What is Metatarsalgia?

What is Metatarsalgia

Your ego used to be the only thing that got bruised during pickup basketball games. But lately, the jump’s gone out of your jump shot. You can still leap, but landing is pure torture. What’s more, running and even walking cause the same burning pain on the bottoms of your feet. If this sounds familiar, you may have metatarsalgia  a condition marked by pain and inflammation in the ball of your foot.

Metatarsalgia frequently affects runners and other athletes who participate in high-impact sports. That’s because excessive amounts of running or jumping put extra stress on the metatarsals — the long bones located in the front part of your feet just below your toes. People with certain foot shapes that create more stress on the metatarsal bones also may have these problems.

Although generally not serious, metatarsalgia can sideline you. Fortunately, conservative treatments such as ice and rest can often relieve symptoms. And proper footwear, along with shock-absorbing insoles or arch supports, may be all you need to prevent or minimize future problems.

Symptoms

The main symptom of metatarsalgia is pain in the ball of your foot the part of the sole just behind your toes. The pain may be sharp, aching or burning. You may feel it in the area around the second, third and fourth toes or only near your big toe.

Other symptoms of metatarsalgia may include:

• Pain that gets worse when you stand, walk or run and improves when you rest
• Sharp or shooting pain in your toes
• Numbness or tingling in your toes
• Pain that worsens when you flex your feet
• A feeling in your feet as if you’re walking on pebbles or have a bruise from a stone
• Increased pain when you’re walking barefoot, especially on a hard surface

Sometimes these symptoms develop suddenly especially if you’ve recently increased your usual amount of running, jumping or other high-impact exercise but problems are more likely to develop over a period of months.

Causes

In each foot, five metatarsal bones run from your arch to your toe joints. The first metatarsal is shorter and thicker than the other four bones, which are usually similar in size. During the push-off phase when you walk, jump or run, your body weight is transferred to your toes and metatarsals. The first and second metatarsal bones take the brunt of this force, which can be as much as 275 percent of your body weight.

Most metatarsal problems develop when the impact load or the mechanics of your foot affect the way your weight is distributed. This can put excess pressure on the metatarsals, leading to inflammation and pain, especially in the metatarsal heads the rounded ends of the bones that connect with your toe bones.

Sometimes a single factor can lead to metatarsalgia. More often, several factors are involved, including:

• Intense training or activity.
  Runners have the highest incidence of metatarsalgia, primarily because the front of the foot absorbs more force when running than during any other activity as much as 110 tons of force per mile. But anyone who participates in a high-impact sport is at risk. Training intensely or for long periods puts even more stress on the metatarsals, often leading to chronic irritation and inflammation.
• Certain foot shapes.
  A high arch can put extra pressure on the metatarsals. So can having a second toe that’s longer than the big toe, which causes more weight than normal to be shifted to the second metatarsal head.
• Hammertoe.
  This foot problem can develop when high heels or too-small shoes prevent your toes from lying flat. As a result, one of your toes usually the second curls downward because of a bend in the middle toe joint. This contraction depresses the metatarsal heads.
• Bunion.
  This is a swollen, painful bump at the base of your big toe. Sometimes the tendency to develop bunions is inherited, but the problem can also result from wearing high heels or too-small shoes. Bunions are much more common in women than in men. A bunion can weaken your big toe, putting extra stress on the ball of your foot. Sometimes surgery to correct a bunion can also lead to metatarsalgia.
• Excess weight.
  Because most of your body weight transfers to your forefoot when you move, even a few extra pounds mean more pressure on your metatarsals. Sometimes losing weight reduces or eliminates symptoms of metatarsalgia.
• Poorly fitting shoes.
  High heels, which cause more weight to be transferred to the front of the foot, are one of the most common causes of metatarsalgia in women. Shoes with a narrow toe box or athletic shoes that lack support and padding also can contribute to metatarsal problems.
• Stress fractures.
  Small breaks in the metatarsals or toe bones can be painful and change the way you put weight on your foot.
• Morton’s neuroma.
  This noncancerous growth of fibrous tissue most often occurs between the third and fourth metatarsal heads. It causes symptoms that are similar to metatarsalgia and can also contribute to metatarsal stress. Morton’s neuroma frequently results from wearing high heels or too-tight shoes that put pressure on your toes. It can also develop after high-impact activities such as jogging and aerobics.
• Aging.
  As you grow older, the fat pads on the balls of your feet become thinner. This makes the metatarsal bones more susceptible to injury.

Risk factors

Almost anyone can develop metatarsalgia, but you’re at higher risk if you:

• Participate in high-impactsports. Metatarsalgia is most likely if you’re a runner or participate in other sports that involve running or jumping, such as soccer, tennis, baseball, football or basketball. Swimming and cycling, which don’t put pressure on your forefoot, aren’t likely to cause metatarsalgia.
• Wear high heels or shoes that don’t fit properly. High heels transfer extra weight onto the front of your foot, and shoes that are too tight can compress your toes. Wearing athletic shoes that aren’t well padded or that aren’t appropriate for a particular sport for example, playing basketball in tennis shoes also can put you at risk of metatarsalgia.
• Are overweight. Extra pounds put more pressure on your metatarsals.
• Have other foot problems. Certain foot shapes such as high arches, a long second toe or unusually long metatarsals can contribute to metatarsalgia. So can conditions such as hammertoe, Morton’s neuroma, arthritis and even gout. These can cause pain and inflammation that change the way you walk and the distribution of weight in your feet.

Ball of Foot Pain

Ball of Foot Pain

When people complain or suffer from pain of the ball of the foot, they are most likely suffering from a condition known as Metatarsalgia. Any pain in the region just under the toes to the arch area is known as ball of foot pain. It is a very common condition affecting millions of people.

Metatarsalgia is usually caused by unnatural pressure on the area over time. This pressure can lead to inflammation in the metatarsals and may manifest itself in acute, chronic, or recurrent pain. One of the most prominent contributory factors is actually improperly fitted footwear. This is more common with women because of the many different styles of women’s shoes, but anyone not wearing a properly fitted and supportive shoe is also at risk for Ball of Foot Pain. The main problem occurs when narrow toe shoes force the ball of the foot into a smaller amount of space that it naturally needs. The changes the mechanics of walking and can lead to damage not only in the foot but also in the lower leg.

There are other factors involved in ball of foot pain but none so obvious as improper fitting shoes. Not only narrow toe boxes and high heels play a role in the condition but participating in exercise without proper support from  athletic shoes can do equal or worse damage. When we fit ourselves with the latest athletic shoes we often give ourselves a false sense of security regarding injury. This becomes more of a problem as we age and the layer of fat in the balls of our feet begin to thin out. It is very important to investigate the use of custom orthotics or arch supports if you experience any symptoms of Metatarsalgia.

However, the treatments for this pain will vary depending on the actual source of the discomfort. So the first thing to do when suffering symptoms is to properly identify them. If there is any swelling, pain, or discomfort in the ball of the foot switching shoes to something which allows a wider space for the foot to occupy should relieve the pressure on the foot itself. This might rid you of your foot pain entirely if it is an isolated event. Over the counter anti-inflammatory medication is also helpful but if any symptoms recur or remain, it is a good idea to see a podiatrist instead of self diagnosing your own foot problems.

There are many products available in drugstores claiming to ease foot pain and if you choose the wrong approach you may risk further injury. There is no substitute for a true custom foot orthotic or arch support and your podiatrist can prescribe or recommend how you might benefit from orthoses.

Orthotic devices are designed to not only relieve the pressure on the ball of the foot but to actually bring the entire foot into proper alignment to allow a normal gait and correct any maladies from the foot up through to the lower back. However, regardless of any advertisements you might see, there is no custom foot orthotic that can be fabricated for your foot without a 3-D mold of your own feet. This is not a complicated process and a foot cast kit can be sent right to your home. The point here is that adding a pre-made insert to your shoe might sound like a great idea but cannot possibly match the shape or condition of your foot with 100% accuracy.