This is a general term used to denote a painful foot condition in the ball of the foot. This is a common foot disorder that can affect the bones and joints at the ball-of-the-foot. Metatarsalgia is often located under the 2nd, 3rd, and 4th metatarsal heads, or more isolated at the first metatarsal head (near the big toe).

This is often caused from improper fitting footwear and other restrictive footwear. Footwear with a narrow toe box (toe area) forces the ball-of-foot area to be forced into a minimal amount of space. This can inhibit the walking process and lead to extreme discomfort in the forefoot. Other factors can cause excessive pressure in the ball-of-foot area that can result in metatarsalgia. These include shoes with heels that are too high or participating in high impact activities without proper footwear and/or orthotics. Also as we get older, the fat pad in our foot tends to thin out, making us much more susceptible to pain in the ball-of-the-foot.


Your podiatrist will carry out a thorough foot examination and may ask you about your medical history, lifestyle, footwear, hobbies and a description of the presenting problem to obtain an accurate diagnosis. Also what brings the pain on and what alleviates it.


Initial treatment usually involves a period of RICE therapy (Rest, Ice, Compression & Elevation) to treat the symptoms. Followed by the following to treat the cause:

Custom orthotics (specially fitted insoles), to stabilise and improve foot function, redistributing pressure and cushioning the ball of the foot. Thorough assessment of footwear and advising on a shoe that will accommodate the foot better to give more support. Giving advice on the relevant medication to prevent inflammation and ease pain, which will allow the body to repair the damaged tissues.

If Left Untreated

If left untreated Metatarsalgia can cause the person to compensate and alter the way they walk both consciously and subconsciously. The pain can then spread to other parts of the foot, the other foot or even further up the limb to the knee and hip.

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