Forefoot Pain (Metatarsalgia)

What is Metatarsalgia?

Metatarsalgia refers to pain and inflammation in the ball of the foot, typically under the metatarsal heads (the area just behind your toes). It can affect one or multiple toes and is often felt during walking, running, or when standing for long periods.

What Can Cause Forefoot Pain?

Forefoot pain isn’t a single condition, it’s a symptom that can arise from several underlying issues:

Common Causes:

• Overuse or High-Impact Activity
  Repeated stress from running, jumping, or prolonged standing can lead to inflammation and pain in the metatarsal area.
• Footwear Choices
  – High heels place excessive pressure on the forefoot by shifting body weight forward.
  – Tapered or narrow shoes compress the toes and restrict natural toe spread, leading to joint irritation and deformities.
• Biomechanical Issues
  Flat feet, high arches, or abnormal pronation patterns can shift pressure to the front of the foot, overloading the metatarsals.
• Toe Deformities
  – Hammer toes, claw toes, and bunions can disrupt the alignment and function of the forefoot.
  – These issues often increase focal pressure and irritation in the metatarsal area.
• Fat Pad Atrophy
  As we age, the natural cushioning under the ball of the foot may thin, exposing metatarsals to more direct impact and discomfort.
• Neuroma
  A thickened nerve (commonly Morton’s neuroma) between the toes can mimic or contribute to forefoot pain.
• Arthritis
  Joint inflammation from osteoarthritis or rheumatoid arthritis can affect the small joints in the forefoot.

How to Reduce the Risk of Forefoot Pain

✅ Choose the Right Footwear:

• Avoid high heels. Heels over 2 inches shift too much pressure onto the forefoot. Over time, this can cause pain, joint irritation, and deformities.
• Avoid pointed or narrow shoes. Tapered toe boxes compress the forefoot and can worsen conditions like bunions or neuromas. Choose footwear with a round or wide toe box to allow natural toe alignment.
• Wear cushioned, supportive shoes. Look for shoes with shock-absorbing soles and good arch support to redistribute pressure evenly.

✅ Manage Activity & Body Mechanics:

• Avoid long periods of standing on hard surfaces without supportive footwear.
• Use shock-absorbing insoles or custom orthotics to improve weight distribution and reduce impact on metatarsals.
• Keep to a healthy weight to reduce mechanical overload on the forefoot.

✅ Address Underlying Conditions:

• Seek treatment for toe deformities, gait abnormalities, or flat feet early to prevent forefoot stress.
• Don’t ignore persistent pain – early diagnosis leads to better outcomes.

How We Can Help at Rowlands Podiatry

We offer comprehensive forefoot pain assessments, including:

• Detailed biomechanical and gait analysis
• Referrals depending on diagnosis
• Footwear and activity advice
• Custom orthotic design based on pressure mapping and foot posture
• Treatment plans at home and in the clinic using advanced technologies like Shockwave and MLS Class IV laser therapies

Depending on the Diagnosis, We May Recommend:

• Toe padding or offloading devices
• Shoe modifications or insole support
• Stretching/strengthening plans
• Referrals for medical imaging or orthopaedic input if structural damage is suspected

Don’t Let Forefoot Pain Stop You

Persistent pain in the ball of your foot isn’t something to push through. With expert assessment and targeted treatment, most cases of metatarsalgia are highly manageable.

📞 Book Your Biomechanical Assessment And Gait Analysis

✅ Book Online
📍 Based in Cambourne | Proudly supporting Cambridgeshire communities
📱 Call Us: 01223 926365
🌐 Visit: www.rowlandsfootcare.com