Pain in the balls of the feet (Latin: Metatarsalgia) is a very common foot complaint, in particular for women. Most women who wear high heels or tight fashion shoes (or who have done so in the past) are likely to suffer from Metatarsalgia. Men can also suffer from this condition, especially if they have to wear hard shoes or boots without any cushioning inside, and their job requires standing or walking for prolonged periods. For example workboots or military/police boots can easily cause ball of foot pain.

People suffering from Metatarsalgia often experience a burning sensation under the ball of the foot. Sometimes combined with a sharp, tingling sensation near the toes (this condition is called Morton's Neuroma, see further below). The pain can also be stabbing pain that comes and goes throughout the day. In some cases people experience a feeling similar to having a pebble sitting under the forefoot.

Ball of Foot pain worsens when wearing high heels/fashion shoes for a longer periods of time or, for men after walking long distances in hard shoes. Typically people with Ball of Foot pain also display excessive callous formation under the balls of their feet.

Typically, the two main causes for ball of foot pain are:

- wearing high heels/fashion shoes

- over-pronation (fallen arches)

Most (young) women like to look stylish and wear a shoe with a medium to high heel. The problem with high heels is that your bodyweight is not evenly distributed across the underside of the foot, but rather 80% of your weight pushes down on only one area of the foot, the forefoot area. i.e. the balls of your feet. This is totally unnatural and before long the entire forefoot structure collapses, leading to constant pressure and friction in the ball of the foot. The body reacts and builds up thick layers of callous in this area which in turn leads to a burning sensation under the foot.

Also, as part of the ageing process women tend to lose the bulk of the shock-absorbing 'fibro-fatty' pad under the ball of the foot. Without this natural padding pain develops due to the pressure on skin over bone.

Another cause of Ball of Foot Pain is over-pronation. Over-pronation (or excess pronation) occurs in a lot of people, especially as they get older. The arches drop and feet and ankles tend to roll inwards. Excessive pronation is a major contributing cause to heel pain and heel spurs, but it also can lead to Metatarsalgia. As the longitidunal arch collapses so does the transverse arch. The transverse arch is the arch that runs across the forefoot and is formed by the 5 metatarsal bones. The bones in the foot drop and the structure of the foot is severely weakened. When we wear shoes that do not provide enough support and cushioning excess pressure is placed on the ball of the foot and often pain is experienced.

Over-pronation, combined with wearing hard, flat shoes and walking on hard surfaces such as concrete, pavements, tiled floors etc often leads to ball of foot pain, but also other common complaints including aching legs, knee pain and lower back pain.

For ladies' high heel and fashion shoes there is a new, unique solution to ball of foot pain: Footlogics 'Catwalk.' New from Spain these specially designed insoles restore our natural body balance by supporting the longitundinal arch, as well as the metatarsal bones and they shift bodyweight away from the forefoot towards the arch and heel. The result is that your bodyweight is more evenly distributed over the entire surface of the feet, and not just pushing into the balls of the feet. Thus, the insole prevents excessive pressure and friction in the ball of the foot are, and greatly reduces/eliminates the pain and burning sensation under the feet - especially with longer periods of standing or walking.

In case of regular flat footwear - whereby Metatarsalgia is caused by over-pronation - a full-length orthotic insoles with arch support as well as metatarsal support is recommended to prevent and relieve pain the ball of the foot.

Removal of excess callous by a Pedicurist, Chiropodist or Podiatrist is highly recommended to relieve ball of foot pain. You can also remove hard skin and callous yourself by means of daily light abrasion (using a pumice stone or fine grit foot file).

Shoes that are very narrow in the forefoot force the metatarsal bones together, pinching nerves and blood vessels that run between the bones. Continued use of shoes that are too narrow can cause one or more of the metatarsal bones to either shift up or down within the transverse arch, causing the arch to completely collapse.

On the other hand, shoes that are too wide can cause shearing stress under the foot as it slides around, causing callus to build up under the ball of the foot and under the toes. A narrow foot in a wide shoe will slide forwards, causing compression and curling of the toes. By allowing your toes to curl inside a shoe, you disturb the resting positions of your extensor and flexor muscles. Over time, this can result in fatigue and even cramp.

Thin soled shoes or shoes without any innersole cushioning will transfer all the hard impact with man-made surfaces directly into the bones of your feet, stimulating callous formation. So always buy shoes with plenty of cushioning and support, or wear orthotics inside your shoes.

Ill-fitting footwear should be replaced by anatomically correct, well-balanced and cushioned shoes. Avoid the use of high-heeled shoes or only wear high heeled shoes for no more than a few hours per day.

If problems persist, please consult a podiatrist.