Metatarsalgia, pronounced as MET-ah-tar-SAL-gee-ah, refers to pain in the area between your arch and toes, commonly known as the ball of your foot. This discomfort typically focuses on one or more of the five metatarsal bones situated under the toes.

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Various factors can contribute to metatarsalgia:

• Long Metatarsal Bones: If one of your metatarsals is longer than usual, it may bear excessive weight, leading to the formation of calluses or extra skin buildup. This increased pressure and the presence of calluses can result in pain, although the formation of a callus is not always necessary for experiencing discomfort.

• Bunions: Metatarsalgia is often linked with bunions, a deformity of the big toe. When a bunion develops, the metatarsal bone of the big toe struggles to support its weight, causing a shift in weight distribution to the smaller metatarsals and potentially leading to metatarsalgia.

• Hammertoes: Imbalances in the tendons supporting the toes can result in hammertoes, a condition where the toes become bent. Hammertoes can exert pressure on the metatarsal bone, increasing the likelihood of metatarsalgia.

• Improperly Fitting Shoes: Shoes that are too tight compress the foot, elevating pressure, while loose shoes permit excessive movement, causing friction. Torn ligaments or inflammation may also contribute to metatarsalgia, with pain under the foot possibly indicating ligament tears or joint inflammation. Your foot and ankle orthopedic surgeon can perform simple tests to evaluate joint stability.

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Treatment

Treatment for metatarsalgia often involves practical measures to alleviate foot pain. Dr. Kamel might recommend using orthotics (arch supports) to absorb shock or suggest wearing shoes with a wider toe box to prevent toe cramping. In some cases, adding a pad to the orthotic can redistribute weight away from the painful metatarsal bones. Soaking your feet to soften calluses and then gently removing the dead skin with a pumice stone or callus file can help relieve pressure, although individuals with diabetes should avoid this and seek professional care. Surgery may be necessary in rare instances to address bony prominences or correct deformities contributing to metatarsalgia.