Causes & Treatments For Metatarsalgia (Forefoot Pain)

Patients with metatarsalgia experience pain and inflammation in the ball of the foot. It is an overuse injury usually occurring in athletes that do high-impact sports like track and field, tennis and soccer. These activities require heavy uses of the forefoot, thus subjecting to a high risk of the injury.



The pain does not happen immediately but gradually increases over a span of a few months. Left untreated, the pain would be aggravated with more walking and running. Sometimes, bursitis may also develop along with metatarsalgia.

Patients would feel a sharp, aching or burning pain in the ball of the foot likened to stepping on sharp pebbles. This follows with a numb, tingling sensation in the toes. You would notice that a callus, or hardened skin, is developed. Often diagnosed as a symptom to other problems, metatarsalgia usually comes with other forms of injuries.



Excessive side-to-side movement required by certain sports is one of the causes of metatarsalgia. However, this is not just a sports injury. Those with tight Achilles tendon, weak toe muscles, or wearing ill-fitting shoes over long periods of time can also cause the injury. Most often, it occurs with a combination of factors. These are some other possible factors:

  • High foot arch
  • Obesity
  • Compensating for previous foot injuries
  • Morton’s neuroma




The first course of treatment would be the RICE (Rest, Ice, Compression, Elevation). Patient should not put any weight on the foot at this point. It is advisable to get a professional to assist with proper stretching exercises to strengthen the foot and restore motion. Special footwear that has stiff soles and padding are also recommended to support the foot.


The doctor may recommend shaving the callus, but this method is just a temporary relief of pain. There is also a risk of bleeding from excessive debridement and the use of acids and chemicals. The callus is merely a reaction to the pressure on the foot that causes the pain. More importantly, the cause of the callus has to be determined to know the appropriate treatment for the long-term. Only in severe cases, the metatarsal bones may need to be surgically realigned.



The goal of therapy is to subside the inflammation and relief the pressure. One or more of these measures may be recommended to assist the recovery process:

  • ROM exercises
  • Swimming
  • Self-mobilization exercises
  • Using an orthotic device
  • Shoe modification with an orthotic support