Metatarsalgia is the medical term for painful metatarsals, commonly described as central forefoot or ball-of-foot pain, and is really more of a symptom than a diagnosis. Metatarsalgia as a diagnosis is a generalized method to state where pain is originating, but provides no information about the cause or source of the condition. Metatarsalgia can be thought of as an “umbrella” term for many conditions including (but not limited to) capsulitis, bursitis, compressive neuritis, interdigital neuroma, stress fractures, hammertoes, arthritis, sesamoiditis, plantar plate tear, callus, plantar keratosis, ligament sprains and muscle/tendon strains.


Footwear with an elevated heel and rigid toe spring will focus pressure onto the balls of the feet at the MTP joints. Pairing these footwear features with a tapered toe box that compresses the toes together and excessively soft cushioning will cause the central forefoot to sink deeper into the shoe, focusing pressure through the midline of the foot. Much of the available conventional footwear, especially athletic shoes, are designed with all of these features that destabilize the forefoot by preventing the toes from fully functioning. Often after many years of wearing footwear with these unfortunate features, the foot can lose its stable tripod base and wide toe splay while developing weaknesses and deficiencies in the ability to move and use the toes. When this happens, being barefoot or in more natural footwear becomes much more of a challenge to the foot. This is why metatarsalgia is a common problem when transitioning from maximalist and supportive shoes that aren’t shaped like feet towards more minimalist and less supportive natural footwear.


Depending on the more specific diagnosis, metatarsalgia can respond well to conservative, non-surgical treatments. Best treated in its early stages to help improve your affected joint’s stability, reduce your pain and other symptoms, and resolve the root cause of your problem. Common treatment strategies for this health problem include:

  • Rest
  • Taping or splinting
  • Toe Extensor Stretch
  • Metatarsal Pads
  • A toe-spacer like Correct Toes to increase volume and space between the toes.
  • Naturally shaped footwear that is flat, widest at the ends of the toes, and flexible.

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