Metatarsalgia Treatment at Home: Is It Possible?
Discomfort and pain in the ball of the foot can be really unpleasant, and it can get worse after physical activity, even a light one such as walking.
That's why the most recommended treatment is resting, and hoping it will go away. Since the source of the pain is inflammation, you may confuse it with sore feet which often happens after a long day.
Only if the pain persists you are right to believe you have developed a medical condition. Metatarsalgia demands to see a doctor only if you have tried out all your options, and the aching remains persistent. In this article, I’m going to discuss everything there is to know about metatarsalgia and its treatment.
What is metatarsalgia?
As I already mentioned, metatarsalgia is the pain in the metatarsal area of the foot, but how can you recognize it without going to the doctor? Here are some symptoms you can recognize yourself when inspecting your foot at home:
- Stabbing or burning pain in the ball region of the foot.
- Numbness, tingling or pain in the toes.
- Pain in the mentioned regions that worsens during physical activities and lessens when resting.
- The increase of pain when you walk barefoot on a hard surface.
Are there any risk factors for metatarsalgia?
As with many other conditions, there are some behaviors and factors that put you in a higher risk of developing it. If you suspect you have metatarsalgia, try to determine whether you are exposed to any of the following risk factors:
- Wearing heels or shoes with narrow toes often.
- Being engaged in a high-impact sport.
- Being in a rigorous athletic training program.
- Weight gain.
- Having hammer toes or high arches.
- Having a bone fracture or bunions.
- Suffering Morton’s Neuroma.
Can metatarsalgia be treated?
Although metatarsalgia is not among the most serious medical conditions, it is certainly dangerous to ignore its symptoms. Such approach can lead to chronic pain in the feet which can furthermore cause secondary conditions of ongoing pain in the neck, back and hips.
The treatments for metatarsalgia vary depending on the cause. If you feel the pain is intolerable, you can use some over the counter medications that can provide relief for the symptoms but can't treat the very condition. Those are anti-inflammatory medications like Voltaren and ibuprofen. You can buy them in any pharmacy, and use them at home, according to the instructions. If you have any doubts about taking them on your own, ask the pharmacist for advice.
Many of the methods designed to treat metatarsalgia include some sort of change in lifestyle and can be done at home without medical assistance, while the more demanding solutions can include physical therapy and surgical procedure, but more on that later.
How to ease discomfort and pain?
Besides using anti-inflammatory medications, there are several other ways to ease the pain in the ball of the foot when you are at home:
- You can wrap some ice and apply it to the sore region several times a day. Keep it like that for about fifteen minutes.
- If you keep the feet up when you are resting, you can feel a slight relief and comfort.
- In more severe cases, after consultations with your physician, you may be recommended steroid injections to decrease the swelling and the pain.
What is the initial treatment for metatarsalgia?
Metatarsalgia is not a condition you can’t be aware of right away. It usually starts off as a slight annoyance, but it can quickly become a painful irritation, and then without a heads up, it sidelines you for weeks. It is essential to take the pain seriously and start with the treatment right away. Fortunately, it is something you can do in the comfort of your home, without the assistance of a physician.
The primary goals of the rehabilitation are to restore normal range of motion and reduce pain, irritation, and swelling. However, it is also critical to restoring strength and function as soon as possible. The first step toward relief is to reduce the pain with RICE (Rest, Ice, Compression, and Elevation):
- Rest: Limit the activities that are causing you pain (running, walking, etc.). As the pain is becoming weaker, you can slowly start returning to your regular activities, while still making sure the unbearable pain doesn’t come back.
- Ice: Apply a gel pack or frozen peas (wrapped in a cloth) to the painful area.
- Compression: Use an ACE wrap around the foot to reduce swelling.
- Elevation: Keep your foot above the level of your heart by using pillows.
How to treat metatarsalgia at home?
After the initial RICE treatment, the pain and swelling should be reduced; you can start self-treating metatarslagia at home. Here are a few tips that can help you with that.
- Strengthen your foot and ankle muscles. Weakness in these muscles can cause extreme strain on the tissues on the bottom of the foot. To avoid this, you can start with a complete ankle/foot strengthening protocol.
- Improve your balance. Poor balance is often linked to muscle weakness in the foot and ankle. Lack of strength and balance can lead to poor foot mechanics, which is considered to be one of the causes of metatarsalgia. Improving your balance with foot exercises helps you, not only to reduce the risk of metatarsalgia but also to achieve more successful rehabilitation.
- Use a metatarsal pad. In the early phases of the treatment, using metatarsal pads is crucial for providing pain relief.
- Use an orthotic. Semi-rigid corrective devices included in supportive shoes can be used as a treatment for metatarsalgia. They are especially recommended when a metatarsal pad is helpful, but it doesn't fully eliminate the pain. Supportive shoes are the most effective when they also include a custom-made metatarsal pad.
- Slowly return to your regular shoes: Don’t make a quick progression into your old minimalistic shoes, unless you want to develop metatarsal pain again. A gradual, slow transition allows your body to adequately adapt to the new pressures. I highly recommend waiting for the offseason as progressing slowly is always a better choice.
Metatarsalgia treatment for runners
If you are a runner, coping with metatarsalgia can be more difficult for you, because it means you will need to give your feet a break from running long mileages. Also, you should try to run on soft surfaces, but it would be best to switch to a low-impact activity, at least until you cure the swelling and reduce the pain.
If the pain doesn’t stop after you took all the measures mentioned in the previous paragraphs, and it continues tormenting you for more than ten days, you need to visit your doctor or podiatrist. After the consultation, the doctor will recommend the solution that will work the best for you. That can be orthotics, metatarsal pad or callus shaving.
Physical therapy is also often recommended for runners and athletes. It includes no-weight-bearing ambulation, passive range-of-motion, and ultrasound treatment.
How to prepare for your doctor’s appointment?
If the pain isn’t relieved after all the methods you have applied, you should consider visiting a general practitioner or your family doctor to learn what to do from then. The doctor may refer you to a podiatrist or an orthopedist.
In order to make sure everything will go well at the doctor’s, you should be prepared for your appointment. Here’s how you can do that:
- Make a list of all of the symptoms you are experiencing, including the ones that may not seem related to your foot pain. Also, note the time when they began.
- Write down your personal information that includes your lifestyle and the sports you are engaged in.
- Make a list of the questions you want to ask your doctor (e.g., Do I need to restrict my activities, Is my pain chronic or temporary, Do I need to do tests, What treatment do you recommend…)
What to expect from the doctor’s appointment?
Besides examining your foot, the doctor will ask you a series of questions, and you should be prepared to answer them all correctly, because that may determine the quality of your recovery.
Some of the things the doctor will need to know are the type of the shoes you wear, the activities you normally do (especially sports), the period of time you spend walking or standing during the day, how severe are your symptoms, are they occasional or continuous, what improves your symptoms, what treatment methods have you tried at home, what worsens your symptoms, etc. Think about these things before you make an appointment.
What is metatarsal surgery?
If metatarsalgia does not respond to at-home treatments, exercises and other relief methods you may require surgical solutions. Consult your podiatrist or a physiotherapist for other options and considerations related to this condition.
The type of metatarsalgia surgery depends on the underlying problem. Surgical intervention can reshape the bones in question and straighten the claw toes or the hammer toe. It can also remove or relieve the irritated or trapped nerve.
Most frequently, the metatarsal surgery includes cutting the metatarsal bone just the toe. The bone is then cut all the way through, to be manually elevated and held in its modified position with a screw or a metal pin.
After the surgery, you will be placed in a cast, and you may have to rely on crutches to walk for several weeks. If the surgeons put a pin to hold the bone in place, it should be removed in three to four weeks. The removal of the pin is quite easy, and it is done without anesthesia.
Usually, you will need up to eight weeks, or sometimes more for the bone to heal completely. During the recovery period, the foot shouldn’t be exposed to excessive weight bearing. You should restrain from walking on the treated foot, to prevent it from healing in an incorrect position. If it is not elevated enough or if it shifts downward the painful callous can come back.
Sometimes it is required to cut out the painful callous on the bottom of the foot. If the metatarsal alignment isn’t corrected during the surgery, it is most likely that the painful callous will return.
At the end of the surgery, the surgeon will place a gauze bandage on your foot. The bandage usually stays in place until the first follow up visit with your doctor. The stitches will remain on the skin for up to fourteen days, but the stitches in the bottom of the foot can stay in place for about three weeks.
The foot must be kept dry while the pin and the stitches are still in place to avoid infection. As I’ve mentioned, some patients have to wear a below the knee cast or use crutches. However, for some patients it’s recommended to wear a stiff-sole post-operative shoe. In this case, limited walking on foot is allowed.
How to prepare for metatarsal surgery?
There are not many things you can do at home to prepare for metatarsal surgery, but the doctor will probably recommend you to stop taking medications a few days before the procedure, especially if you are using aspirin or any other blood-thinning drugs.
You don’t have to stress out about the surgery. If you feel nervous you can try meditating or deep breathing. This is an outpatient procedure, which means that you can go home a few hours after the anesthesia stops working. Just in case, you should call a friend or a family member to take you home.
How long does it take to recover from metatarsal surgery?
The recovery period that includes work absence or restraining from your regular activities will depend on your job and your lifestyle. The usual minimum is one week off work. During that time you should stay at home and keep your foot elevated above the level of your heart.
Is there a risk of complications?
Although this is usually a harmless procedure, as with every surgery, there is a risk of complications. Some of the most frequent risks are an infection, failure of bone healing, excessive swelling, stress fractures of adjacent metatarsals, failure of bone healing in the correct position, which can result in the return of the painful callous and the elevation of the toe connected with the elevated bone that was operated on.
Metatarsal surgery for treating diabetic ulcerations
Diabetic patients who have non-healing ulcerations on the ball of the foot can’t undergo the typical metatarsal surgery. They are usually subjected to a different type of procedure where the section of the metatarsal bone linked with the extreme pressure needs to be removed entirely.
While it is definitely different, it is still a relatively common surgery with a prevailing number of successful outcomes. Possible complications with this surgery are quite similar to the ones with the typical metatarsal procedure, and they include infection, failure to heal the ulceration, or the development of new ulcerations on the ball of the foot.
How to prevent or cure metatarsalgia with lifestyle changes?
The best road to prevent or cure metatarsalgia is to cut it straight in its root, that is, to eliminate the cause of this condition. I named several causes of metatarsalgia in this article, so you already have got a pretty good idea about how to address them, but just in case, here are the things you can do, depending on what’s causing the pain in your ball of the foot.
- If you frequently wear uncomfortable footwear, be that high heels or narrow toes shoes, you should switch them for more comfortable shoes. The best shoes for metatarsalgia should give you the extra support and padding under the arch of the foot. This can spread the metatarsal bones and relieve the pinching of the nerves and the pain.
When in search of the best walking shoes for metatarsalgia, pay attention to cushioning that alleviates the pressure. Also, it is essential for the shoes to be properly fitted. The wide toe box is an important feature because tight fit can worsen this condition. You should avoid footwear that is too soft and flexible and don't provide sufficient arch support.
- If you have gained weight and that is the cause of you developing metatarsalgia, you should do your best to lose the excess weight by maintaining a healthy diet and exercising. If you start a weight-loss exercising program, make sure you don’t put too much pressure on your feet. When you succeed in losing weight, you should proceed with the healthy lifestyle and maintain your weight.
- If you are engaged in a high-impact sport or rigorous athletic training, you should take a break at least until your metatarsalgia is treated. After this, you should consult your doctor about how to proceed with the previous lifestyle.
- Diabetes can also be the cause of metatarsalgia. This is yet another good reason to take proper care of yourself and keep your diabetes under control. This can reduce your chance of developing this condition.
Although metatarsalgia doesn't seem like a serious condition at first glance, it can really diminish your life quality and prevent you from going into some normal activities as casual as you did before. It can also impact the rest of your body, including your neck, hips, and the back. When all of these complications accumulate, they may prevent you from living your life the way you are used to.
This is why it is important to start treating metatarsalgia the first second you notice something is wrong. At home treatment is possible, and frequently it is very helpful. In most cases, you won’t even need to pay your doctor a visit, but be prepared to do so if the symptoms are persistent and severe.
Finally, since the causes of metatarslagia are most frequently associated with your lifestyle, you need to be willing to make healthier choices regarding your footwear and your weight, to be sure the problem will not return to haunt you.