Quick Summary
Pain under the ball of the foot is a symptom rather than one diagnosis. Find out what is increasing pressure and which treatment or referral is most appropriate. Our physiotherapists in New Malden can assess your symptoms and help you choose appropriate next steps for your goals.
Understanding Metatarsalgia
Metatarsalgia describes pain in the forefoot around the metatarsal heads. It may relate to load, footwear or joint and soft tissue problems. A nerve irritation, plantar-plate injury or stress fracture can produce similar pain, so treatment should identify the likely cause rather than use the label alone.
Assessment at J&J Therapy
We examine the painful area, walking and toe movement and discuss footwear and work demands. We explain whether a podiatry review, medical investigation or an exercise plan is the most useful next step, especially when symptoms persist.
Do You Experience These Symptoms?
- Aching or burning beneath the ball of the foot.
- Pain during push-off, prolonged standing or barefoot walking.
- Local tenderness, sometimes with callus or a sensation of pressure.
An assessment helps guide your next step, based on your symptoms, health and goals.
Why symptoms may develop
Changes in activity, narrow shoes, higher heels and differences in how load is shared across the foot may contribute. Joint inflammation, toe deformity or nerve problems can also be relevant. Numbness and focal bone tenderness deserve specific assessment.
Treatment and rehabilitation options
Hands-On Manual Therapy
Gentle work to calf or foot muscles may help associated stiffness, but deep pressure over an irritable forefoot is avoided. Hands-on care should not delay assessment of a suspected fracture, nerve problem or plantar-plate tear. We explain the purpose and check your comfort and response throughout treatment.
Is Shockwave Suitable?
Shockwave is not a routine treatment for the broad symptom label metatarsalgia. The underlying diagnosis needs to be established before considering any specialised treatment. Your physiotherapist can explain the more suitable options and how their effect will be reviewed during your ongoing rehabilitation.
Targeted Exercise Programme
Management may include roomier supportive footwear, an individually positioned pad or insole and temporary load changes. Suitable foot and calf exercise can support walking capacity. The programme is adjusted to the diagnosis rather than forcing painful toe extension. Your home plan is adapted as your function and confidence improve.
When to Seek Urgent Medical Help
While most symptoms are not serious, urgent medical attention is required if you experience any of the following:
- Seek urgent GP or NHS 111 advice for severe pain after injury, inability to bear weight, or a hot swollen joint with fever.
- Go to A&E for an obvious deformity or a foot that becomes cold, pale or numb.
- If you have diabetes and a new foot wound, redness or swelling, contact your GP or diabetic foot team the same day; use NHS 111 if unavailable. Persistent altered sensation also needs medical review.
Your questions answered
Is metatarsalgia the same as Morton’s neuroma?
No. Metatarsalgia means ball-of-foot pain; a Morton’s neuroma is one possible cause involving a nerve. Tingling or burning into the toes helps guide the assessment.
Do I need custom insoles?
Not necessarily. Footwear changes or a simple pad may be enough for some people. A podiatrist can advise when more specific support is appropriate.
Which appointment should I book?
Start with a Physiotherapy Initial Assessment for new, persistent or recurring symptoms. We can assess the problem and agree a plan linked to your daily activities. If you have already had medical care or surgery, bring the relevant instructions.
Book a Physiotherapy Assessment or call our reception team on 07935 869938. Find J&J Therapy at CI Tower, Ground Floor, New Malden.
Related conditions
Morton’s Neuroma · Bunions (Hallux Valgus)
Sources and further reading
This page is for general information only and does not replace professional medical advice.
Information updated 15 October 2026. General information only; this page cannot diagnose your symptoms. Treatment is agreed after assessment. For urgent or severe symptoms, use the medical services described above.