What is is?

Metatarsalgia is not an injury; it is a symptom or a group of symptoms. These may include pain in the ball of the foot, with or without bruising, and imflammation. It is often localised in the metatarsal heads or it may be more isolated in the area near the big toe. One of the hallmarks of this disorder is pain in the ball of the foot during weight bearing activities. Sharp or shooting pains in the toes also may be present, and pain in the toes and/or balls of the foot may be increased when the toes are flexed. Accompanying symptoms may include tingling or numbness in the toes. It is common to experience acute, recurrent or chronic pain as a result of this problem.

What causes it?

Metatarsalgia develops when something changes or threatens the normal mechanics of the foot. Ultimately, this creates excessive pressure in the ball of the foot, and that leads to metatarsalgia. Some of the causes of metatarsalgia include:
Being overweight: the more weight is brought to bear on the foot, the greater the pressure is on the forefoot when taking a step. As men and women age, the fat pad in the foot tends to thin out, creating less cushioning and making them more susceptible to pain in the ball of the foot.
Wearing shoes that do not fit properly: shoes with a narrow or tight toe box, or shoes that cause a great deal of pressure to be put on the ball of the foot (high heels, for example) are often the cause of metatarsalgia. Because such footwear inhibits the walking process and forces the wearer to alter their step to adjust to the shoe, the mechanics of the foot are compromised.
Certain foot shapes contribute to metatarsalgia: a high arched foot, or a foot with an extra long metatarsal bone can cause pressure on the forefoot region and contribute to pain and inflammation there.
Claw toes or hammertoes can press the metatarsals toward the ground and cause stress on the ball of the foot.
Arthritis, gout and other imflammatory joint disorders can produce pain in the ball of the foot.

What is the treatment?

Some of the best treatments come from being proactive. Having the patient keep their body weight at a healthy level and wear shoes that fit properly, particularly in the toe area. Patients should avoid high heels whenever possible.

For patients with metatarsalgia one or more of the following measures should be taken:
Orthotics help feet function more normally inside the shoe. Metatarsal support should be considered in the design of the orthotics.
Wearing appropriate footwear: clinicians should take a look at the footwear of their patients.
Advise the patient to keep their body weight in a healthy range.
Rest and ice.

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