrate on much more than when you can get off your aching feet.

Be kind to your feet; they do a lot for you! In addition to providing the stability and coordination required to maintain your balance and strength so you can confidently walk and do the things we demand of our bodies daily, remember that the feet absorb the shock of each stride you take so your body can continue to move undisturbed through life.

Doing simple exercises like the ones outlined above, keep the muscles of your feet strong and flexible, making it easier for you to recover from an injury if you do sustain one. Wearing sensible shoes and treating any injury as soon as it occurs will keep your feet in good condition, and your body will thank you for it!

References:

Kashefsky, H. (May 2016). Managing Metatarsalgia in Athletic Populations.
Brazier, Y. (22 January 2022). What are Metatarsalgia and Metatarsal Pain?
Axtell, B. (26 February 2018). 9 Foot Exercises to Try at Home.