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?

You may be treated with an anti-inflammatory medicine. Adults aged 65 years and older should not take non-steroidal anti-inflammatory medicine for more than 7 days without their healthcare provider's approval. Your healthcare provider may prescribe a pad to put underneath the tender metatarsal. Custom-made arch supports (orthotics) are often prescribed for metatarsalgia.

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 will be determined by 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 you 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 good shoes that fit well.