Metatarsalgia

Metatarsalgia is a painful condition in the ball of the foot. It is caused by excess stress being placed on the metatarsals, or the long bones that run along the base of the toes. There are five metatarsal bones that run across the foot, one for each toe. During the push-off phase of running or walking, all the weight of your body is transferred to the metatarsals. This usually becomes a real problem among people who already have structural problems with their feet, such as bunions, hammertoe, or overpronation to name a few, since these problems affect the way weight is distributed on the foot.

Metatarsalgia is most common among runners and other athletes who exert a lot of impact on their feet. The most primary symptom of metatarsalgia is the pain - it may be burning, dull, or sharp, but is generally worse during activity and lessens during periods of rest. Those with metatarsalgia may also experience numbness or pain in the toes. These painful symptoms are most likely to develop slowly over a number of month. They may develop suddenly, although it is more uncommon.

Causes

As previously mentioned, the main cause of metatarsalgia is a combination of stress to the metatarsals from exercise and structural or mechanical problems with the foot. Some structural problems that may cause metatarsalgia include bunions, hammertoe, Morton's neuroma, and high arches.

Besides structural problems, aging and being overweight are also factors in metatarsalgia. Aging thins the fat pads along the bottom of the foot, leading to more direct impact on the metatarsal bones, and being overweight also puts extra weight stress on the metatarsals.
Poorly fitting shoes that cramp the toes or have a narrow toe box are also a contributing factor to metatarsalgia, as well as high heels that transfer most of the weight onto the ball of the foot and athletic shoes that lack padding and shock absorption.

Treatment

Avoiding the activities that contribute to metatarsalgia is a significant way to lessen the pain and pressure on the metatarsal heads. Plenty of rest and cold ice packs should help reduce pain significantly, along with over-the-counter pain relievers such as ibuprofen or acetaminophen.

Along with reducing activity level, shock-absorbing insoles and metatarsal pads can help lessen the pain and pressure. Wearing shoes with a wide toe box and avoiding high heels will also help to alleviate symptoms. If insoles and pads are not helping with the pain, your podiatrist or doctor may suggest arch supports help the foot to function more properly in general and keep pressure off the metatarsals.
In very serious cases, surgery to realign the metatarsal bones may be an option if the previously mentioned treatments do not help.