Metatarsalgia: Causes and Relief for Ball of Foot Pain
Medically Reviewed by Dr. Pedro Yelamo Vera, MD
Licensed Physician No. 484814280 · Official Medical College of Bizkaia (Spain)Last reviewed: 31 October 2026
Metatarsalgia is pain in the ball of the foot. What causes it, how to ease it at home, how it differs from Morton's neuroma and when to see a doctor.
You don't have to figure this out alone
Dr. Pedro Yelamo Vera is an independent, bilingual GP licensed in Spain. Book a 15-minute video consultation in English or Spanish for €50, with a private electronic prescription issued under Spanish law when clinically appropriate.
Metatarsalgia is pain in the ball of the foot, just behind the toes, where the long foot bones (metatarsals) take your weight. It often feels burning or aching, like a small stone in your shoe. It is usually not serious. Most people improve with rest, better shoes and soft insoles or pads.
- Metatarsalgia is a description of where it hurts, not one disease.
- Common causes are tight or high-heeled shoes, running, extra weight, foot shape, bunions and hammertoes.
- Morton's neuroma and stress fractures can feel similar and need a different plan.
- Rest, ice, roomy low-heeled shoes and soft insoles help most people.
- See a doctor if it lasts over 2 weeks, you have tingling or numbness, or promptly if you have diabetes.
Dr. Pedro Yelamo Vera is a GP licensed in Spain (Colegiado No. 484814280).
For a medical emergency, call 112 or go to the nearest local emergency department. Do not wait for a video consultation or an online reply.
What does metatarsalgia feel like?
It tends to build up slowly. Mayo Clinic and nidirect describe these signs:
- Sharp, aching or burning pain in the ball of the foot, just behind the toes.
- Pain that gets worse when you stand, walk or run, and eases with rest.
- More pain barefoot on hard floors.
- Shooting pain, tingling or numbness in the toes.
- A feeling of a pebble or small stone under the foot.
It may affect one or both feet. In Spain it is also called dolor en la planta del pie.
What causes metatarsalgia?
Usually there is too much pressure on the front of the foot. Often several causes add up:
- Shoes. High heels, tight or pointed shoes, and worn-out trainers.
- Sport. High-impact activity, such as running, jumping or tennis.
- Foot shape. A high arch, flat feet, or a second toe longer than the big toe.
- Toe problems. Bunions (juanetes) and hammertoes (dedos en martillo).
- Extra body weight, which loads the forefoot.
- Arthritis, including rheumatoid arthritis and gout.
- Age. The fat pad under the ball of the foot thins as we get older, the MSD Manual notes.
nidirect adds that it is more common in older people and in people with diabetes.
Is it Morton's neuroma or a stress fracture?
- Morton's neuroma (neuroma de Morton). A nerve between the toe bones is irritated and thickened. Mayo Clinic says the pain is usually between the third and fourth toes. It burns or shoots, and the toes may tingle or go numb. nidirect says it is over four times more common in women, often around age 55.
- Stress fracture (fractura por estrés). A tiny crack in a metatarsal, most often the second. It is common in runners who build up too fast and in people who walk long distances with a load. The MSD Manual says pain comes after exercise at first, then sooner, and later at rest. An X-ray may look normal at first, so an MRI or bone scan is sometimes needed.
Rarer causes include sesamoid problems and Freiberg's disease.
How is metatarsalgia diagnosed?
A doctor asks where it hurts, when it started and what makes it worse. They press on the forefoot and look at your shoes. Many people need no tests.
nidirect says a GP may arrange X-rays, scans or blood tests to look for a cause such as arthritis. They may refer you to a podiatrist, a physiotherapist or a foot and ankle surgeon. In Spain these are the podólogo, the fisioterapeuta and the traumatólogo.
Ball of foot pain that is not settling after a couple of weeks of rest and better shoes?
You can book a video visit with a GP licensed in Spain, in English or Spanish. He goes through your symptoms, looks at your foot and shoes on camera, and helps you plan the next steps.
How do you treat metatarsalgia at home?
The NHS advises these steps:
- Rest and raise your foot when you can.
- Ice. Hold an ice pack wrapped in a towel on the sore area for up to 20 minutes, several times a day.
- Change your shoes. Wear roomy shoes with a low heel and a soft sole.
- Use soft insoles or pads. At a pharmacy, ask for metatarsal pads (almohadillas metatarsales).
- Stretch gently. Regular foot and ankle stretches help.
- Lose weight if you are overweight.
Avoid the sport that brings on the pain and long periods on your feet. Swim or cycle instead.
Painkillers can help while the foot settles. The NHS mentions paracetamol and ibuprofen gel, or tablets if needed. Ask a pharmacist which suits you, especially with stomach, kidney or heart problems.
What if home treatment does not work?
A foot specialist may suggest:
- Custom-made insoles (orthotics, plantillas a medida) to take pressure off the sore area.
- Foot and ankle exercises.
- A steroid injection in some cases.
- Surgery, which nidirect says is rarely needed.
For Morton's neuroma, options also include radiofrequency ablation, which uses heat on the nerve. Left untreated, Mayo Clinic notes that limping can cause pain in the hip or lower back.
How is care different in Spain, the UK and the US?
- UK. The NHS suggests 111 for urgent advice. In many areas you can refer yourself to community physiotherapy.
- Spain. There is no 111. You see your médico de familia at the centro de salud, or go to urgencias. Pharmacies sell insoles and pads, and the pharmacist can advise on pain relief.
- US. The emergency number is 911. In Spain and across the EU it is 112.
When should you see a doctor about ball of foot pain?
Book a visit if:
- The pain stops you doing normal things.
- It is getting worse or keeps coming back.
- It has not improved after 2 weeks of home treatment.
- You have tingling or loss of feeling in the foot.
If you have diabetes, see a doctor promptly about any foot pain. Do not treat it yourself. MedlinePlus advises contacting your doctor right away about pain, redness, warmth, swelling, sores or cracks, or tingling or burning in the foot.
Go to urgencias today if the pain is severe, you cannot walk, or the foot has changed shape. Go too if you heard a snap or grinding at the time of an injury, or the foot is hot, swollen and painful. Feeling hot, cold or shivery with the pain, or faint from it, also needs urgent care. These can be signs of a broken bone or an infection.
Talking it through with a doctor by video
Dr. Yelamo is a GP licensed in Spain. He sees adults, children and pregnant patients by video, every day from 07:30 to 20:30 (Spain time). In the visit he will:
- Ask where it hurts, when it started and what shoes and sport you do.
- Ask you to point to the sore spot, stand on tiptoe and show your shoes on camera.
- Agree a plan for rest, footwear, insoles and pain relief, and tell you if you need an X-ray or an in-person exam.
He does not promise any test or prescription before the visit. Where clinically appropriate, following a genuine evaluation. Treatment and prescriptions are issued solely at the doctor's discretion based on evidence-based clinical guidelines.
A prescription is never guaranteed: it is issued only where clinically appropriate after a genuine evaluation, as a private electronic prescription under Spanish law. This service is for urgent, non-emergency care. In an emergency, call 112.
See how the Urgent Care video visit works. It lasts 15 minutes and costs €50.
This guide is general information. It does not replace a consultation with your doctor.
Frequently asked questions
What is the fastest way to ease metatarsalgia?
Rest the foot, use an ice pack wrapped in a towel, and swap to roomy, low-heeled shoes with a soft sole and a cushioned insole or metatarsal pad. Painkillers such as paracetamol or ibuprofen gel can help while it settles.
Is metatarsalgia serious?
Usually not. Mayo Clinic says it is not often serious, and nidirect says it often improves with simple self-help. It needs a check if it does not settle, keeps coming back or you have diabetes.
Is it metatarsalgia or Morton's neuroma?
Morton's neuroma is one cause of metatarsalgia. It is an irritated nerve, usually between the third and fourth toes. It causes burning or shooting pain, often with tingling or numbness in those toes.
Can metatarsalgia be a stress fracture?
Yes. Pain in the forefoot that starts after more walking or running, gets worse with activity and later hurts at rest can be a stress fracture. An X-ray may look normal at first.
When does ball of foot pain need urgent care?
Go to urgencias today if the pain is severe, you cannot walk, the foot has changed shape, you heard a snap at the time of injury, or the foot is hot and swollen and you feel shivery.
Sources
- NHS: Pain in the ball of the foot
- Mayo Clinic: Metatarsalgia, symptoms and causes
- nidirect (NHS Northern Ireland): Metatarsalgia
- nidirect (NHS Northern Ireland): Morton's neuroma
- MSD Manual: Stress fractures
Related guides
Medical Citations & Sources
This content is written and reviewed by a licensed physician with reference to the following official health authorities.
