Ouch…the Balls of my Feet Hurt!


“The balls of my feet burn and pain a lot, when I walk these days, and I can’t understand why!” “When I wear a certain height shoes, I feel a lot of discomfort to the front of my feet.” “I dunno what’s going on with me, but don’t care what kind of shoes I wear, I feeling like I walking on gravel!” All common cries that amount to the same thing…PAIN!

The different expressions of pain or discomfort mentioned reflect a condition called METATARSALGIA, which is felt in the ball of the feet or forefoot area. It’s another popular ailment that many people simply know nothing about, but which is growing in frequency at our Clinic. Although it is generally not too serious, metatarsalgia can sideline you.


It is a painful foot condition in the metatarsal region of the foot, located just before the toes, commonly referred to as the ball-of-the-foot. Metatarsalgia is a known foot disorder that can affect the bones and joints in that area. It is an ailment that is also marked by inflammation.

The term is derived from the name of the bones in this part of the foot, that is, the metatarsals. These are the long bones at the base of each toe. The metatarsal bones run through the forefoot from the arch in the mid-foot, to the base of the toe joints.

Each time we take a step forward, we push-off with our toes and the ball of the foot, forcing ourselves forward. To do this, we force 100% of our body weight on these structures. If they are not aligned perfectly, or if we have insufficient fatty padding, we experience the sometimes searing pain in the ball of the feet.


The key symptom of metatarsalgia is a sharp, aching, burning or shooting pain. It may also be felt in the area around the second, third and fourth toes, or only near the big toe. Other main symptoms could include:

  • Pain that worsens when you stand, flex your feet, walk or run and improves when

you rest.

  • Tingling or numbness in the toes
  • A feeling in your feet as if you’ve been walking on pebbles
  • Increased pain when walking barefoot, especially on a hard surface
  • Callousing under the second, third or fourth toes.


You may experience metatarsalgia if you’re physically active (athletes for example), and your feet are impacted by excessive walking, running and jumping, or some of the following:

  • Extra strain or pressure on the ball of the foot.
  • High arched feet, which can be genetic
  • Flat feet, another factor that may be hereditary
  • Improper footwear (high heels in particular), or worn out shoes
  • Overweight or obesity
  • Incorrect posture during movement
  • Trauma, such as from a car accident
  • Deformed or crooked toes
  • Strained arches – excessive pronation or supination
  • Nerve disorders
  • Rheumatoid arthritis
  • Stress fractures
  • Fluid accumulation in the foot
  • Muscle fatigue.


The first step in the treatment of metatarsalgia is to identify the cause and work on same. Specific lines of treatment could consist of:

  • Medications
  • Use of metatarsal pads or cushioning.
  • Arch Supports (orthotics) or metatarsal pads, which fit inside the shoes and help minimize stress (shock absorb) and improve foot function.
  • Shock-absorbing insoles, which are cushioned inserts that fit inside your shoes to help cushion shock.
  • Surgery for realignment of the metatarsal bones is advised if all other measures fail, and especially if you have a bunion deformity.

Self Care

Self-care measures are known to be of great help for metatarsalgia. Here are a few main home care guidelines:

  • Wear well-fitting footwear, with moderate heel height and a wide toe-box.
  • Cut down on running and extended walking to rest the foot.
  • Massage the area with the finger tips
  • Ice the location. It can be done for approximately10 minutes to the painful area, no more than every four hours.

  • Do exercises such as stretching the calf muscles.

If conservative treatments fail and your symptoms persist, the doctor may recommend a surgical option to rebalance the metatarsal heads and reduce abnormal pressure on the ball of the foot. During surgery, the metatarsal bone is cut just behind the toe. This procedure is called an osteotomy. Because of complications that may be involved as with any surgery, one should make sure that any possible risks are clearly understood.

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