Ball of the Foot Pain (Metatarsalgia)

Ball of the foot pain is a common painful foot condition that affects the metatarsal area of the foot. This area is usually referred to as the ball of the foot.


Metatarsalgia is increasingly prevalent nowadays because more people are more frequently wearing heeled shoes and walking on hard surfaces, such as hard concrete & hard tiles.

Wearing heeled shoes can unnaturally shift up to 70% -80% of our body’s weight forward to the balls of our feet.

Walking on hard, non-accommodative surfaces, such as concrete footpaths and roads, unnaturally provides no cushioning to our movement.

The combination of heels and hard surfaces can result in very damaging stresses & strains being exerted on our feet, especially on the balls of our feet. Our feet were never designed to withstand hours of pounding and high levels of counter forces originating from heeled shoes or walking on non-absorbing hard surfaces.

Persistent unnatural forces originating from heeled shoes and walking on hard surfaces cause our metatarsals to drop and the surrounding ligaments to weaken. As a result, our transverse arches can collapse. In addition, burning pain, inflammation and/or calluses & corns may also develop under our forefeet in response to the excess pressure and friction on the balls of our feet.


Other Contributing causes of ‘Ball of the Foot’ Pain

Besides wearing high-heeled footwear and walking barefoot on hard surfaces, other causes of ball of the foot pain may include:

  • Wearing shoes with thin soles.
  • Faulty foot biomechanics. Excessive foot pronation (inwards rolling) is the main cause.
  • Underlying diseases that cause a thinning of the fatty pad on the undersides of our feet e.g. rheumatoid arthritis, connective tissue disorders, endocrine diseases, etc.
  • High arched feet that are rigid, similar to wearing high heeled shoes, shifting pressure to our forefeet.
  • Injuries that are not properly treated, such as fractured bones or dislocated joints.
  • Hammertoes.

Treatment of ‘Ball of the Foot’ Pain

Most people with ball of the foot pain tend to excessively pronate their feet.

Orthotic footwear, preferably open-toe styles, such as quality made, affordable over-the-counter orthotic sandals or thongs, would normally be ideally suited for such people. These people can expect to experience both increased comfort and pain relief.

Ideally, the underside of the forefoot region of these orthotic shoes should also incorporate an upward rising concavity to support our transverse arches.

People with supinated, high arched rigid feet (Pes Cavus) or forefoot valgus may need to consult a specialist podiatrist. A pair of prescribed customised shoes or insoles may be required.