How to tell if I have metatarsalgia in my feet? | Bilt Labs
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How to tell if I have metatarsalgia in my feet?

  • G

    I've been dealing with a really painful problem that seems centered right under the ball of my foot, specifically near the base of my second and third toes. It feels like walking on a pebble or like the joints are badly bruised, and the discomfort flares up badly when I wear anything other than my softest sneakers or after I've been standing for a long time. I've done some searching online and keep seeing the term metatarsalgia, but the symptoms seem to overlap with a few other foot issues like neuromas or even just simple shoe issues. I'm trying to gather enough information before heading to the doctor so I can describe the pain accurately.

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  • Dr. William Naughton, DPM

    Yes - metatarsalgia commonly causes aching, sharp, or burning pain in the ball of the foot and often improves with proper forefoot support.

    Pain in the ball of the foot that worsens with standing, walking, or push-off is frequently due to excessive pressure on the metatarsal heads. While metatarsalgia is a common diagnosis, several other forefoot conditions can present with similar symptoms, making proper evaluation important.

    Metatarsalgia develops when the metatarsal heads absorb more load than they are designed to handle. This often occurs due to poor foot mechanics, inadequate cushioning, high-impact activity, or loss of the natural fat pad beneath the forefoot. As pressure increases, irritation and inflammation develop, leading to sharp, aching, or burning discomfort during weight-bearing activities.

    Because the symptoms overlap with other conditions — such as Morton’s neuroma, stress fractures, capsulitis, or fat-pad thinning — it is important not to assume a single cause without considering the full clinical picture. However, regardless of the specific diagnosis, excessive forefoot pressure is a common contributing factor.

    One of the most effective conservative treatments is improving how pressure is distributed across the forefoot. Insoles or custom orthotics with a built-in metatarsal pad help lift and spread the metatarsal bones, reducing direct stress on the painful area. When properly positioned and combined with adequate arch support, these devices can significantly reduce symptoms and improve comfort during daily activities. Custom options such as Bilt Labs Orthotics are designed from precise foot impressions, allowing support to be tailored to individual structure and pressure patterns.

    • Metatarsalgia causes pain in the ball of the foot, especially during standing or walking
    • Symptoms may be sharp, aching, or burning
    • Similar symptoms can occur with:
      • Morton’s neuroma
      • Stress fractures
      • Capsulitis
      • Fat-pad thinning
      • Vascular Disease (especially if pain is associated with color changes, coldness, or delayed in healing)
    • Reducing forefoot pressure is a key treatment goal
    • Insoles or orthotics with a metatarsal pad can:
      • Redistribute pressure
      • Reduce stress on the metatarsal heads
      • Improve daily comfort
    • Persistent symptoms should be evaluated to rule out other conditions

    "Disclaimer: This post is for educational purposes only and is not a substitute for other professional medical advice. No doctor-patient relationship is formed. If you have a medical emergency, please contact emergency services immediately."

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