Metatarsalgia is a general term used to denote a painful foot condition in the metatarsal region of the foot (the area just before the toes, more commonly referred to as the ball-of-the-foot). Morton’s Neuroma is a more specific condition that affects the same area. It is an inflammation of a nerve, usually between the 3rd and 4th toes. Morton’s Neuroma may also cause numbness, tingling, or cramping in the forefoot. The cause of these conditions is usually due to excessive pressure to this area over a long period of time, usually from improper fitting footwear. A shoe that is too tight in the toes or that is too high in the heel can cause constricting and excessive pressure on the ball-of-the-foot. This pressure can be the root cause of both Metarsalgia and Morton’s Neuroma. Another condition that can cause pain in the ball-of-the-foot is Sesamoiditis. This term is a general description for any irritation of the sesamoid bones, which are tiny bones within the tendons that run to the big toe. Every time you push off against the toe the sesamoids are involved, and eventually they can become irritated. Most pain associated with this condition is directly under the 1st metatarsal joint or behind the big toe. Also, as we get older, the fat pads in our feet tend to thin out, making us much more susceptible to all of these conditions.
Treatment and Prevention of Ball-of-the-Foot Pain
The first step in treating ball-of-the-foot pain is to select proper footwear. Footwear designed with a wide toe box and a rocker sole are ideal for treating these conditions. The wide toe box allows the foot to spread out while the rocker sole reduces stress on the ball-of-the-foot. Unloading pressure to the ball-of-the-foot can be accomplished with an orthotic featuring a metatarsal pad. This pad placed behind the ball-of-the-foot is designed to relieve pressure, and redistribute weight from the painful area to more tolerant areas. Different metatarsal pads can be utilized that are designed specifically for each condition. For example, a pad can be placed to separate metatarsal joints that are irritating the nerve causing the Morton’s Neuroma or a different pad can be placed to remove pressure off of the sesamoid bones in the case of Sesamoiditis.