The Center for Podiatric Care and Sports Medicine

Metatarsalgia: What It Is & What to Do

Posted by on Thursday, October 23rd, 2014


The metatarsals are the five long bones running down the foot, connecting the ankle and toe bones. The five metatarsals help the body move along uneven ground and reduce the total carrying load. Injuries to these bones may be acute or slow-developing in nature–occurring due to direct impact, twisting movements, overuse, or faulty foot mechanics. Podiatrists at The Center for Podiatric Care and Sports Medicine in New York City help athletes, soldiers, dancers, and retail workers with foot problems associated with these bones.

The long bones connecting ankle to toe are the metatarsals. Pain on the top may be due to a fracture, whereas pain below is likely inflammation-related. Image Source:

What Is Metatarsalgia?

“Metatarsalgia” refers to a group of symptoms that include:

– Localized pain in the ball of the foot, just before the toes

– The sensation that you’re always walking on stones

– Sharp or shooting pains during weight-bearing activities like running, walking, or standing

– Flexing the toes sometimes causes tingling or numbness

What Causes Metatarsalgia?

When the foot joints swell up, this puts pressure on the nerves and causes strange sensations. Excessive pronation is the most common issue we treat alongside metatarsalgia. Similarly, a study published in the Journal of the American Podiatric Medical Association in 1993 found that recreational walkers and hikers often suffer from pain in the metatarsals due to “structural anomalies and faulty biomechanics” such as limb length discrepancy and abnormal pronation. Overstretching the transverse ligaments and poor arch support are known contributing factors as well. A NY podiatrist can usually tell if you have abnormal wear patterns by looking at callus formation on the feet. Calluses under the metatarsal heads in the forefoot or under the anterior part of the heel provide evidence that the foot is not wearing evenly.

What Treatments Are Available for Metatarsalgia Foot Pain?

Fear not–treatment for this type of pain is pretty non-invasive. Immediate pain relief and reduction of inflammation are our first priorities. Changing improper footwear has to be included in the original treatment, and aggravating activities have to be limited or stopped. Anti-inflammatory pain medication and metatarsal pads for the shoes are good first steps. Long-term control is facilitated through custom orthotic inserts to address structural anomalies without surgery. Often, we’ll tell people to avoid heels over 1.5 inches or shoes with a tight toe box. Our physical therapy team can guide you through calf stretches and strengthening exercises, which will provide long-term relief. Custom orthotics and forefoot padding are necessary for cushioning, absorbing shock, and supporting the foot arches.

Contact a NY Podiatrist

You can limit your walking and take over-the-counter anti-inflammatory medication at home, but you won’t find the long-term relief you need without visiting a foot doctor. The Center for Podiatric Care and Sports Medicine offices in Manhattan and Westchester offer a few specialties you may not find elsewhere. For starters, we have a gait analysis lab, which uses computer technology attached to a pressure-sensing treadmill to properly detect and diagnose any foot or gait abnormalities. We also offer patients the latest technology for quick resolution of acute pain. The Extracorporeal Pulse Activation Technology (EPAT) system is especially effective at treating conditions like heel pain or ball-of-the-foot pain. Contact us to schedule an appointment to discuss your foot pain today.


If you have any foot problems or pain, contact The Center for Podiatric Care and Sports MedicineDr. Josef J. GeldwertDr. Katherine Lai, Dr. Ryan Minara and Dr. Mariola Rivera have helped thousands of people get back on their feet. Unfortunately, we cannot give diagnoses or treatment advice online. Please make an appointment to see us if you live in the NY metropolitan area or seek out a podiatrist in your area.