About Your Diagnosis
Metatarsalgia is a term used to describe pain in the ball of the foot. This type of forefoot pain can be confused with many other causes of forefoot pain, so it is important to ensure the diagnosis is correct. Specifically, metatarsalgia refers to inflammation or pain of the metatarsal heads. Or in other words, “bone pain.” This pain usually is due to increased forces through the forefoot, such as when wearing high heels or when the normal fat pad has shrunk. Increased pressure through the ball of the foot results in inflammation of one or more of the metatarsal bones. Diagnoses that can be confused with metatarsalgia include Morton’s neuroma (nerve pain), sesamoiditis, and synovitis.

Living With Your Diagnosis
Metatarsalgia usually can be managed without surgical intervention, but it may persist for several months or even years. Only after all nonsurgical treatments have failed should you consider surgical intervention. Many times a simple pad or soft shoe insert makes a dramatic difference. You must stop wearing the offending shoe to prevent a recurrence. Appropriate shoes are necessary to provide adequate cushioning for the painful foot.

Metatarsalgia is managed with appropriate footwear such as running shoes, soft shoe inserts, and sometimes custom soft orthotic devices. All are designed to reduce friction and pressure through the forefoot. The soles of shoes can be modified to further reduce pressure by means of placement of a
metatarsal bar or rigid rocker on the sole. When callouses are present, regular trimming may provide dramatic relief. Medications and diet are not as effective as local care and do not seem to alter the course of this painful condition. Surgical intervention before adequate attempts at conservative therapy may result in unpredictable results and actually worsen the condition.

The DOs
• Eliminate as much pressure and friction as possible by changing the type and style of shoes you wear.
• Switch to non-weight-bearing forms of exercise, such as cycling or swimming.

The DON’Ts
• Avoid wearing fashionable but impractical shoes.

When To Call Your Doctor
• If the pain becomes constant or does not respond
to conservative therapy.


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