What is Metatarsalgia?

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If you lead a very active lifestyle, encountering foot pain can dramatically affect your routine. So what are you supposed to do? How do you stave off the pain in order to keep up your hobbies or responsibilities?

Of course, there are a variety of different foot pains, but if your discomfort is focused in the balls of your feet, then you may be suffering from metatarsalgia.

ball of foot

Metatarsalgia may sound frightening or even life-threatening, but fear not! It is simply the medical term for this ‘ball of foot pain’ you are experiencing, and it’s easily treatable.

About one in every ten people of any age can suffer from metatarsalgia, and it is the leading cause of forefoot pain reported by athletes and other active people.

But what exactly is metatarsalgia? What really causes it and what are some ways you can alleviate your discomfort? Let us take a look at that below.

Metatarsalgia Definition

Metatarsalgia, also referred to as “the stone bruise,” is a condition that results in painful inflammation at the ball of your foot.

This area can be a common source of foot pain due to its role in supporting your weight as you stand, walk, or run.

Because this area is also connected to the five metatarsal bones that bridge the arch between your ankle and toes, this pain can spread out to the whole width of your foot if left untreated for too long.

Symptoms of Metatarsalgia

The ball of foot pain caused by metatarsalgia ranges from mild to severe.

It is typically characterized as anything from: a tingling or numbness in your toes, a sharp or shooting sense of pain, a burning pain, or a sensation much like walking with a small pebble or stone in your shoe – hence metatarsalgia’s other name, “the stone bruise.”

This pain is, of course, more noticeable and unpleasant when you are on your feet, as opposed to when you are resting. Metatarsal pain may affect one or both of your feet, and symptoms only get worse with time.

Your foot pain may also worsen by flexing your feet, standing for prolonged periods of time, walking (especially when treading barefoot on hardwood floors or pavement), jumping, running, or from other forms of high-impact exercise.

Please note that these symptoms usually develop gradually. If they do happen to appear suddenly, it is most likely due to increased strain on your feet from exercise.

Of course, if you are still unsure if you have metatarsalgia, you should consult a licensed medical practitioner or physician.

Causes of Metatarsalgia

A number of factors can cause metatarsalgia, including:

Poor-Fitting Shoes

There are a number of different types of ill-fitting shoes that can cause metatarsalgia. High heels over two inches in length, and other types of pointy-toed shoes that restrict the amount of space for your toes and the balls of your feet, are especially heinous.

There are small toe nerves laid in between the metatarsal bones in your foot, and the pressure these shoes put on your feet can cause the head of one or many metatarsal bones to press against each other.

The small nerves caught between these bones then become inflamed and may cause foot pain. Putting any weight on your feet by standing or walking only worsens this pain, as this weight makes the metatarsal bones continue to rub together, increasing the inflammation.

Similarly, athletic shoes that are too tight for you can also put this type of pressure on your feet. On the other hand, athletic shoes that are too loose will make your feet slide around or rub against the inside, which creates a painful friction that may also result in inflammation.

You are especially susceptible to this if you participate in high-impact sports, such as running or tennis.

Ballet shoes, flip flops, or other similar types of shoes that offer very little shock absorption, padding, or arch support can also throw off your foot’s normal pronation (or the motion your foot go through as you stand or move).

Overpronation or underpronation can cause a wealth of problems on their own, and they can also increase the effects of metatarsalgia.

what is metatarsalgia

Overpronation or Supination

Metatarsalgia may be caused by narrow feet, flat feet (which in itself can be caused by a condition called overpronation), or overly arched feet (which may be caused by a condition called supination).

Overpronation is when your feet roll excessively downward and inward at the ankle. The big toe and the second toe thus have more pressure on them to push the foot off the floor.

Supination, also known as underpronation, is when your feet do not roll inward enough after they land on the ground, resulting in excess shock absorption to the outer foot areas. This typically results in higher arches in your feet, which can also cause metatarsal damage and pain.

Excess Weight

Excess weight can naturally put more strain on the balls of your feet, making you more susceptible to friction-induced damage that can cause metatarsalgia.

Other conditions that may accompany excess weight, such as diabetes, can lead to metatarsalgia if the small nerves in your feet become irritated because of it.


The pad of fat which surrounds the balls of your feet, as well as your tendons and other connective tissues, becomes thinner as you age, making you more susceptible to metatarsal pain. Older women in particular are more likely to suffer from metatarsalgia than older men.

Bone or joint conditions such as arthritis, gout, and/or bunions that older people are prone to may also cause or aggravate existing metatarsalgia.

Stress Fractures

Stress fractures are small cracks or severe bruising within your bones due to overuse or repetitive activity.

The bones of your feet and lower legs bear the majority of your weight and are thus more susceptible to fracturing, leading to all types of foot pain, including metatarsalgia.


This is a painful condition that typically affects your joints. Bursae are fluid-filled sacs that act as a cushion between your bones, tendons, joints, and other muscles.

The bursae are lined with synovial cells, which produce a lubricant that reduces friction between tissues, allowing our joints to move around easily.

These sacs can become inflamed, making movement painful and creating a build-up of fluid in the afflicted area.

Inflamed bursae may also lead to the inflammation of your metatarsal bones as well.

Morton’s Neuroma

This is a thickening or fibrous growth of the tissue that surrounds the nerve between the third and fourth toes, leading to metatarsal pain, numbness, or burning.

It usually develops because of irritation, repeated trauma, or excessive pressure on this nerve.

Please note that not all cases of Morton’s neuroma cause ball of foot pain. You may have it and do not even know until you get an X-ray of your foot.

Be warned that this condition is often confused for metatarsalgia and vice versa, because they feel very similar. Therefore, it is wise to consult a doctor for a proper assessment.

Treatment for Metatarsalgia

Your doctor will first ask about your medical history, lifestyle, occupation, hobbies, and especially about the characteristics of the pain you feel.

Often these types of questions are to ensure your pain is not, in fact, some other preexisting condition you may or may not already have.

Conditions like arthritis, gout, bunions, edema, or Morton’s neuroma are often mistaken for metatarsalgia.

Your doctor may have to run a number of radiological imaging tests, including X-ray imaging, ultrasonography tests, and/or MRI scans. They may also order blood tests to check your uric acid levels to exclude the diagnosis of gout.

After confirming that you do indeed suffer from metatarsalgia, there are a number of simple ways to relieve your ball of foot pain:

foot pain ball of foot


Be sure to rest your feet often, propping them up to remove any pressure.

You may also choose to soak your feet if you wish.


Foot massages are a good way to soothe your pain, as this will release the pressure felt in the ball of your foot.

Be sure to massage your feet before you go to sleep at night and once more when you get up in the morning.

You can also use aromatherapy oil or lotion during the massage to moisturize rough skin and calluses.


Applying an ice pack or another cold compress to the afflicted area several times a day, for 15-20 minutes each time, can help alleviate painful inflammation.

Heat should be avoided, as this will only aggravate your symptoms.


Taking any over-the-counter anti-inflammatory medication, such as ibuprofen or naproxen, can reduce inflammation and temporarily reduce metatarsal pain.

If pain becomes too severe, your doctor may recommend you get steroid injections that will reduce your discomfort.

Alternate Exercises

Daily toe and foot stretches are a good way to relieve pain, as well as to prevent metatarsalgia from returning. Other light exercises that work your ankle and stretch your Achilles tendon are also advised.

If you want to remain active, it is best to switch over to low-impact sports such as swimming or cycling until your foot is fully healed.


Over-the-counter or custom-fit orthotic shoe inserts that provide shock absorption and arch support can alleviate the pressure on your feet.

A gel pad or metatarsal bar under the ball of your foot can ease the pain as well.


If pain becomes too intense and the above methods do not work to relieve it, your doctor may then suggest you undergo surgery to reshape your metatarsals into lessening the pressure on your nerves.

Here’s a video explaining more on metatarsalgia.


Luckily, metatarsal pain is quite simple to relieve.

Your pain does not have to upset your daily routine. Rather, by making minor adjustments to your exercise routine, this will aid in your healing process.

With enough patience and care, you will be able to get back on your feet – pain-free – in no time!

Do you have any tips for dealing with matatarsal pain?