Metatarsalgia is pain in the forefoot, or ball of the foot, in the area of the metatarsal bones (the bones that connect to your toes). Although the pain can feel like it is across the entire ball of your foot, most often it is only under one of the metatarsal heads. You can easily find out which one by pushing up underneath each metatarsal head with a thumb or finger until you feel the one that is painful. You may also feel a callus there. Metatarsalgia may also feel like a bone bruise, or as if you are walking on a pebble.

Causes

This is usually caused by either an alignment problem with the bones, whereby the one that is painful is generally lower than the others, or by a functional problem with the foot, whereby over-pronation causes excessive pressure on one or more of the metatarsal bones.

Treatment

The best way to treat this condition is to reduce, or eliminate, the pressure on the affected bone(s). This can be done one of several ways: a metatarsal pad can relieve some forefoot discomfort if placed properly inside the shoe. A hole cut in the shoe insole directly under the painful metatarsal can help relieve pressure. The best alternative usually involves custom orthotics to help control the over-pronation, with or without pads, along with proper running shoes.

Prevention

Wearing well-cushioned running shoes with soft insoles are important. Some over-the-counter insoles may be helpful.

Activity Restrictions

You shouldn’t run if it is painful. Doing so may lead to a worse injury, such as a stress fracture.