Some questions answered
Metatarsalgia is pain in the ball of the foot. It is usually felt in the sole of the foot and sometimes feels like “walking on pebbles”. Other people feel a more diffuse vague pain, ache or burning. Some people have trouble around only one or two toes, others have it throughout one or both feet.
Anything which puts extra stress on the front of the foot can cause metatarsalgia. Common examples are:
A bunion or arthritis in the big toe can weaken the big toe and throw extra stress onto the ball of the foot. This can also happen after an operation on the big toe, such as a bunion correction.
A stretched or irritated nerve in the ball of the foot (interdigital neuroma) or behind the ankle (tarsal tunnel syndrome) can produce pain in the ball of the foot. Diabetes can also produce problems with the small nerves in the foot leading to a burning pain.
Athletes or walkers occasionally get stress fractures of the metatarsal bones.
Arthritis, gout or inflammation of the joints in the ball of the foot (metatarso-phalangeal joints) can produce local pain.
As you can see from the list above, some causes of metatarsalgia can be prevented by :
However, many causes of metatarsalgia just happen and cannot be prevented
Try to take the pressure off your feet as far as possible.
Other things you could try:
If none of these simple measures help your pain and this is interfering with your normal activities, it is worth consulting your Orthopaedic Foot and Ankle doctor. They may be able to help you, and at times further tests or an operation is thought necessary.
Many causes of metatarsalgia can be diagnosed by listening carefully to your complaints and examining you carefully, especially your foot. A simple test of the urine will check for early diabetes. Blood tests for inflammation, arthritis, diabetes or gout may be useful. An Xray of your foot may show a problem in the bones or joints.
Most people will not need any other tests. However in a few people, more complicated tests such as a bone scan, magnetic resonance (MR) scan, foot pressure measurements or nerve tests may be helpful in diagnosing a difficult problem.
Even after tests the cause of your problem may not be known for certain.
The simple measures outlined above will be re-emphasised by your professional adviser, especially about weight and shoes! Treatment can be offered for any disease such as diabetes, gout or arthritis. An insole to share the weight more evenly about your foot may be prescribed. An injection of steroid into an inflamed joint or around an irritated nerve may reduce inflammation and pain. However caution is to be taken for not to take repeated steroid injection as it might be more harmful. Exercises may improve stiffness.
The great majority of people with metatarsalgia will be helped by the measures outlined above. In a few people an operation may help:
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