How Do I Treat Metatarsalgia?

Metatarsalgia is pain at the ball of the foot.

Metatarsalgia is pain at the ball of the foot. It is a common injury that is attributed to poor posture and being overweight.

Treatment to eliminate metatarsalgia is to manage its symptoms:

• Weight reduction: Staying within a healthy weight range for your height (known as body mass index) is important for the health of your entire body, including your feet. Reduce pressure on the metatarsal bones by dropping excess pounds and keep them off by monitoring your weight regularly.
• Resting: Try to rest the feet as much as possible and elevate them after walking, running, or long periods of standing.
• Icing: Apply an ice pack to the ball of the foot for up to 20 minutes, several times daily. Ice can also be applied on the foot following an exercise.
• Proper-fitting footwear: Take care of the whole body by investing in high-quality and supportive footwear. Good shoes for metatarsalgia will adequately support the arch, heel, and ball of the foot. They will also have a roomy toe box and extra padding.
• Stretching exercises: These exercises for the heel will strengthen the calf muscles and reduce the swelling over the ball of the foot.

Shoe inserts and orthotics:

• Shock-absorbing insoles: These inserts are designed to provide additional padding for the feet, while also reducing the impact on the muscles, ligaments, and bones. For high-level support for the metatarsals, look no further than metatarsal pads.
• Metatarsal pads: These shoe inserts are usually made from silicone gel or another cushioning and shock-absorbing material, and they can be extremely effective in preventing and treating moderate metatarsalgia.
• Bunion splints: Keep the sore joints supported with a rigid splint that can be worn throughout the day. Trying bunion splints promptly could reduce metatarsalgia symptoms.
• Arch supports: They reduce stress on the metatarsal bones and encourage a healthy gait.

Strengthening and exercises:

• Calf stretches: Stand 2 feet away from a wall, placing your hands, at eye level, firmly on the wall. Step back with one foot and move the other foot forward. Press the toes of that foot onto the wall and push your hips forward. You should feel a stretch along the back of the calf muscle. Hold the stretch for up to 60 seconds. Repeat this exercise thrice daily.
• Ankle flexion stretch: Kneel on the ground, placing the top third of the feet on the block. Keeping your heels together, sit backward, keeping your back straight. You should feel a stretch along the front of the ankle. Hold this position for 60 seconds. Repeat thrice daily.
• Towel toe curls: Begin by sitting barefoot on a chair and place a towel on the floor in front of you. Curl your toes (including the baby toe) and use them to pull the towel toward you. Do at least 10 repetitions of this exercise while trying to scrunch up the towel. Then, use your toes to try and straighten out the towel again. Repeat this activity at least twice daily.
• Cross training: Engaging only in high-impact activities dramatically increases the risk of foot or leg injury and hip and back pain. Therefore, it is always recommended that you mix up your workout program to include swimming and other low-impact activities such as cycling and yoga. Cross-training is a key consideration in metatarsalgia treatment for runners.
• Physical therapy: Working with a physical therapist may ease metatarsalgia symptoms by encouraging normal foot biomechanics and relieving pressure on the ball of the foot. Once the pain and swelling are gone, a physical therapist will then implement a program of stretching and strengthening exercises to restore normal function to the foot and prevent future occurrences of metatarsalgia.

Medications:

• Nonsteroidal anti-inflammatory drugs: These drugs such as Advil, Motrin, and Nuprin (ibuprofen) or Aleve and Naprosyn (naproxen) can relieve pain in the short term. If a pinched nerve is the cause of your pain, the doctor may try a nerve block in combination with long-acting steroids. 
• Steroid injection: Injecting steroids in the muscle at the ball of the foot will relieve pain in many cases. Multiple shots may be needed for a long-lasting cure.

Surgery: This is the last resort that is only considered when other treatments fail or when there are complications such as co-occurring foot conditions.

Weil’s osteotomy (proximal displacement osteotomy):

• The Weil’s osteotomy has been used to shorten and when necessary elevate one or all three of the central metatarsals to provide an even distribution of weight across the forefoot.
• Post the surgery, you must use a post-operative sandal for 10 days.
• Post-operative stretching is advocated across the metatarsal phalangeal joints to reduce the risk of complications, notably floating toes.

Lengthening of the calf tendon:

• A tight calf muscle will cause the heel to come off the ground when walking prematurely, increasing forefoot loading.
• Lengthening of the tendon allows normal foot function, but the calf is often weaker and smaller than the other side.
• Rarely, the sural nerve is irritated leaving numbness or hypersensitivity to the lower leg.

Summary:

• Metatarsals are five long bones that form part of the mid foot.
• Metatarsalgia is just another name for foot pain.
• Many people with metatarsalgia experience pain in the center of their feet and between the arch and toes.
• A full recovery from metatarsalgia is possible even with at-home treatments.
• One must be diligent about treating the symptoms, especially when it comes to resting the feet, switching up your workouts, and adequately supporting the metatarsal bones with proper shoes and shoe inserts.