What Causes Pain The Ball Of The Foot (Metatarsalgia)?

August 12, 2023

Metatarsalgia is when an individual has inflammation and painful sensations in the ball of their foot, the region between the toes and foot arches. The metatarsals are the five bones positioned at the base of the toes. Symptoms of metatarsalgia include bruising, inflammation, and swelling in the metatarsal part of the foot. Tingling and numbness also frequently occur in an affected individual's toes. Some patients describe pain in the ball of their foot like having a pebble stuck in the inside bottom of their shoe. A physical examination, thorough medical history, and x-rays may be used to rule out other types of foot problems. Most cases of metatarsalgia are treated using conservative measures, including metatarsal pad use, wearing better shoes, and resting. Severe cases that are unable to be managed in other ways may require surgery for treatment.

Metatarsalgia has several possible causes. Learn about them now!

Distance Running

Individuals who participate in long-distance running or activities involving running long distances can develop pain in the ball of their foot as a result of their intense exertion. Track-and-field runners, football players, soccer players, tennis players, and baseball players are more likely to develop metatarsalgia than other individuals. When an individual runs or jogs, most of the force is absorbed by their metatarsals. Excessive force may be placed on the metatarsals when running or jogging if the individual is not wearing proper shoes that help absorb the force. Distance running can cause the metatarsal bones in the individual's foot to squeeze together. There are small nerves that sit in between the metatarsal bones become compressed as a result of the metatarsal bones rubbing together. The nerve becomes inflamed and causes the individual to feel painful sensations as a result. Individuals who are overweight and participate in distance running are more likely to be affected because of the excessive force the extra weight puts on their metatarsals.

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High Arch In The Foot

Specific foot shapes can cause an individual to be more likely to develop metatarsalgia, such as having high arches in the feet. An individual's foot arch is made up of their metatarsal bones, tarsal bone, and the tendons and ligaments that support them. An individual has a high foot arch if they step in water or other fluid barefoot, and their footprint shows the circle of their heel separately from the top part of their foot with the toes. A high foot arch in an individual means their body weight and activity force are distributed improperly, where they are concentrated on the heel and ball of their foot. This abnormal distribution of weight and force causes the metatarsal bones to compress the nerves that sit between them, causing inflammation and resulting in metatarsalgia. This condition can be avoided if an individual who has high foot arches uses shoe inserts, orthotics, or arch supports to help stabilize the heel, support their arch, and relieve some stress on the metatarsals.

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Poorly Fitting Shoes

An individual's metatarsalgia can be caused by their excessive use of poorly fitting shoes. Shoes are meant to support and protect an individual's feet. However, some individuals wear shoes simply due to fashion reasons without considering how well they serve their protective and supportive purposes. Shoes known to cause pain in the ball of the foot include high heeled shoes, shoes with a narrow toe box, and athletic shoes that do not provide enough support and padding for the individual's level of activity. Very narrow shoes can impair the natural and healthy distribution of weight in the feet. Narrow shoes press the metatarsal bones together, which is compounded with inappropriate weight and force distribution to cause an individual to experience pain in the ball of their foot. Due to the nature of gravity, shoes with an elevated heel, like high heels and wedges, cause most of the body weight and force to be placed on the front portion of the foot. Wearing these types of shoes too often can cause an individual to develop metatarsalgia.

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A hammertoe deformity may cause individuals to be more likely to develop pain in the ball of their foot as a symptom of their toe abnormality. Hammertoe describes a bending deformity that occurs in the first or second joints of the individual's second, third, fourth, or fifth toes. The toes appear to point in a downward direction instead of pointing straight forward in individuals with hammertoe. Hammertoe is caused by abnormal contracture or tightening of the tendons that hold the toe joints. All of an individual's toes perform functions important to the foot and even the spine. The toes are supportive because they keep in contact with the ground seventy-five percent of the time when an individual is walking. They help better distribute an individual's body weight throughout the foot by exerting pressure during movement. This mechanism of the toes helps support an individual's posture and upright balance. An untreated hammertoe deformity can cause the individual's metatarsal bones and toe joints to become misaligned, compromising the function of the toes and causing inflammation and pain.

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A type of foot deformity referred to as bunions can cause an individual to develop metatarsalgia. A bunion is a structural abnormality of the foot where a bony bump forms on the side of an individual's big toe. This causes the base of the big toe to stick outward and be wider than the rest of the foot. An individual may be born with bunions, or certain factors can cause them to develop one over time. When pressure is placed on the joint of the big toe over an extended period, the toe starts to angle inward toward the middle toe. This results in an alteration of the bone structure, causing the bunion bump to develop. An individual's bunion causes their forefoot alignment to become altered in a complicated fashion. This misalignment results in unhealthy areas of prominence in an individual's foot and distorts the functional anatomy of the forefoot. Individuals with bunions end up placing inappropriate force and weight on the metatarsal bones to alleviate the pain and pressure they feel when they place more weight on their bunion. This mechanism can result in the formation of metatarsalgia.

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