In most of my videos, I like to discuss a very specific causes of foot pain. Today I'm going get a little more general. My name is Dr. Andrew Schneider, and I'm a podiatrist in Houston TX. Pain in the ball of your foot can be due to a very specific reason, such as a Morton's neuroma, capsulitis or a planter plate rupture. In today's video, I will discuss pain in the ball of your foot due to metatarsalgia.
Metatarsalgia is the general term that is used to describe an overuse injury causing pain in the ball of your foot. It causes pain that could be described as sharp, aching, or burning. That pain worsens when you stand, walk, or run. This is particularly true if you're doing so on hard surfaces.
The pain can occur for several reasons. First is excessive running or training. The ball of the foot absorbs shock when you run. This can lead to development of metatarsalgia. This is particularly true if your shoes don't fit well or are old and worn.
Certain foot mechanics can increase the strain on the ball of your foot. This is the case with a high-arched foot, where lots of pressure is placed at the ball of your foot. It can happen if your second toe is longer than your great toe, known as a Morton's toe. Metatarsalgia can be caused by a bunion or hammer toe deformity that increases the pressure at the ball of your foot. Wearing certain shoes, such as high heels or Western boots, put more pressure on the ball of your foot. This can serve as another cause of metatarsalgia. There can also be more significant causes, such as a stress fracture of a metatarsal bone that weakens due to repetitive and persistent pressure.
To diagnose metatarsalgia, I'll take an x-ray in the office. This will help to rule out some causes, such as a stress fracture. I may also use a diagnostic ultrasound unit to assess the soft tissue in the ball of your foot.
Most cases of metatarsalgia are managed without surgery. If you are getting pain during exercise or activity, you may need to take a small break until we're able to treat your pain. You also may want to consider new running shoes and aware of the surface that you're running on. Try to avoid harder surfaces, such as asphalt and concrete. Ice is a natural anti-inflammatory and is helpful to reduce the inflammation causing the ball of foot pain. Remember, however, not to use ice for more than 20 minutes at a time. The inflammation that is causing your pain can also be treated with anti-inflammatory medication. I generally prescribe this medication to reduce the inflammation in the ball of your foot.
If you wear high heels, it's helpful to lower the heel height. This will reduce the pressure on the ball of your foot. If you have to wear high heels, consider adding a metatarsal pad to add support to the ball of your foot. Speaking of support, it is very useful to have a custom orthotic made. The orthotic is a custom insole designed to redistribute pressures of your feet and to avoid any one area for being overloaded. A custom orthotic is the best long term treatment for metatarsalgia, especially when it's caused by your foot mechanics.
There is no surgical treatment metatarsalgia itself. If the pain in the ball of your foot is due to a foot deformity, such as a bunion or a hammer toe, surgery might be necessary to correct the deformity. In most cases, the surgery will also resolve the Metatarsalgia that results from it.