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Metatarsalgia
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Metatarsalgia

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Metatarsalgia a common foot disorder that can affect the bones and joints at the ball of the foot. Your ego used to be the only thing that got bruised during pickup basketball games. But lately, the jump's gone out of your jump shot - you can still leap, but landing is pure torture. What's more, running and even walking cause the same burning pain on the bottoms of your feet. If this sounds familiar, you may have metatarsalgia - a condition marked by pain and inflammation in the ball of your foot.

Metatarsalgia frequently affects runners and other athletes who participate in high-impact sports. That's because excessive amounts of running or jumping put extra stress on the metatarsals - the long bones located in the front part of your feet just below your toes. People with certain foot shapes that create more stress on the metatarsal bones also may have these problems.

Treatment

Although different cases may require different treatments, your doctor is likely to try conservative approaches first, including one or more of the following:

  • Ice. Applying an ice pack or package of frozen peas to the affected site several times during the first 24 hours can reduce inflammation and help relieve pain.

  • Relative rest. To recover from metatarsalgia, you need to keep stress off the injured area, but you also need to remain active so that you don't get out of shape. Sound impossible? Not at all. You may not be able to play your favorite sport for a while, but you can stay fit with low impact exercises, such as swimming and cycling. And you can continue with stretching and lower-body strength training as your pain permits.

  • Medications. Sometimes your doctor may prescribe a non-steroidal anti-inflammatory drug such as ibuprofen (Advil, Motrin, others) to help reduce pain and inflammation.

  • Orthotic devices. These fit inside your shoes and help minimize stress and improve foot function. They're usually prescribed by your doctor and can be custom-made from a plaster cast of your foot. You can also use off-the-shelf orthotics, which come in various shoe sizes and can be fitted immediately, although they usually wear out more quickly than molded ones. Orthotics are categorized as rigid, semi-rigid and soft. As the name suggests, rigid orthotics are constructed of a firm material such as plastic or carbon fiber. They're designed to control motion in two major foot joints below your ankles. Semi-rigid orthotics are made of softer materials such as leather and cork reinforced by silicone. Most orthotics designed to treat metatarsalgia have a metatarsal pad placed in your shoes just ahead of the metatarsal bone. These help deflect stress away from the painful area. You can also use metatarsal pads on their own, without an orthotic.

  • Shock-absorbing insoles. These are cushioned inserts that fit inside your shoes to help cushion shock. Insoles are often made of cork, plastic, rubber or a gel-like substance called visco-elastic that's found in brands such as Sorbothane, Airplus and Spenco. You can buy insoles in drugstores and athletic shoe stores. Your doctor may suggest trying inexpensive insoles or foot pads before turning to orthotics.

  • Proper shoes. Your doctor may recommend a shoe that's especially suited for your foot type, your stride and your particular sport. The right shoes are important in helping prevent re-injury.

  • Surgery. For most people, rest, physical therapy, proper shoes and orthotics or insoles can effectively treat metatarsalgia. When these conservative measures don't provide relief, your doctor may recommend an operation to realign the metatarsal bones, especially if you have a bunion deformity. If you're considering foot surgery, be sure to discuss the benefits and risks carefully with your doctor.

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