Metatarsalgia

What is metatarsalgia?

The metatarsal bones are the long bones of the feet. They are located between the bones that form the ankle (tarsal bones) and the bones of the toes (phalanges). Metatarsalgia is pain in the long bones of the feet, especially located at the heads, or tips, of these bones.

How does it occur?

Metatarsalgia typically occurs from doing too much of a weight-bearing activity such as running, jumping, or walking. It may occur if you start wearing a new type of shoes, especially high-heeled shoes. In some people, the tips of some metatarsals point further down than in others, making these bones more likely to hurt.

What are the symptoms?

Symptoms include pain in the middle of the foot, especially over the bones. You have pain when the bones move and tenderness over the bony surfaces.

How is it diagnosed?

Your healthcare provider will examine your foot and may order an X-ray to see if a foot bone is fractured. If you have metatarsalgia, the X-ray will show no break.

How is it treated?

To treat this condition:

• Take an anti-inflammatory such as ibuprofen, or other medicine as directed by your provider. Nonsteroidal anti-inflammatory medicines (NSAIDs) may cause stomach bleeding and other problems. These risks increase with age. Read the label and take as directed. Unless recommended by your healthcare provider, do not take for more than 10 days.
• Use a pad underneath the tender metatarsal. Your healthcare provider may recommend shoe inserts, called orthotics. You can buy orthotics at a pharmacy or athletic shoe store or they can be custom-made.
• Follow your provider’s instructions for doing exercise to help you recover. While you are recovering from your injury, you will need to change your sport or activity to one that does not make your condition worse. For example, you may need to swim or bicycle instead of run or walk.

How long will the effects last?

The length of recovery depends on many factors such as your age, health, and if you have had a previous foot injury. Recovery time also depends on the severity of the injury. Mild foot pain may recover within a few days to a few weeks, while severe foot pain may take longer to recover.

When can I return to my normal activities?

Everyone recovers from an injury at a different rate. Return to your activities depends on how soon your foot recovers, not by how many days or weeks it has been since your injury has occurred. In general, the longer you have symptoms before you start treatment, the longer it will take to get better. The goal of rehabilitation is to return to your normal activities as soon as is safely possible. If you return too soon you may worsen your injury.

You may safely return to your normal activities when, starting from the top of the list and progressing to the end, each of the following is true:

• You have full range of motion in the injured foot compared to the uninjured foot.
• You have full strength of the injured foot compared to the uninjured foot.
• You can walk straight ahead without pain or limping.

How can I prevent metatarsalgia?

Metatarsalgia is best prevented by wearing shoes that fit well and provide cushioning and support.