Foot Pain Explained  >  Ball of foot pain, Metatarsalgia and Mortons neuroma

Ball of foot pain / Metatarsalgia its Causes and Treatment

Ball of foot pain or metatarsalgia is usually described as a "burning and sometimes sharp pain in the ball of the foot". This is usually aggravated when walking barefoot or on hard surfaces. When the foot rolls in too far (over pronation), the spaces between the bones in the forefoot (metatarsals) become narrowed. Nerves and tendons can become pinched between the bones of the forefoot which causes pain and swelling. Docpods help to prevent pain in the ball of the foot through limiting the amount of pronation. This helps to maintain spaces between the bones of the forefoot (metatarsals) and reduces the extent to which they are pinched.

The location of the discomfort can usually be localized between the 3rd and 4th toes and to a lesser extent the 2nd and 3rd toes or one foot. Shooting pain that radiates up the leg may also accompany this condition.

Metatarsalgia and Mortons Neuroma are most common in women aged 25-55 years however it can affect anyone at any time.


The cause of metatarsalgia is largely mechanical in nature. The pain stems from direct irritation of the plantar digital nerve when the nerve is pinched between the metatarsal heads. This is usually the result of a biomechanical abnormality causing abnormal pronation of the foot.

When the foot is in a poor mechanical position (through excess pronation) the bones of the foot unlock and move more freely about the foot. This allows the bones of the forefoot to pinch on the plantar digital nerve and surrounding structures (tendons, muscles and ligaments).

When the plantar digital nerve and surrounding structures are pinched they bleed and swell. As the space surrounding the nerve is limited (between the metatarsal
heads) and the swollen nerve is now more likely to become pinched again which will cause more swelling and an increased chance of further damage. This cycle of pinching and swelling continues without treatment and will w
orsen over time.

Treatment of metatarsalgia involves correcting the biomechanical abnormality (excess pronation) with orthotic
s and selecting footwear that will not irritate the condition (deep roomy toe box – see our Good things to loo
k for in a shoe page). In some cases the irritation of the nerve will be so severe that surgical removal of the nerve will be the best method of treatment. This will usually result in a numb area where the nerve has been removed and should only be used when all conservative measures have failed.