Article by J.Miller, S.Armfield

What is Metatarsalgia?

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

The metatarsal bones design equally shares the weight of a person during walking and daily activities. When you disrupt this delicate balance between bones, the result can be mild to intense foot pain, plus ultimately foot deformity. The term metatarsalgia refers to the number of problems people can experience in this area.

Causes of Metatarsalgia

The causes of metatarsalgia pain attribute to several 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 descends 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 unevenly distributed weight on your foot,
  • Ageing, which tends to thin out or shift the fatty tissue of the footpad,
  • 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,
  • Small toe box shoes, which cramp and compress your toes.

Symptoms of Metatarsalgia

The main symptom of metatarsalgia is a 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 there is foot impact, such as running.

Metatarsalgia Treatment

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

Footwear Orthotics or Metatarsalgia Accessories

metatarsal domes

  • 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.


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 foot’s toes and ball. Fashion designers are very inconsiderate of people suffering from 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 reduce the symptoms but do not correct the main “postural” reasons for irritation, so a recurrence is likely. Please consult your doctor before taking these drugs.

Corrective Metatarsalgia Exercises

Relief and Prevention

PhysioWorks physiotherapists have designed dynamic corrective foot posture exercises that they have been prescribing and fine-tuning over the past decade. These exercises aim to correct the dynamic muscle control of your foot. Ideally, if we can help you retrain your foot muscles, you won’t need to wear shoes with orthotics to solve your problem passively.

metatarsalgia treatment

Our foot muscles are ordinarily effective and efficient. It is common for these muscles to 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.

Surgery for Metatarsalgia

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