Unlike most Americans who cannot wait to come home at night and kick off their shoes, some people with Metatarsalgia actually experience more pain when they walk in their socks or barefeet. Metatarsalgia is condition characterized by a sharp aching or burning pain and inflammation in the ball of the foot. It affects the metatarsal heads, the bones that make up the ball of the foot. The first metatarsal head behind the big toe is the most common area affected but it can also affect the other toes, the entire foot, or both feet. Other symptoms include tingling or numbness in the toes, pain around the second, third and fourth toes or only near the big toe, increased pain when you walk, run or jump, or when you stand or flex your feet. Patients with this condition often feel like they have a stone in their shoe or that their socks are wadded up causing them to walk on the side of their foot to avoid pressure.
Metatarsalgia can affect males and females of all ages. It is primarily related to repetitive stress and impacts on the foot, and often experienced by people who participate in intense physical activities or training such as running, tennis, soccer and basketball. Metatarsalgia generally occurs from a single cause but other factors that may contribute to this condition. These include wearing ill-fitted shoes (high heels), having certain foot and toe shapes (high arches, a second toe that is longer than the first metatarsal), being overweight, or older age. It can also be attributed to a stress fracture or other foot deformities like a hammer toe or bunion, or from Morton’s Neuroma (a fibrous tissue around a nerve between two metatarsal heads), diabetes, Rheumatoid Arthritis, fluid in the foot and gout.
There are a variety of home remedies that should be tried prior to contacting your physician or podiatrist. Some of the things that can be done include wearing proper fitting shoes indoors and outdoors, avoiding pressure and impact loads, resting your feet and keeping them elevated, applying ice throughout the day, taking anti-inflammatory drugs (such as ibuprofen), using metatarsal pads or sock absorption pads or arch supports.
If your pain persists for a month or so, schedule an appointment with your podiatrist for a diagnosis and proper treatment. There are a variety of problems that can cause symptoms similar to Metatarsalgia. Most likely it will be necessary to do a gait analysis to identify the parts of the foot that are receiving pressure, image tests (X-ray or MRI) or ultrasound to confirm if there are fractures or if the problem is related to a metatarsal drop or improper length. Imaging will also help your doctor determine if the pain is being caused by a Morton’s Neuroma. Blood tests may also be necessary to rule out gout, diabetes or arthritis.