Metatarsalgia

Metatarsalgia, also known as stone bruise, is a type of pain and inflammation that occurs in a part of the foot known as the metatarsal (ball of foot). It often occurs in the metatarsal heads – where the three middle toes meet the ball of the foot. It is a common problem which can affect the bones and joints of the metatarsals.

Most commonly, the first metatarsal head is affected – the ball of the foot just behind the big toe.

  • A burning pain
  • Sharp aching
  • Pain in the ball of the foot, this is the metatarsal region, which is just behind the toes
  • Pain that can occur near the toes
  • Pain that increases when walking in bare feet, and even more so when walking on a hard surface
  • Pain that worsens when standing or moving around but decreases when the weight is taken off the feet.
  • Shooting pain in the toes
  • Tingling sensation in the toes
  • Footwear that doesn’t fit properly – footwear that is tight around the toes or has high heels that can add pressure on the ball of the foot as it is forced into a tight space.
  • Overweight people – may suffer this pain as the excess weight can put strain on the foot.
  • Age – the pad of fat that protects the foot can get thinner as a person ages; metatarsalgia can subsequently develop as the foot has less protection from the strain of impact and load.
  • High impact exercise – people who run or play high impact sports are at risk of metatarsalgia. When we are running our feet absorb large amounts of force.
  • Shape of the foot and toes – having a high arch in your foot or a second toe longer than the big toe can add to the pressure on the metatarsals.
  • Stress fractures – these are small breaks in the toe bones or metatarsals. They can cause pain when weight is put on the foot – the individual compensates by changing the way they put weight on his/her foot.

The following are medical conditions which can cause Metatarsalgia:

  • Bunion – this is a painful swollen bump that occurs at the base of the big toe. It weakens the big toe, which results in increased stress on the ball of the foot. This condition can be caused by wearing shoes that are too small, or can be inherited. It is more common in women than men.
  • Rheumatoid Arthritis – swelled joints in the foot, or gout can cause Metatarsalgia.
  • Build up of fluid in the foot.
  • Morton’s neuroma – this is a growth of fibrous tissue of one of the nerves between the metatarsal heads. Morton’s neuroma has very similar symptoms to Metatarsalgia and can cause further stress to the metatarsals.
  • Diabetes – the small nerves in the foot can become irritated, thus causing Metatarsalgia

The following approaches may help ease discomfort and/or pain:

  • Apply ice to the area several times a day each time for approximately 15-20 minutes. Wrap the ice in something to protect your skin – do not let the ice touch the skin.
  • Take over the counter (OTC, no prescription required) anti-inflammatory medicines such as ibuprofen, this will reduce the inflammation and relieve the pain.
  • Avoid high impact sports and exercise that puts pressure on the feet. Try something lighter on the feet, such as swimming or cycling.
  • Try to keep pressure off the feet, when resting try putting your feet up.
  • Be sure to exercise your ankle and keep stretching the Achilles tendon.
  • Use fitted insoles (orthotics) as these will reallocate pressure, improve foot function and guard the ball of your foot.
  • Use metatarsal pads as they reduce pressure from the metatarsal bones.
  • Use shock absorbing insoles to relieve pressure when walking.
  • Arch supports may be recommended by your doctor if fitted insoles were not effective. There are various sizes which can be bought over the counter, or you can have ones custom made to fit your foot.
  • Change to better fitting flat headed shoes.