Q: After walking about 1 kilometer, the balls on both feet are really sore. And I find it hard to walk around for about 2 hours after. What could this be?
A: Pain in the balls of the feet is a common problem. The medical term is metatarsalgia. Some people describe it as "walking on marbles."
1. Poorly-fitting shoes (especially ones with a high heel and narrow toe)
2. Certain types of arthritis, especially gout and rheumatoid arthritis
3. A swelling along nerves near the toe joints (called a Morton's neuroma)
4. Flat feet or high arches
7. Loose ligaments or weak muscles in the feet
8. Obesity may be a risk factor for metatarsalgia. Many people have more than one risk factor (such as obesity and flat feet).
Treatment depends on the cause. Options include:
a) Wearing shoes that provide cushioning and more room for the front of the foot
b) Shoe inserts (orthotics) that take pressure off the metatarsal-phalangeal joint
c) Filing down callouses
d) Exercises to strengthen the small muscles of the feet
e) Loss of excess weight.
f) Pain medicine (such as acetaminophen or ibuprofen)
g) Medicine directed against a particular type of arthritis. For rheumatoid arthritis, a number of treatments are available to reduce inflammation and modify function of the immune system. For gout, drugs that reduce inflammation and lower uric acid levels are effective.
h) Steroid injections
i) Surgery. For instance, a Morton's neuroma that does not improve with other treatments may require surgery.
If properly diagnosed, most people with metatarsalgia can be treated effectively. So, see your doctor for evaluation. He or she may recommend that you see a podiatrist, orthopedist or rheumatologist, all specialists in conditions that cause foot pain.
(Robert H. Shmerling, M.D. is a practicing physician in rheumatology at Beth Israel Deaconess Medical Center, Boston, Mass., and an Associate Professor in Medicine at Harvard Medical School.)
(For additional consumer health information, please visit http://www.health.harvard.edu.)
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The right diagnosis is key to effectively treating foot pain after walking
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