The ball of your foot functions to absorbs stress when you walk, stand, run, and jump. An increase in activity, old age can cause this part of the foot to become injured and sore. This pain is called “metatarsalgia.”. This pain can get severe enough to limit daily activity and sports. Patients will alter their gait causing further problems in their foot, knees, and hips.


Overuse injury

Calf tightness (leading to overloading the forefoot structures)

Fat pad atrophy (Old age)

Cortisone injections

Unsupportive shoe gear



Flat feet (pain usually present sub-second metatarsal head)

High arch feet (pain present sub 1st 5th metatarsal heads and styloid process)


Pain and tenderness with palpation of the plantar aspect of the forefoot

Pain with dorsiflexion of the digits

Numbness/Tingling in the foot

Callus present at the area of pain

Pain after physical activity


Xrays/MRI/CT scans/imaging modalities may be used. This is to determine the area of pain, determine deformity, ligamentous instability, and overall foot structures. Each of these conditions may be contributing to the pain. 

Conservative therapy:

Rest, Ice, Elevation, decrease in activity, Nsaids, Custom orthotics, Fat transfer/dermal fillers. 

Surgical Intervention:

Surgical intervention relies on focusing on the cause of the deformity and level of pain. Surgical intervention ranges from metatarsal osteotomies, medial column stabilization procedures, hammertoe contracture release. The surgeon will determine what type of procedure is best for each patient.