Metatarsalgia Pain, Causes, and Treatment | PreferredMD
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Metatarsalgia Pain, Causes, and Treatment

Condition • By Biraj Patel

Metatarsalgia is a condition that often creeps into our lives, uninvited, like an unexpected guest. It's not always easy to recognize, but once it settles in, the discomfort can be hard to ignore. In this article, we'll delve into what metatarsalgia is, its symptoms, causes, and, most importantly, how to treat it effectively. 

What is metatarsalgia?

Metatarsalgia, despite its intimidating name, is a relatively common condition. It refers to pain and inflammation in the metatarsal region, which is the front part of your foot, just before the toes. This area bears a significant portion of your body weight when you walk or run, making it prone to stress and injury.

Metatarsalgia symptoms

Recognizing metatarsalgia can be tricky, as its symptoms are often mistaken for other foot problems. Some common signs to watch out for include:

  • Pain and aching in the ball of the foot, which worsens when standing, walking, or running.
  • A burning sensation or sharp, shooting pain in the toes.
  • Numbness or tingling in the toes.
  • Increased pain when wearing narrow, tight, or high-heeled shoes.

Metatarsalgia causes

Understanding the root causes of metatarsalgia is crucial for effective treatment. Some common factors contributing to this condition are:

  • Overuse and high-impact activities: Athletes, particularly runners, dancers, and those who engage in high-impact sports, are at a higher risk.
  • Ill-fitting shoes: Wearing shoes that are too tight, too high, or lack proper cushioning can put excess pressure on the metatarsal area.
  • Aging: As we age, the fat pads in our feet naturally thin, reducing their ability to absorb shock and protect the metatarsals.
  • Foot deformities: Conditions like bunions or hammertoes can alter the distribution of weight on the foot.
  • Obesity: Carrying excess weight places extra strain on the metatarsals.

What deficiency causes metatarsalgia?

Metatarsalgia is typically not caused by a nutrient deficiency. However, nutritional deficiencies can lead to weakened bones and muscles, making your feet more susceptible to conditions like metatarsalgia. Ensuring you have a well-balanced diet can contribute to overall foot health.

Is metatarsalgia a nerve issue?

Metatarsalgia is primarily a musculoskeletal problem related to the metatarsal bones and surrounding tissues. While it can result in nerve compression and pain, it is not a nerve issue in itself.

Is walking bad for metatarsalgia?

Walking is a necessary activity, and avoiding it entirely isn't practical. Instead, opt for supportive metatarsalgia shoes, insoles, and follow your healthcare provider's advice on managing the condition while staying mobile.

Can metatarsalgia go away?

With appropriate treatment and lifestyle modifications, many people find relief from metatarsalgia. However, recovery time varies from person to person, and in some cases, it may be a chronic condition that requires ongoing management.

How is metatarsalgia diagnosed?

Diagnosis typically involves a physical examination and discussion of your symptoms and medical history with a healthcare provider. In some cases, imaging studies like X-rays or MRIs may be necessary to rule out other conditions and confirm the diagnosis.

When dealing with metatarsalgia, remember that early intervention and proper care are essential. If you're experiencing persistent foot pain, consult with the best orthopedic doctor near you to explore the most suitable treatment options and get back on your feet pain-free.

Finding the right footwear: Shoes for metatarsalgia

One of the most critical aspects of managing metatarsalgia is choosing the right shoes. Ill-fitting or unsupportive footwear can exacerbate the pain and discomfort associated with this condition. Here are some tips for selecting the best shoes for metatarsalgia.

  • Arch support: Look for shoes with good arch support to help distribute the weight more evenly across your feet. Custom orthotics can be particularly helpful in achieving the right level of support.
  • Cushioning: Opt for shoes with ample cushioning in the forefoot area. Gel or foam insoles can also provide extra padding and reduce pressure on the metatarsals.
  • Wide toe box: Shoes with a roomy toe box can prevent crowding of the toes, reducing the risk of discomfort.
  • Low heels: High heels should be avoided. Instead, choose shoes with a moderate, stable heel that doesn't put excess pressure on the front of the foot.
  • Adjustable straps or laces: These features allow you to customize the fit to your foot, ensuring a snug and comfortable feel.

Metatarsalgia exercises

Regular exercise can play a pivotal role in managing metatarsalgia. Strengthening exercises for the muscles in your feet can improve their ability to absorb shock and support your metatarsals. 

Some useful exercises include:

  • Toe raises: Stand on your tiptoes and then lower your heels back to the ground. Repeat this motion several times to strengthen the muscles in the front of your legs and feet.
  • Toe spreading: Sit with your feet flat on the floor and spread your toes as wide as possible, then squeeze them back together. This exercise can improve the flexibility and strength of your toes.
  • Marble pickup: Place a few marbles on the floor and use your toes to pick them up and put them in a container. This exercise can enhance the dexterity and strength of your toe muscles.
  • Towel scrunch: Place a towel on the floor and use your toes to scrunch it up toward you. This exercise helps strengthen your toe muscles and improve flexibility.

How to prevent metatarsalgia?

Preventing the recurrence of metatarsalgia is as crucial as its treatment, so let’s discuss some secondary prevention techniques.

  • Maintain a healthy weight: If you're overweight, losing excess pounds can reduce the pressure on your metatarsals and decrease the risk of a relapse.
  • Regular footwear assessment: Keep assessing your footwear to ensure it remains supportive and comfortable. Shoe quality can degrade over time, so it's important to replace them when necessary.
  • Foot health maintenance: Pay attention to your overall foot health. Keeping your feet clean and dry can help prevent skin problems that can lead to metatarsalgia.
  • Stay active: Engage in low-impact activities that don't put excessive stress on your metatarsals, such as swimming or cycling.

How to treat metatarsalgia

Treatment options for metatarsalgia depend on the severity of your symptoms. Here’s a list of common approaches.

Lifestyle adjustments

The first step is often to reduce or modify activities that exacerbate the pain. Switching to supportive shoes, wearing cushioned insoles, and avoiding high heels can make a world of difference.

Orthopedic inserts

Custom or over-the-counter orthotic inserts can redistribute pressure on your foot and provide extra cushioning for the metatarsals.


Medications can be a valuable component of metatarsalgia management, primarily aimed at reducing pain and inflammation associated with the condition. They are typically used in conjunction with other non-invasive treatments and lifestyle adjustments.

NSAIDs like ibuprofen or naproxen can help reduce pain and inflammation in the affected area. In cases of severe or persistent metatarsalgia, a healthcare provider may prescribe stronger NSAIDs, such as diclofenac.

Creams or ointments containing analgesic ingredients, such as capsaicin or lidocaine, can be applied directly to the affected area to provide localized pain relief. In some cases, a healthcare provider may recommend corticosteroid injections into the metatarsal area to reduce inflammation and pain. However, these injections are usually reserved for more severe and persistent cases due to potential side effects.

Physical therapy

Specific exercises, like the ones we listed a few paragraphs ago, can strengthen the foot muscles, providing better support for the metatarsals. 

Surgical options for metatarsalgia

In some cases of metatarsalgia, conservative treatments may not provide adequate relief, or the condition may be associated with structural abnormalities that necessitate surgical intervention. Surgical options for metatarsalgia are typically considered as a last resort when all other non-invasive treatments have failed to provide relief. 

The specific surgical procedure will depend on the underlying causes and severity of the metatarsalgia, and it should be discussed thoroughly with an orthopedic surgeon who specializes in foot and ankle conditions.

Metatarsal osteotomy

This surgical procedure involves repositioning one or more metatarsal bones to redistribute weight more evenly across the foot. By correcting any structural abnormalities, this can alleviate pressure on the metatarsals and reduce pain.

Neuroma removal

If a Morton's neuroma, which is a thickening of the tissue around a nerve in the foot, is contributing to the metatarsalgia, surgery may involve removing or releasing the affected nerve to relieve pain.

Bunion correction

For individuals with metatarsalgia caused by bunions, surgical correction of the bunion may be necessary to realign the metatarsal bone and reduce pressure on the forefoot.

Tendon repair or ligament repair

In cases where damage to the tendons or ligaments in the foot is contributing to metatarsalgia, surgical repair may be needed to restore proper function and alleviate pain.

Joint fusion

Fusion of the metatarsal joints may be recommended in cases of severe arthritis or joint deformities, where pain is caused by the motion in these joints.

Discuss metatarsalgia treatment with the best orthopedic surgeons on PreferredMD

Metatarsalgia can be a persistent and uncomfortable condition, but with the right approach, you can effectively manage and prevent it from interfering with your daily life. If you suspect you have metatarsalgia or are currently dealing with its symptoms, consult an orthopedic doctor for an accurate diagnosis and personalized treatment plan. By taking the necessary steps to address the root causes and following the appropriate treatment and lifestyle adjustments, you can find relief from the pain in your feet and continue enjoying an active and pain-free lifestyle.

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