Forefoot Pain and orthopedic shoes as treatment

Have you ever experienced a persistent ache or a burning sensation in the area around the ball of your foot? If so, you may be curious about the causes of this pain and how to effectively address it. Maybe changing your shoes can bring a great difference.

This blog post aims to provide insights into metatarsalgia. It utlines its definition, the factors contributing to the pain, symptoms, and optimal treatment options.

Metatarsalgia, also known as forefoot pain, means discomfort felt around the ball of the foot during weight-bearing activities. One prevalent cause of metatarsalgia is irritation of a fibrocartilage plate located beneath the joint where a metatarsal meets a toe in the foot's ball. Another potential source of forefoot pain is inflammation or enlargement of the sheath surrounding the nerve. It is situated between the bones in the forefoot, a condition referred to as Morton's neuroma. Neuromas typically manifest between the 3rd and 4th toes at the ball of the foot. Note that metatarsalgia and neuroma both affect the forefoot, not everyone experiencing metatarsalgia necessarily has a neuroma.

Common causes of foot pain

1. Foot mechanics: Typically, normal feet exhibit an arch across the ball of the foot known as the metatarsal (or transverse) arch. When this arch collapses, it results in increased pressure on the central three bones. Additionally, the fallen arch can compress these bones together. It leads to the pinching of the soft tissues—such as nerves and tendons—that are situated between and around the bones.

Transverse and longitudinal foot arch

2. Shoes: The choice of footwear plays a crucial role. High-heeled shoes impose added pressure on the ball of the foot. Narrow pointed shoes force the toes into close distance. Shoes with a tight fit in the toe-box can exacerbate forefoot pain by compressing soft tissues and restricting both blood and nerve supply.

3. Rigid High Arch Feet: Feet with a higher arch that is less flexible result in less surface contact with the ground, increasing pressure on both the forefoot and heel. This foot type is more prone to conditions like metatarsalgia and neuroma.

4. Short Big Toe: Some people have a Big Toe that is shorter than the average length, specifically a short 1st metatarsal. This can lead to the transfer of load to the second toe, compensating for the reduced leverage of the Big Toe.

Normal vs Morton's toe

5. Soft Tissue and Muscular Factors: The natural aging process results in the gradual loss of the protective fat pad beneath the ball of the foot. Weakened foot muscles may contribute to the collapse of the transverse (metatarsal) arch. Additionally, tight calf muscles can lead to premature heel lift during walking, intensifying stress on the forefoot. Weight gain further exacerbates the pressure on the ball of the foot.


The sensation of metatarsalgia pain varies among individuals; some liken it to walking on pebbles, while others experience a more generalized aching. This discomfort typically shows in one or both feet, with some feeling the pain beneath specific metatarsal heads, and others experiencing it under all of them.

Metatarsalgia tends to develop gradually over several weeks rather than suddenly. Pain increases with prolonged periods of standing, walking, or running, and often subsides upon removing shoes from the feet.

In contrast, Morton's neuromas may present with numbness or tingling in the toes, accompanied by sharp, electric-like shocks that radiate up into the leg or down into the toes.

The sooner you begin the treatment, the better. Disregarding forefoot pain could lead to long-term damage and persistent discomfort, restricting your ability to engage in active pursuits. Neglecting treatment may force you to limit activities or modify your walking patterns to alleviate pain, potentially giving rise to additional issues in the feet, knees, hips, or back.


Timely intervention is crucial, and a combination of various treatments is recommended for optimal results. In cases involving poor foot function, the focus of long-term treatment is typically on lowering pressure on the forefoot and providing support to the metatarsal arch. Surgical intervention for severe neuromas is considered a last resort.

1. Optimal Shoes: Discontinue the use of high heels and narrow pointed-toe shoes. Instead, opt for lower and wider-fitting shoes that offer easy stretching to decrease pressure across the ball of the foot. Choosing shoes with metatarsal support can help reduce pressure points. In our eshop we have a wide variety of arch supporting certified off-the-rack orthopedic sandals with a metatarsal support. Arch contouring in these orthopedic sandals will increase the surface area contacting your foot; therefore, redistributing pressure off hot spots at your forefoot. Similarly, with a lower transverse arch, orthotics (with the help of metatarsal pads) can help support and align your foot in a correct position and lower stress on the metatarsal heads and joints.

Orthopedic sandals redistribute the pressure on the foot

2. Metatarsal Pads: These pads can be placed in your shoes to re-establish the transverse arch. They can improve the alignment and help to relieve pressure on the nerves and soft tissues.

3. Stretching: Use a massage ball to perform foot stretches. Use a foam roller to massage the calf muscles throughout the day. Massaging the tissue in your feet and legs helps reduce fatigue and increase circulation.

4. Night Splint: A night splint maintains your calf and foot in an ideal position for healing. By stabilizing the tissues in an elongated position, it reduces tension, facilitating the healing and recovery of the tissues.


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