The symptoms of metatarsalgia include pain under the balls of the feet and swelling and inflammation at the heads of the metatarsal bones. (The metatarsal heads form the balls of our feet.)
Joint tissues, or capsules and ligaments, become increasingly painful during episodes of prolonged walking and weight-bearing activities. Gradually and with repetition, fibrotic scar tissue can develop.
What causes metatarsalgia?
There are three different contributing causes of metatarsalgia:
First, wearing footwear with a concave surface under the metatarsal heads. In essence, this causes a drop of the heads of the second, third, and fourth metatarsals, significantly increasing the load they bear. The concave supportive surface of the footwear may be a result of the footwear design – or caused by a breakdown or compression of its midsole or insole material, with long-term use.
Second, long-term use of footwear or insoles that provide excessive cushioning. This causes the body to stop producing robust soft tissue padding under the metatarsal heads. This creates a highly sensitized area.
Third, failure of the foot muscles to correctly align the bones of the feet into strong and dynamically adaptable arches. This leads to foot instability and torsional forces on the metatarsal bones.
These causes can present simultaneously – and can worsen the severity of the symptoms and difficulty in eliminating the causes.