Foot

What It Is

Metatarsalgia is the name for pain in the ball of the foot (NHS, 2025). It is a general term rather than one specific condition, and it can have many underlying causes (Royal Orthopaedic Hospital NHS Foundation Trust, n.d.; Robert Jones and Agnes Hunt Orthopaedic Hospital NHS Foundation Trust, 2024). You might get it if you take part in activities involving running and jumping, if you wear shoes that are too tight, or if the shape of your foot puts extra pressure on the ball of the foot (NHS, 2025). Other causes exist as well, including arthritis (NHS, 2025).

Even though the condition often isn't serious, it can sideline you. Thanks to self-care and other conservative treatments, you can usually relieve the symptoms (NHS, 2025). Well-fitting footwear with good cushioning, and soft insoles or pads, may be all that is needed to prevent or reduce problems with metatarsalgia (NHS, 2025; Royal Orthopaedic Hospital NHS Foundation Trust, n.d.).

Long-distance runners can suffer from this problem. Pain in the ball of the foot can also be caused by a metatarsal stress fracture, so do not try to diagnose the cause yourself (NHS, 2025; Robert Jones and Agnes Hunt Orthopaedic Hospital NHS Foundation Trust, 2024).

Metatarsalgia Anatomy

In each foot, you have five metatarsal bones running from the toe joints towards the arch. The heads of the metatarsals are the rounded ends of the bones that connect with the toe bones, and they form the ball of the foot. When you walk, run or jump, your body weight passes onto the forefoot as you push off.

Many problems with the metatarsals develop when something changes the way the foot works, which affects how weight is spread across the foot. For example, your foot type, tight calf muscles or being overweight can increase the pressure through the front of the foot, leading to pain under the metatarsal heads (Royal Orthopaedic Hospital NHS Foundation Trust, n.d.; Robert Jones and Agnes Hunt Orthopaedic Hospital NHS Foundation Trust, 2024).

Not a diagnosis — for more information, contact me or another trusted healthcare provider.

Symptoms

How It Feels

Signs & Symptoms

Pain in the ball of the foot, which may be burning, aching, or sharp and shooting, and is often worse when standing, walking or running
A feeling like walking on pebbles
Tingling or numbness in the toes

(Royal Orthopaedic Hospital NHS Foundation Trust, n.d.; Robert Jones and Agnes Hunt Orthopaedic Hospital NHS Foundation Trust, 2024)

Treatment

Self-Care & Treatment

How to Treat Metatarsalgia

Gentle foot, ankle and calf stretches can help (NHS, 2025; Robert Jones and Agnes Hunt Orthopaedic Hospital NHS Foundation Trust, 2024). I can guide you through stretches and strengthening for your foot and calf, with hands-on work and advice on footwear, insoles and pads. See the My Approach tab for how I work.

1. Anti-Inflammatory Medication

The NHS (2025) suggests painkillers such as paracetamol or ibuprofen gel (or ibuprofen tablets if needed) for pain in the ball of the foot. Robert Jones and Agnes Hunt Orthopaedic Hospital NHS Foundation Trust (2024) advises not using ibuprofen or other anti-inflammatories for more than 7 to 14 days, because some causes of metatarsalgia, such as a stress fracture, may heal more slowly with ongoing use. (This medicine information comes from the NHS and Robert Jones and Agnes Hunt Orthopaedic Hospital NHS Foundation Trust, not from me. Always check with a pharmacist or your family doctor or nurse practitioner before taking any medicine.)

2. Wear Proper Fitting Shoes

Wear shoes with plenty of room for your feet, with enough width and depth across the front of the foot, a low heel and a soft, cushioned sole (NHS, 2025; Robert Jones and Agnes Hunt Orthopaedic Hospital NHS Foundation Trust, 2024). Replace shoes that have worn out, as they lose their ability to absorb shock (Robert Jones and Agnes Hunt Orthopaedic Hospital NHS Foundation Trust, 2024).

3. Shock-Absorbing Insoles

Soft insoles or pads, made from materials such as foam, felt or gel, fit inside your shoes to help cushion the foot (NHS, 2025; Robert Jones and Agnes Hunt Orthopaedic Hospital NHS Foundation Trust, 2024). A pharmacist can advise on insoles and pads (NHS, 2025).

4. Metatarsal Pads

Dome-shaped metatarsal pads are placed in the shoe, under the ball of the foot, to help take pressure off the painful area (Robert Jones and Agnes Hunt Orthopaedic Hospital NHS Foundation Trust, 2024). I can help you work out the right type and position for your foot and how to get them, and point you to a chiropodist or podiatrist if you need custom orthotics.

5. Rest

Protect the foot from further injury by "relative rest": cut down on high-impact exercise such as running, and avoid long periods of standing or walking (Robert Jones and Agnes Hunt Orthopaedic Hospital NHS Foundation Trust, 2024; NHS, 2025). You might have to avoid your favourite sport or activity for a while, but you can do low-impact exercise such as swimming or cycling. Rest and raise your foot when you can (NHS, 2025).

6. Ice

I can show you how to use ice safely at home. The NHS (2025) advises putting an ice pack (or a bag of frozen peas) wrapped in a towel on the painful area for up to 20 minutes every 2 to 3 hours.

Treatments you may want to discuss with your family doctor or nurse practitioner

Options outside my scope

Orthoses: medical shoe insoles prescribed to reduce pressure under the forefoot and improve how the foot works (Royal Orthopaedic Hospital NHS Foundation Trust, n.d.).
Steroid injection: may be used to settle inflammation in a toe joint or a pinched nerve (Morton's neuroma) (Robert Jones and Agnes Hunt Orthopaedic Hospital NHS Foundation Trust, 2024).
Tests: blood tests, X-rays or scans may be used to look for causes such as gout, arthritis, diabetes, a stress fracture or a neuroma (Robert Jones and Agnes Hunt Orthopaedic Hospital NHS Foundation Trust, 2024).
Surgery: may be an option in some cases, such as straightening a hammer toe, depending on the cause (Royal Orthopaedic Hospital NHS Foundation Trust, n.d.).

How I can help (see the My Approach tab)

Hands-on work for the calf, foot and toes

Stretches and strengthening for the foot and calf

Taping to offload the ball of the foot

Advice on footwear, insoles and pads

Tips

Runners are more likely to get this condition because of the large forces placed on the foot when running (NHS, 2025).
Both high-arched and flatter feet can put extra pressure on the metatarsals (Royal Orthopaedic Hospital NHS Foundation Trust, n.d.).
Foot deformities such as hammer toes, where a toe curls downwards from a bend in the middle joint, can lead to pain in the ball of the foot (Royal Orthopaedic Hospital NHS Foundation Trust, n.d.).
A tight calf muscle or Achilles tendon can increase pressure on the metatarsal heads (Robert Jones and Agnes Hunt Orthopaedic Hospital NHS Foundation Trust, 2024).
Since your body weight passes through the forefoot when moving, extra body weight can mean added pressure on the metatarsals. Losing weight if you are overweight can help (NHS, 2025; Royal Orthopaedic Hospital NHS Foundation Trust, n.d.).
High heels, which shift more weight onto the front of the foot, are a common cause of this condition, as are tight, pointy or poorly cushioned shoes. Athletic shoes that are worn out or lack proper support and padding can also cause problems (NHS, 2025; Robert Jones and Agnes Hunt Orthopaedic Hospital NHS Foundation Trust, 2024).

Treatment

My Approach

Pain in the ball of the foot usually comes from too much pressure through the front of the foot, from your shoes, your activity, tight calves or your foot shape. My aim is to ease the pain, take pressure off the ball of the foot, and help your foot and lower leg share the load.

I start by assessing your foot and ankle, how your foot moves when you walk and push off, your calf flexibility and strength, and your footwear. Massage doesn't change the shape of your foot, so where a high arch, flat foot or curled toes play a part, I work on the aches, tightness and strain that come with them.

When It's Sore

Hands-on work for the calf and the sole of the foot, keeping pressure off the most tender spots
Gentle mobilisation of stiff foot and toe joints, with no quick or forceful movements
Warm or cool applications in the clinic, and I'll show you how to use ice safely at home
Cutting back high-impact activity rather than stopping everything
Taping to offload the ball of the foot, and I'll show you how to tape it yourself

As It Settles

Calf and foot stretches and mobility work
Strengthening for the foot and toe muscles, building to heel raises and balance work, with a home programme between visits
A gradual return to running or sport, building the load back up step by step

Footwear and Insoles

Roomy, cushioned shoes with a low heel
Working out whether insoles or metatarsal pads would help and where they should sit, and pointing you to a chiropodist or podiatrist if you need a custom orthotic

If you have diabetes or reduced feeling in your feet, I use lighter pressure and only mild warm or cool applications; at home, always test water temperature with your hand first. If you have tingling or numbness, your foot is hot and swollen, or it hasn't improved after 2 weeks of home care, see your family doctor or nurse practitioner (see When to Get Help).

What to Expect

Typical Course

Typical course: Most people come once or twice a week at first, then weekly, with a reassessment at about 4 to 6 weeks, then less often. Usually the pain starts to ease within a few weeks of offloading the ball of the foot and changing footwear, and most people are back to their normal activities within about 6 to 8 weeks.

What I Focus On

Assessment

Calf & Foot Release

Offloading the Ball of the Foot

Foot Strength

Footwear & Insole Advice

Please read

When to See a Doctor First

When to Get Help

See your family doctor or nurse practitioner if the pain is stopping you doing normal activities, is getting worse or keeps coming back, has not improved after 2 weeks of treating it at home, or if you have tingling or loss of feeling in your foot, or diabetes and foot pain (NHS, 2025).

Get urgent medical advice the same day, for example from Health811 (call 811), if you have severe pain, cannot walk, your foot has changed shape, you heard a snap, grinding or popping noise when you were injured, you feel faint, dizzy or sick from the pain, your foot is hot, swollen and painful, or you have foot pain and feel hot, cold or shivery. These can be signs of a broken bone or an infection (NHS, 2025).

Sources

References

NHS (2025) Pain in the ball of the foot. Available at: https://www.nhs.uk/symptoms/foot-pain/pain-in-the-ball-of-the-foot/ (Accessed: 7 October 2026).
Robert Jones and Agnes Hunt Orthopaedic Hospital NHS Foundation Trust (2024) Metatarsalgia. Available at: https://www.rjah.nhs.uk/media/egphef3k/metatarsalgia-print-friendly.pdf (Accessed: 7 October 2026).
Royal Orthopaedic Hospital NHS Foundation Trust (n.d.) Metatarsalgia (forefoot pain). Available at: https://roh.nhs.uk/services-information/foot-and-ankle/metatarsalgia-forefoot-pain (Accessed: 7 October 2026).

Massage therapy · Kitchener–WaterlooMetatarsalgia

What It Is

Metatarsalgia Anatomy

How It Feels

Signs & Symptoms

Self-Care & Treatment

How to Treat Metatarsalgia

1. Anti-Inflammatory Medication

2. Wear Proper Fitting Shoes

3. Shock-Absorbing Insoles

4. Metatarsal Pads

5. Rest

6. Ice

Treatments you may want to discuss with your family doctor or nurse practitioner

Tips

My Approach

When It's Sore

As It Settles

Footwear and Insoles

Typical Course

When to See a Doctor First

When to Get Help

References

Related Conditions

Book a session

Massage therapy · Kitchener–WaterlooMetatarsalgia

What It Is

Metatarsalgia Anatomy

How It Feels

Signs & Symptoms

Self-Care & Treatment

How to Treat Metatarsalgia

1. Anti-Inflammatory Medication

2. Wear Proper Fitting Shoes

3. Shock-Absorbing Insoles

4. Metatarsal Pads

5. Rest

6. Ice

Treatments you may want to discuss with your family doctor or nurse practitioner

Tips

My Approach

When It's Sore

As It Settles

Footwear and Insoles

Typical Course

When to See a Doctor First

When to Get Help

References

Related Conditions

Bunions

Cavus Foot (High Arches)

Claw Foot

Claw Toe

Book a session