What is metatarsalgia?
This is a condition in which the ball of your foot becomes painful and may sometimes develop callosities.
What causes metatarsalgia?
There are multiple causes ranging from high impact activity like running to having a foot shape with high arches or a long second toe that increases the pressure through the ball of your foot. High heeled shoes and narrow shoes also increase the pressure through the ball of your foot and can lead to metatarsalgia.
What are the symptoms?
The symptoms include an aching or burning pain under the ball of your foot. Patients often describe a feeling of walking on pebbles. There can be associated hard skin (callosities) that form under the ball of your foot.
Symptoms are worse after activity, particularly barefoot activity and high impact activity.
How is it diagnosed?
The diagnosis is mainly based on the history of the pain and the clinical examination of the foot shape. X-rays are useful to assess the bony alignment and can identify causative problems.
What treatments are available?
Initial treatment involves wearing wide soft shoes with minimal heel to allow the foot to spread out reducing the pressure on ball of the foot. Modification of activities with reduced impact sports like running. Orthotics with a metatarsal dome support can be useful. If you are overweight then weight loss can help with metatarsalgia symptoms.
What is the surgical treatment?
If all other management fails then surgery to correct the problem leading to metatarsalgia can be carried out. The surgical treatments very much depend on the underlying cause but may involve osteotomies to change the shape of the bones in the foot to reduce the pressure. They may also involve surgery to lengthen the calf to reduce the pressure through the ball of the foot when walking and running.