Signs or Symptoms

Localized moderate to severe pain in the area of the foot just before the toes.


Metatarsalgia is a general term used to denote a painful foot condition in the metatarsal region of the foot (the area just before the toes, more commonly referred to as the ball-of-the-foot). This is a common foot disorder that can affect the bones and joints at the ball-of-the-foot.


It is usually due to excessive pressure over a long period of time. It is often caused from improper fitting footwear, most frequently by women’s dress shoes and other restrictive footwear. Footwear with a narrow toe box (toe area) forces the ball-of-foot area to be forced into a minimal amount of space.

Standard Treatment

If improper fitting footwear is the cause of the pain, the footwear must be changed. Footwear designed with a high, wide toe box (toe area) and a rocker sole is ideal for treating metatarsalgia. Orthotics are usually fitted. Cortisone injections are the next line of treatment. Surgery is also a possibility.

AK Approach

The muscles that support the foot and ankle are evaluated to find the ones that are malfunctioning. These are corrected and then the alignment of the foot bones is corrected. The attention is then shifted to the localized structures that are injured and failing to support the foot joints properly. These can include specialized treatments for ligaments, muscles, skin and joints. This is followed by an analysis of how the person walks or runs. Depending on the foot ankle complex, orthotics may be needed to support the foot properly. Finally, attention is directed to corrective procedures that can help stabilize and strengthen the structures to help prevent future injuries. Nutritional therapies aimed at increasing factors that would speed healing and reduce any inflammation are considered. Other lifestyle modifications are used to prevent or minimize exacerbating the condition. A specific program for your needs is created.

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