Metatarsalgia

Metatarsalgia refers to pain and inflammation in the ball of the foot—the area just behind the toes where the metatarsal bones absorb your body’s weight with every step. When this delicate region becomes overloaded or irritated, it can feel like walking on a pebble, standing on bruised bone, or carrying a sharp, burning pressure beneath the forefoot.

Although symptoms may appear suddenly, metatarsalgia often develops from a combination of underlying factors. High-impact activity, tight calf muscles, or footwear that shifts weight forward—such as narrow dress shoes or high heels—can overload the metatarsal heads. Structural issues like long metatarsals, bunions, hammertoes, flat feet, or collapsing arches can further disrupt weight distribution. Thinning of the natural fat pad is a major contributor as well, leaving the bones with less cushioning and increasing pressure on the forefoot. Nerve irritation or a developing Morton’s neuroma may intensify the discomfort.

At New Orleans Podiatry, we take a comprehensive approach to identifying the true source of your forefoot pain. Your evaluation may include digital imaging and targeted diagnostic testing to determine whether symptoms stem from mechanical overload, nerve involvement, inflammation, fat-pad atrophy, or a combination of these factors.

Treatment is tailored to restore comfort while preserving the long-term health of the forefoot. Depending on your needs, care may include custom orthotics, footwear optimization, offloading techniques, or biologic interventions. For patients with thinning or diminished cushioning beneath the metatarsal heads, Leneva® Fat Pad Restoration can provide remarkable relief by replenishing lost support, redistributing pressure, and protecting the bones from further irritation.

With the right individualized plan, most patients experience significant relief and a return to effortless, comfortable movement—whether you’re walking the Quarter, training for a race, or simply hoping to get through your day without forefoot pain.