# Ball-of-foot pain (metatarsalgia)

> Ball-of-foot pain, or metatarsalgia, is pain on the sole of the foot near the toes. It's a symptom with several possible causes, often extra pressure on the forefoot. Roomier, low-heeled shoes, calf stretching and easing off what aggravates it can help, and a podiatrist can look for the cause.

Guide in [Toes and forefoot](https://footanklelowerlimb.com.au/learn/topics/toes-and-forefoot), from Foot Ankle Lower Limb: https://footanklelowerlimb.com.au/learn/metatarsalgia
Reviewed by Andrew Schox, BSc(Hons) PGradDipPod MPod (Podiatrist) on 27 October 2026.
Next review by 27 October 2027.

- **It's pain in the ball of the foot,** on the sole near your toes, and it's best seen as a symptom with a cause to find.
- **Overload is a common story:** foot structure, a sudden jump in activity, tight calves or unsuitable shoes can all add pressure.
- **Home care comes first:** roomier shoes with a low heel, calf stretching and easing back on what aggravates it.
- **See a podiatrist or your GP if it isn't improving,** or if you have warning signs such as tingling, or if you have diabetes.

## What is ball-of-foot pain, and how common is it?

Ball-of-foot pain, known medically as metatarsalgia, is pain on the sole of your foot near your toes [1]. It's best seen as a symptom with several possible causes rather than a diagnosis on its own [2], so the aim is to work out what's overloading your forefoot.

It's common. In adults aged 45 and over, the toes and forefoot are the most common place for foot and ankle pain, and foot and ankle pain seems to be more common in women [3]. Published figures for how many people get it vary widely, so treat any single number as a rough guide.

## What causes it, and who gets it?

It's mainly a mechanical problem. The way your foot is built or moves can raise pressure under the metatarsal heads (the rounded ends of the long bones behind your toes) when you push off [4]. A high arch or a long second metatarsal are examples [4]. Foot injuries or forefoot surgery can also change how load is shared across the forefoot [4].

A sudden increase in activity can set it off [5]. Tight calf muscles are often linked with forefoot pain, though it isn't clear whether tightness is a cause or a result [6]. Activity, body weight and footwear are all risk factors for foot and ankle pain [7].

It can help to think back to what changed around when the pain started: new shoes, a new activity, or more time on your feet.

## What does it feel like, and how is it diagnosed?

It often feels sharp, stabbing, burning or tingling in the ball of the foot, sometimes into the toes. It's usually worse when you're on your feet and eases with rest, and some people feel as if they're walking on a pebble or lump [8]. It tends to build gradually over several weeks rather than appearing suddenly [1].

A podiatrist or doctor will ask when it started and what changed, then examine your foot, especially the sole [2]. X-rays taken while you stand are often enough to find the cause [9].

Other problems can feel similar, so it's worth having it checked rather than guessing. Tingling or burning in typically 3–4 toes, with a pebble feeling, can point to Morton's neuroma (an irritated nerve between the toe bones) [7]. A toe that starts to drift or bend can point to a torn plantar plate (the supporting tissue under the toe joint) [8].

## What can I do first?

Most people start with self-care, and non-surgical care is usually enough [10]. First-line care means learning about the condition and using steps you can do yourself [11]:

- **Change your shoes.** Look for a wide, deep toe box and a low heel [11].
- **Stretch your calves.** It may ease forefoot pain by reducing the force on the ball of the foot [11].
- **Ease back, don't stop.** Cut down on what aggravates it, and build activity up gradually.

It isn't clear yet which of these works best, so a podiatrist can tailor the plan to you. If you have a health problem, injury, recent operation or heart attack, or are pregnant, check with a health professional before starting general exercises, and stop if pain or unwellness occurs [5].

> [!tip] Try this
> Stand facing a wall with one foot behind the other and your back heel flat on the floor. Lean forward until you feel a stretch in the back calf and hold for a slow count. Repeat a few times on each side, keeping it comfortable.

## What helps if that isn't enough?

If home care isn't working, the cause is unclear or the pain is getting worse, see a podiatrist or your GP about next steps [12]. Referral on to a musculoskeletal service can be considered after at least 3–6 months of thorough non-surgical care, or sooner if the pain has a big impact or the cause isn't clear [7].

Injections and surgery come after non-surgical options. A steroid injection can cause a flare of pain, rarely an infection, and higher blood sugar in people with diabetes [13]. After surgery that shifts or shortens a metatarsal bone, adults can have long-lasting swelling, slow bone healing or pain that moves to a neighbouring bone [14]. Forefoot surgery means 6 weeks on crutches and in a surgical shoe, and diabetes, poor circulation and a high body mass index are best managed beforehand [13].

It isn't clear yet how surgery compares with carrying on with non-surgical care. If it's offered, ask about risks, recovery time and what happens if it doesn't help.

## How long does it take to get better, and how can I stop it coming back?

How long it takes to settle isn't clear, so give each step a few weeks and keep track of any change. Body weight can matter: people living with obesity are more likely to have symptoms that last, so it's worth asking your GP or another health professional about support if that applies to you [7].

Wide, deep toe-box shoes with a low heel are the usual advice [11], though it isn't clear yet whether footwear changes stop the pain coming back. Build walking, running and standing up gradually. Runners who move to minimalist shoes have more injuries, including bone swelling in the metatarsal region, so make that change gradually [15].

## When to see a podiatrist

See a podiatrist or your GP if:

- the pain hasn't improved after 2 weeks of home care [16];
- you have tingling or loss of feeling in your foot [16];
- you have diabetes and foot pain, because foot problems can be more serious with diabetes [16];
- the pain increases greatly after exercises [5];
- it's getting worse, or the cause isn't clear [12].

See your GP soon if you think you could have a stress fracture (a small crack in a bone), for example after a big increase in activity. It needs weight taken off the foot quickly, so don't wait for it to settle [9].

See your GP or a podiatrist the same day if:

- you can't put weight on your foot after an injury, as a broken bone or torn tendon needs prompt assessment [12];
- you have spreading redness, heat, swelling or pus in your foot, which can mean infection [12];
- you have diabetes and a wound, sore, blister or colour change on your foot;
- you have sudden severe pain or numbness in your leg or foot.

For urgent advice when it isn't an emergency, call healthdirect on 1800 022 222 (24 hours a day), or go to a Medicare Urgent Care Clinic.

Call 000 and ask for an ambulance if you have signs of a severe allergic reaction after an injection, such as sudden severe breathlessness [13].

## Common questions

### Can I keep running with ball-of-foot pain?

You may not need to stop everything. It can help to cut back on what makes the pain worse, such as long runs, keep active in ways that don't aggravate it, and build back up gradually as it settles. If running keeps flaring it or the pain is getting worse, a podiatrist can help you plan.

### Do insoles or metatarsal pads help?

Insoles are one of the usual first treatments, alongside shoe changes and calf stretching. It isn't clear yet how much they help compared with those other steps, so they work best as part of a plan. A podiatrist can advise which kind, if any, suits your feet.

## Further reading

- [Ball-of-foot pain (metatarsalgia) on Clindice](https://clindice.com/metatarsalgia)
- [Metatarsalgia - NHS Lanarkshire](https://www.nhslanarkshire.scot.nhs.uk/services/podiatry/metatarsalgia/), NHS
- [Kick Metatarsalgia to the Curb](https://my.clevelandclinic.org/health/diseases/15890-metatarsalgia), Cleveland Clinic
- [Metatarsalgia and dislocated toe deformities](https://www.chelwest.nhs.uk/your-visit/patient-leaflets/surgery-services/metatarsalgia-and-dislocated-toe-deformities), NHS
- [Foot pain - Metatarsalgia](https://www.mskdorset.nhs.uk/foot-pain/foot-pain-metatarsalgia/), NHS
- [Foot and Ankle Pain Pathway (Age 16+)](https://www.dgft.nhs.uk/wp-content/uploads/2026/10/Foot-and-Ankle-Pain-v1.8.pdf), NHS

## Sources

1. Pain in the ball of your foot (metatarsalgia) · Health New Zealand | Te Whatu Ora. https://www.healthnz.govt.nz/health-topics/conditions-treatments/feet-and-ankles/pain-ball-of-foot-metatarsalgia
2. Overview of Metatarsalgia · Charen DA, Markowitz JS, Cheung ZB et al. · Orthopedics · 2019. https://doi.org/10.3928/01477447-20181206-06
3. The population prevalence of foot and ankle pain in middle and old age: a systematic review · Thomas MJ, Roddy E, Zhang W et al. · Pain · 2011. https://doi.org/10.1016/j.pain.2011.09.019
4. Forefoot disorders and conservative treatment · Park CH, Chang MC · Yeungnam University Journal of Medicine · 2019. https://pmc.ncbi.nlm.nih.gov/articles/PMC6784640/
5. Pain in your toe or the ball of your foot - Metatarsalgia · Bradford District Care NHS Foundation Trust · 2025. https://www.bdct.nhs.uk/pain-in-your-toe-or-the-ball-of-your-foot-metatarsalgia/
6. Gastrocnemius recession in the treatment of isolated metatarsalgia: A systematic review of surgical outcomes and complications · Calori S, Giuliani A, Bocchino G et al. · Journal of Orthopaedic Surgery (Hong Kong) · 2026. https://doi.org/10.1177/10225536251350416
7. G-care: The primary care clinical information system · NHS. https://g-care.glos.nhs.uk/clinical-topic/foot-and-ankle-pain
8. Metatarsalgia · NHS Lanarkshire · 2022. https://www.nhslanarkshire.scot.nhs.uk/services/podiatry/metatarsalgia/
9. Radiological approach to metatarsalgia in current practice: an educational review · Palka O, Guillin R, Lecigne R et al. · Insights Into Imaging · 2025. https://doi.org/10.1186/s13244-025-01945-3
10. Metatarsalgia · Espinosa N, Brodsky JW, Maceira E · The Journal of the American Academy of Orthopaedic Surgeons · 2010. https://doi.org/10.5435/00124635-201008000-00004
11. Lesser metatarsals pathologies · NHS. https://www.rightdecisions.scot.nhs.uk/ggc-msk-foot-and-ankle/forefoot/lesser-metatarsals-pathologies/
12. Forefoot pathologies · NHS. https://www.rightdecisions.scot.nhs.uk/refhelp-nhs-ayrshire-and-arran/orthopaedicsmsk/foot-and-ankle/forefoot-pathologies/
13. Foot and Ankle Pain Pathway (Age 16+) · NHS. https://www.dgft.nhs.uk/wp-content/uploads/2026/10/Foot-and-Ankle-Pain-v1.8.pdf
14. Complications in Distal Minimally Invasive Metatarsal Osteotomies: Systematic Review and Meta-Analysis · Fernández-Gómez AM, Nieto-García E, Ramírez-Andrés L et al. · Medicina (Kaunas, Lithuania) · 2025. https://doi.org/10.3390/medicina61081435
15. Injury risk associated with the transition to minimalist footwear in runners: A systematic review and meta-analysis · Sánchez-Del Río E, Galán-Arriero I, Palomo-Fernández I et al. · Gait & Posture · 2027. https://doi.org/10.1016/j.gaitpost.2026.110614
16. Pain in the ball of the foot · NHS. https://www.nhs.uk/symptoms/foot-pain/pain-in-the-ball-of-the-foot/

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This page is general information, not a diagnosis or a treatment plan for you. For advice about your own feet or legs, see a podiatrist or your doctor. In an emergency, call 000.