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Article by John Miller

What is Metatarsalgia?

The most common source of Ball of Foot pain is metatarsalgia. The term is derived from the medical term metatarsals (long bones of the foot) and algos (the Greek word meaning pain).


The metatarsal bones are designed to equally share the weight of a person during walking and daily activities. When this delicate balance between bones is disrupted, the result can be mild to intense foot pain. The term metatarsalgia refers to the number of problems people can experience in this area.

Causes of Metatarsalgia

The causes of metatarsalgia pain can be attributed to a number of factors, from bone abnormalities to systemic diseases such as diabetes.

The most common cause is an alteration of the posture in the long bones (metatarsals) of the foot. These bones absorb the weight during walking, and if one of the bones falls down through weakness or lack of support, is abnormally long or fractured from stress, it will create dysfunction among all bones.

Other causes include:

  • An enlarged metatarsal head.
  • Arthritis or any degenerative disease of the joints.
  • Systemic conditions such as diabetes, which can cause nerve-type pain in the foot.
  • Calluses or skin lesions that cause the weight on the foot to be unevenly distributed.
  • Ageing, which tends to thin out or shift the fatty tissue of the foot pad.
  • Sports that place tremendous pounding on the ball of the foot, like jogging.
  • Ill-fitting shoes that put pressure on the bones of the feet.
  • Shoes with small toe boxes that cramp your toes.

Symptoms of Metatarsalgia

  • The main symptom of metatarsalgia is pain in the ball of the foot, and is most pronounced when walking (especially on your toes) or engaging in sports. Since the foot supports the body in all its activities, chronic pain in the ball of the foot impacts the ability to perform ordinary tasks.
  • Discomfort when wearing shoes and socks.
  • Pain during activities where an impact is applied to the foot, such as running.

Relief and Prevention of Metatarsalgia

Treatment of metatarsalgia depends on the cause. Here are a few suggestions to help alleviate the pain and discomfort associated with this condition:


Taking a good look at the shoes you wear is the first step in eliminating and preventing the painful condition of Metatarsalgia. The objective is to find appropriate footwear that distributes the weight and pressure evenly across the foot, rather than concentrates it in the toes and ball of the foot. Fashion designers are very inconsiderate of people suffering Metatarsalgia.


Massage the afflicted area to relieve swelling pressure, increase local circulation and reduce your pain.

Anti-inflammatory Medications

Over-the-counter medications such as Ibuprofen, Voltaren etc may help to reduce the symptoms but do not correct the main "postural" reasons for irritation so a recurrence is likely. Please consult your doctor prior to taking these drugs.

Footwear Orthotics or Metatarsalgia Accessories

  • Metatarsal domes or pads that help separate the foot bones and relieve pressure on the metatarsals.
  • Supportive foot arch orthotics and insoles to prevent the abnormal collapsing of the arch.

Corrective Metatarsalgia Exercises

foot pain

PhysioWorks physiotherapists have designed a dynamic corrective foot posture exercises that they have been prescribing and fine tuning over the past decade. The aim of these exercises is to actually correct the dynamic muscle control of your foot. Ideally, if we can help you to retrain your own foot muscles then hopefully you won't need to wear shoes with orthotics to passively solve your problem. 

Our foot muscles are designed to work effectively. It is common for these muscles to simply weaken and become lazy. The good news is that most foot muscle weakness can be retrained successfully within weeks. 

Please consult your physiotherapist for specific advice. Your physiotherapist will also inspect other reasons for your foot collapsing, such as muscle tightness or referred pain from your back.

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Surgery for Metatarsalgia

When metatarsalgia does not respond to these treatments, surgical solutions may be required. Consult your physiotherapist or a podiatrist for further options and considerations related to metatarsalgia.

Helpful Products for Metatarsalgia


Related Injury Information

General Information

Heel Pain

Traumatic Ankle Ligament Injuries


Foot Injuries

Bone Injuries

Degenerative Conditions

Soft Tissue Inflammation

Biomechanical Conditions

Nerve-Related Sources

Common Treatments for Metatarsalgia

  • Early Injury Treatment
  • Avoid the HARM Factors
  • Soft Tissue Injury? What are the Healing Phases?
  • Acupuncture and Dry Needling
  • Sub-Acute Soft Tissue Injury Treatment
  • Active Foot Posture Correction Exercises
  • Gait Analysis
  • Biomechanical Analysis
  • Balance Enhancement Exercises
  • Proprioception & Balance Exercises
  • Medications?
  • Orthotics
  • Soft Tissue Massage
  • Brace or Support
  • Dry Needling
  • Electrotherapy & Local Modalities
  • Heat Packs
  • Joint Mobilisation Techniques
  • Kinesiology Tape
  • Neurodynamics
  • Physiotherapy Instrument Mobilisation (PIM)
  • Prehabilitation
  • Strength Exercises
  • Supportive Taping & Strapping
  • TENS Machine
  • Video Analysis
  • FAQs about Metatarsalgia

  • Common Physiotherapy Treatment Techniques
  • What is Pain?
  • Physiotherapy & Exercise
  • When Should Diagnostic Tests Be Performed?
  • Barefoot Running: Your MUST READ Guide to the Pro's and Con's.
  • Can Kinesiology Taping Reduce Your Swelling and Bruising?
  • Heat Packs. Why Does Heat Feel So Good?
  • How Do You Improve Your Balance?
  • How Much Treatment Will You Need?
  • What are the Common Massage Therapy Techniques?
  • What are the Early Warning Signs of an Injury?
  • What is a TENS Machine?
  • What is Chronic Pain?
  • What is Nerve Pain?
  • What is Sports Physiotherapy?
  • What's the Benefit of Stretching Exercises?
  • When Can You Return to Sport?
  • Why Kinesiology Tape Helps Reduce Swelling and Bruising Quicker
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    Last updated 14-Feb-2019 10:44 AM

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