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Foot & Ankle Surgeon

What is metatarsalgia?

Metatarsalgia is a term to describe pain and inflammation in the ball of the foot. It is often thought of as a symptom, rather than a specific condition

What are the symptoms of metatarsalgia?

The primary symptom of metatarsalgia is pain in the ball of the foot. Often the most symptomatic area is at the base of the 2nd and 3rd toes. The pain is aggravated when walking or running. Most often, the pain comes on over a period of several months, rather than suddenly. You can also have the feeling that there a pebble in your shoe.

Are there other conditions with similar symptoms to metatarsalgia?

Metatarsal stress fractures, inter-metatarsal bursitis, Morton’s neuromas all have similar symptoms to metatarsalgia.

What are the causes of metatarsalgia?

Metatarsalgia is caused by repetitive overloading of the forefoot and often there are several factors involved, these include:

  • High impact sport. The front of the foot absorbs significant forces whilst running and during intense training. Long distance runners are at risk of metatarsalgia.
  • Foot shapes. Having a high arched foot or a long second toe can put extra pressure on the metatarsal heads. A bunion can also aggravate symptoms.
  • Excess weight. Most of your body weight transfers onto your forefoot whilst walking. Being overweight means more pressure on your metatarsals.
  • Ill fitting shoes. High heeled shoes transfer more pressure onto the front of your foot. A narrow toe box shoe can also contribute to the problem.
  • Tight calf muscles. Having a tight calf muscles means that your heel comes off the ground earlier when walking increasing the forces through your forefoot.

What is the treatment options for metatarsalgia?

In the first instance simple treatment measures are recommended to try and reduce your symptoms. These can have significant benefit and help avoid having surgery. Listed below are some of the main first line treatments for metatarsalgia but it is not exhaustive.

  • Activity modification aims to reduce activities that cause symptoms of
    metatarsalgia. A reduction in impact activities, such as running, may be required for a specified period of time.
  • Orthoses (medical insoles) can be useful to improve the foot position and reduce
    the forces transmitted through the forefoot whilst walking. You can be referred to the Orthotist for a specialist opinion.
  • Simple painkillers such as paracetamol or anti-inflammatory tablets (e.g. ibuprofen) can be beneficial. Ask advice from your doctor or pharmacist before taking anti-inflammatory medicines as they can have side-effects in some people.
  • Appropriate footwear is recommended with a wide toe box and thicker soles. Avoid high heeled shoes.
  • Weight-loss is an important part of the treatment plan, if you are overweight. It might be discussed as a part of your consultation. If required your general practitioner will be able to refer you onto a weight loss programme.
  • Stretching exercises to the calf muscles is a very effective for many patients and form the mainstay of treatment to promote long term resolution of metatarsalgia. It is important the stretching exercises are undertaken regularly. You can be referred to the physiotherapist for specialist input.

Surgery for metatarsalgia would only be considered an option as a last resort after non-surgical treatments have failed, and would depend on the extent of your symptoms and medical co-morbidities. Surgery is not without risks and has an associated recovery period.

Wellbeing Advice

Patients that have a healthy diet, take regular exercise and refrain from smoking are more likely to experience a quicker recovery with a more successful outcome from their surgery.

If you have any concerns about your general health and well-being (diet, exercise, smoking cessation) you are encouraged to discuss this with your GP, who will be able to provide advice on the options available to you.

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Our Aim

Our aim is to help eliminate your pain and allow you to get back to the things you want to do, as quickly as possible. Experienced in the latest advances in surgery and rehabilitation, we want to get you back on your feet and help them last a lifetime.

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Meet Our Team

Mercury Foot & Ankle Surgeon Intro Video
Mr Arul Ramasamy

Consultant Orthopaedic Foot & Ankle Surgeon
PhD, FRCS(Tr&Orth), DipSportsMed, MFSEM, MA(Cantab)

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Mercury Foot & Ankle Surgeon Intro Video
Mr Joel Humphrey

Consultant Orthopaedic Foot & Ankle Surgeon
BSc(Hons), MBBS, MSc(SportsMed), FRCS(Tr&Orth)

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Foot & Ankle Surgeon

My condition had deteriorated to the point that I was unable to walk for extended periods of time without pain and swelling of the ankle, and I would rarely be able to join in most family activities. The support and guidance provided by Mr Ramasamy were exemplary and enabled me to make a fully informed decision regarding the options available to me. Now, the pain is much more manageable and the stability that the treatment has provided is such that I feel that I regained a significant part of my life and as such my confidence.

Private Client

I found Mr Ramasamy extremely professional and reassuring. On the day of my procedure I received the most efficient, organised and professional care in my life. Your nurses were the best I have ever experienced. Mr Ramasamy’s team, in theatre made me feel at ease and made the whole procedure more bearable. They go way beyond the extra mile for their patients.

Private Client

I wanted to share my excellent experiences and compliment Mr Ramasamy and his team. I found him extremely professional and reassured that he understood how much pain I was in. On the day of my procedure, it was the most efficient, organized and professional care I have ever received – from checking into reception to being allocated a bay and taken into theatre – your nurses in the recovery area were the best I have ever received. Mr Ramasay’s team, especially in theatre, made me feel at ease, kept me informed throughout the whole procedure and made the whole procedure more bearable.

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Health care is the diagnosis, treatment,and prevention of disease, illness, injury, and other physical impairments in human beings.

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Frequently Asked Questions

Foot & Ankle Surgeon
What is the process if I am paying for my own treatment?2020-08-27T13:58:16+01:00

After your appointment you will be emailed an invoice to be paid within 30 days via a bank transfer.

Will my insurance cover me?2020-06-28T13:37:20+01:00

Our practice is covered by the major healthcare insurance providers. If you have private medical insurance, please contact your insurer to confirm that you are covered for your consultation and imaging appointments and whether you will need a GP referral. Please do this prior to seeing your Consultant. Your insurance company will provide you with an authorisation code which we will need when booking your appointment, along with your policy or membership details. All of this information can be obtained from your insurance company.

Depending on your specific insurance policy you may liable for some of the costs and there may be certain outpatient treatments such as joint injections and blood tests that may not be fully covered by your insurance policy. Please note, even if you are privately insured, you are entirely responsible for all of your consultants’ fees and that the contract you undertake is with your consultant and not your insurance company.

Foot & Ankle Surgeon
Foot & Ankle Surgeon
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Foot & Ankle Surgeon
How much does it cost?2023-03-17T15:24:59+00:00

In most cases, your outpatient costs should be covered by your insurance company, but please check as this can vary depending on your individual insurance and excess policy. If you are a self-pay, new appointments are £250 and follow up appointments are £175.

Do I need a new or follow-up appointment?2020-06-23T15:52:11+01:00

If you have not seen the Consultant previously for this problem, you have a different problem or if it is more than 1 year since your last appointment then please book a new appointment.

Do I need a referral letter?2023-03-17T15:35:57+00:00

If you are claiming through your health insurance, they may require a referral from your GP or therapist before authorising your consultation and treatment. If you are unsure then please call 01908 014 486 or email us on and one our team will be able to assist you. If you are paying for treatment yourself then you do not need a referral letter.

How do I make an appointment?2023-03-17T15:24:20+00:00

To arrange an appointment with one of our Consultants, please call 01908 014 486 or email us on

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Foot & Ankle Surgeon

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