Metatarsalgia is sometimes called ball-of-foot pain, which is appropriate considering that people with this condition often feel pain around the ball of their feet. But even though people feel pain there, the actual problem arises from the metatarsal bones that go from the arch of the foot to the toes. While many patients with metatarsalgia feel pain where their metatarsal bones join their toe bones, some also feel pain along the entire length of the metatarsals and possibly between them. The pain can also vary depending on the cause of the condition. If your forefoot feels stiff or sore when you move it, the joints are probably not functioning properly. If you feel burning or stinging, nerves are probably responsible for your pain.
A number of internal and external factors can cause these problems. Internal factors can be structural, functional or both. Structural problems refer to abnormalities in the metatarsals themselves. Sometimes your metatarsals can grow too long and change the mechanics of your feet. This can lead to abnormal movements that strain the forefoot and possibly cause joint dysfunction. Functional problems refer to abnormalities in other foot structures that then affect the metatarsals and cause metatarsalgia. If, for example, someone has flat feet, the lack of arches could affect how he or she walks, putting excess strain on the metatarsals.
External factors include excess body weight, tight or high-heeled shoes and repetitive foot activity. Excess weight can overload the metatarsals and affect the way people walk, which can cause joint pain and nerve irritation. High-heeled shoes stress the metatarsals, because the raised heel channels the majority of pressure from walking onto the front of the foot. Repetitive foot activities, like running, directly stress the metatarsals by exposing them to constant trauma. If you are athletic, you want to make sure that you choose a good athletic shoe for your type of foot.
The first step in caring for metatarsalgia is to stop doing anything that causes pain. If you have the condition, your doctor will probably suggest a plan of management that includes removing or modifying the underlying cause of your condition and restoring the proper position of your bones and joints to promote healing.
To achieve the latter, a chiropractor will probably perform an adjustment or mobilization technique to restore any restricted movement in the joints of your feet. When performing an adjustment, your chiropractor will use his or her hands or a tool called an activator to perform a quick, strategic thrust to help realign bones and joints to make walking comfortable. When performing a mobilization technique, your chiropractor will slowly take joints through their proper range of motion, by moving them manually.
If poor foot mechanics, such as pes planus (flat feet), caused your metatarsalgia, your chiropractor may also prescribe custom-made shoe inserts called orthotics. These shoe inserts cushion, support, align, and correct arches and structural problems, which promotes healing and helps prevent injury, deformity and the progression of existing conditions. To make them, your chiropractor will first take a mold of your feet or scan your feet with a specialized scanner to construct the orthotics. We utilize the Foot Levelers Orthotics in our office and are very pleased with the results we get with them. In addition, if your metatarsals become irritated when you walk your chiropractor can prescribe a special metatarsal pad to sit under the head of the metatarsals, near where they join the toes, to provide additional cushioning.
For most patients, chiropractic care is very effective in the treatment of metatarsalgia. But for some patients with extreme metatarsalgia, a medical referral may be necessary. Medical doctors may treat the condition with cortisone injections or anti-inflammatory drugs to relieve pain and inflammation, and may also perform surgery. Regardless of the type of care you receive, however, chiropractors can maintain the health of healed feet to prevent problems from returning.