illustration showing metatarsalgia |Experienced Idaho PodiatristMetatarsalgia is a common overuse injury. People who have metatarsalgia may experience pain and swelling in the ball of one or both feet. Symptoms are often mild, but they can be exacerbated by intense physical activity.

While metatarsalgia is not typically serious, it could force otherwise-active people to take an extended break from work, hobbies, and sports. Left untreated, metatarsalgia can cause additional complications, some of which are irreversible.

Understanding Metatarsalgia

Metatarsalgia is a medical condition that can cause the ball of the foot to become swollen and painful. It has a variety of causes but is associated with excess pressure on the metatarsals, a group of five long bones located in the middle of each foot.

The most common causes of metatarsalgia include the following:

Intense Physical Activity

Anyone who regularly participates in high-impact sports has a greater-than-average risk of developing metatarsalgia. However, distance runners are among the most likely to be diagnosed with this condition since running exerts a significant impact on the metatarsal bones of the foot.

Foot Deformities

People who wear constrictive shoes, like high heels, are at high risk for other foot-related conditions. Both hammer toe and bunions, for instance, can cause or exacerbate metatarsalgia.

Body Weight

The feet bear almost all of the body’s weight. People who are carrying extra weight are more likely to develop metatarsalgia because excess weight often translates to additional pressure on the metatarsals.

Stress Fractures

Metatarsal-related stress fractures are not visible and do not always “feel” like broken bones. However, they are still painful, and they can change the way patients walk and distribute their weight.

The Symptoms of Metatarsalgia

The symptoms of metatarsalgia include the following:


Metatarsalgia-related pain can be sharp, aching, or burning. For some patients, this pain is constant. However, metatarsalgia-related symptoms are sometimes situational insofar as they might worsen when you stand, run, or otherwise flex your feet.


Metatarsalgia is characterized by inflammation. This inflammation is not always evident or visible to the naked eye. Instead, people with metatarsalgia may notice localized pain or tenderness around their metatarsals.

Physical sensations

Many people with metatarsalgia report an unusual sensation: the feeling of a pebble, rock, or other object inside their shoe. While this may sound like a minor complaint, inexplicable sensations should always be investigated. The feeling of having a pebble in the shoe, for instance, is also a symptom of Morton’s neuroma, a closely-related medical condition that has no cure.

Metatarsalgia is not always easy to identify or diagnose. In many cases, metatarsalgia-related symptoms disappear or dissipate without intervention. However, anyone who experiences long-lasting foot pain—or foot pain that lasts for more than a few days—should schedule an appointment with their podiatrist.

Treating Metatarsalgia

Since many metatarsalgia-related symptoms are not specific to metatarsalgia, your podiatrist may have to conduct a brief physical examination to make a definitive diagnosis. If a physical examination is not sufficient, you may also be asked to sit for an X-ray or MRI scan.

While physical examinations can be uncomfortable, and imaging tests can be time-consuming, they are often necessary steps in ensuring that patients do not have comparatively serious and potentially disabling conditions.

After metatarsalgia is confirmed, your podiatrist may recommend any of the following treatments:

Custom Orthotics

Custom orthotics are prescription footwear devices. They are custom-fitted to your feet, and they can be used to correct a wide range of gait- and pain-related problems.


Over-the-counter pain medications can be used to relieve metatarsalgia-related swelling and metatarsalgia-related pain.


Metatarsalgia can usually be treated conservatively, without any need for surgery. However, surgery might be necessary if your metatarsalgia has been complicated by hammer toe or another foot-related condition. During metatarsalgia surgery, your podiatrist will typically realign displaced metatarsal bones while mitigating other complicating factors.

Dr. P. Roman Burk
Providing experienced private practice podiatry services in the Caldwell and Meridian, ID area since 2007.