Metatarsalgia – Toothache of the Foot

barefoot photo

Metatarsalgia or Stone Bruise

Oww!   Feels like there’s a pebble in your shoe, but when you check… nothing?  What’s going on?  Why does your foot hurt?  Metatarsalgia, or as it’s commonly called, a Stone Bruise is a condition where there is pain in the ball of your foot, between your toes and the arch of your foot.   This pain is often compared to a “toothache”, the area becomes tender to the touch and there may be some swelling, but without discoloration.  This pain occurs where the five long bones in your foot (metatarsals) connect to the toe bones (phalanges).  Most often metatarsalgia is centered on the big toe.

Causes of Metatarsalgia

So what causes a stone bruise?   The pain in the head of the metatarsal can be caused by a variety of things.   The pain can by a symptom of another problem, overuse, a deformity or poorly fitting shoes.  Here are a few of the potential causes:

  • Calluses
  • Poor fitting shoes or shoes that are worn out.  Typically shoes that are too narrow or high heels.
  • Overuse
  • Stress fractures
  • Diabetes
  • Morton’s Neuroma
  • Rheumatoid Arthritis
  • Excessive Pronation (the movement your foot makes side to side while walking or running)
  • Standing for long periods on concrete or other hard surfaces.
  • Prominent metatarsal heads.
  • Changing the style of running shoe to something more minimal.
  • Tightness in the Achilles tendon or calf muscles, poor ankle mobility.
  • Excessively High Arches or Flat Feet
  • Poor muscle strength in the foot, specifically the muscles that support the arch of the foot and provide stability.
  • Hammertoe
  • Bunions
  • Torn ligament

Treatment of Stone Bruise

If your metatarsalgia is minor it can be treated at home.   The RICE protocol is the best method for home treatment and evaluation.

    • Rest Limit any activity that is causing pain.   Give your body a chance to get better.  As pain subsides activity can be reintroduced.
    • Ice Icing an injury will reduce inflammation and pain. Apply ice, but take care not to put ice directly on the skin. The best rule is to ice an injury for no more than 20 minutes every hour. Take extra care if you have poor circulation or impaired sensation
    • Compression Wrapping the foot can reduce swelling and pain.   Do not wrap too tightly, and if compression irritates the injury it may not be the best approach.
    • Elevation Raise the foot above the level of your heart.  Elevating the injury will reduce swelling.

Once you have completed RICE, evaluate the injury.  If there is still pain, visiting the podiatrists at Foot and Ankle Center of Northern Colorado for further evaluation is recommended. Our doctors can diagnose your injury and recommend treatment.

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