Metatarsalgia is ball of the foot pain.  Metatarsalgia is a catch all term for ball of foot pain. There are different types of ball of the foot pains.  In this article I will address general ball of foot pain.  The patient will have pain of the bones and or joints of the ball of the foot.  I will review general metatarsalgia and future articles I will address more specific ball of foot pain for example; Morton’s neuroma, plantar plate injury, metatarsal fracture, hammertoes.  

With ball of foot pain one would have pain, discomfort, soreness of the ball and may or may not have inflammation, bruising or temperature. 

There are many causes of metatarsalgia but not limited to; Position of the bones-metatarsals:

  • Foot biomechanics

  • Trauma 

  • Shoes

  • High arch foot type

  • Increased pronation

Symptoms-Pain, discomfort, inflammation usually develops over time, but can be acute.  Can form thickened callus or corn on the ball of the foot which usually develops over time and then suddenly becomes sore.

Examination of the foot- Check the foot for pain with palpation of the ball of the foot, range of motion of the ball of the foot joints and toes, presence of thickened skin, bone alignment and position, swelling. Also check muscle strength and toe position.   Imaging may be ordered ie xray, ultrasound, CT, MRI.

Treatment- As a generalization treatment would include but not limited to change of shoe gear a more supportive shoe also make sure shoes are not worn out.  Ball of foot pads- gel pad, metatarsal pad or U shaped pad to offload a metatarsal head. Topical, oral or injectable medications. Insoles or custom orthotics. Immobilization- wrap, cast or post op shoe.  Debridement of thickened callused skin.  Surgery.

As stated earlier I will address other ball of the foot problems in future articles.