April 23, 2018

Pain in Ball of Foot

Foot Pain: Ball of Foot

The well-being of one’s foot is something many take for granted as we bustle about the kitchen, dash out the door for work or kick a soccer ball around the yard. But the importance of a healthy foot becomes very evident when one develops a foot condition that causes more than passing pain.

In this article, I take a look at a few of the more common causes of pain in the ball of the foot as well as some steps for the ball of foot pain relief and prevention practices.

Metatarsalgia Pain: Ball of Foot

Metatarsalgia takes its name from the long metatarsal bones at the base of the foot. Sometimes too much pressure is put on the ends of the bones and the result is inflammation that causes the ball of foot pain.  

learn about metatarsal foot anatomy and causes of metatarsalgia pain

Sometimes this discomfort can be characterized as a sharp pain in the ball of the foot and in other instances, the discomfort might be described as a burning or aching sensation just behind the toes. Sometimes ball of foot and toe pain occur together; one might also experience tingling or numbness in the toes.

The pain associated with metatarsalgia is typically more intense when one is standing, walking barefoot, running or flexing the feet. Conversely, the pain in the ball of the foot is typically least severe after giving the feet a rest.

Sometimes the ball of your foot pain will come on suddenly, but typically this develops gradually over time.

So what causes the ball of foot pain known as metatarsalgia? Generally speaking, this foot pain in the ball of foot stems from being active or from wearing shoes that do not fit well or that have high heels that put excess weight on the forefront of the foot. (See a slideshow on the worst shoes for your feet.)

High-impact sports stress the ball of the foot, such as a running ball of foot pain, are not uncommon. Stress fractures can also increase one’s risk of metatarsalgia, as can being overweight.

Abnormal foot structures such as a high arch, a second toe that exceeds the length of the big toe or hammertoe can cause metatarsalgia ball of the foot pain.

Some amount of pain at the forefront of the foot does not necessarily imply a ball of a foot injury. Rest, ice, anti-inflammatory medications and a switch to supportive shoes and possibly shock-absorbing insoles for the ball of foot pain will usually suffice for the ball of foot pain treatment. Other foot orthotics for metatarsalgia such as pads or arch supports may also be helpful.

If this does not take care of the condition within several days, it is best to see a doctor. In rare cases, surgery is needed to remedy metatarsalgia.

Burning Pain in Ball of Foot: Morton’s Neuroma

Morton’s neuroma refers to a condition where the tissue around the nerve leading to the toes thickens, causing severe pain in the ball of the foot that is often described as a burning sensation. This typically occurs between the third and fourth toes. Morton’s neuroma is another condition where toe and ball of foot pain are linked. It can cause a stinging, burning, tingling or numbing sensation in the toe or toes. 

foot pain can be caused by morton's neuroma condition around nerves

The cause of this foot pain in the ball of the foot is thought to be irritation, injury or pressure to the nerves running into the toes, though the condition is not well understood. Similar to metatarsalgia, the ball of foot pain causes are thought to be linked to wearing high-heeled or tight shoes. Subjecting the foot to repetitive trauma or engaging in sports that require tight-fitting shoes, such as snowboarding or rock climbing, is also thought to be tied to this type of foot pain on the ball of the foot.

Foot deformities like bunions, hammertoe or flat feet are also thought to be tied to Morton’s neuroma.

Treatment for Morton’s neuroma typically involves switching to better shoes for ball of foot pain and the use of shoe inserts, such as arch supports or foot pads. To get the ball of foot pain and big toe discomfort under control, one should rest the foot, give the region an ice massage and use anti-inflammatory medications. In some instances, a steroid injection may be needed. In rare cases, a doctor may recommend surgery or cryogenic neurulation.

Pain on Ball of Foot from the Sesamoid Bones

Another source of pain under the ball of foot revolves around two bones that I, for one, had never heard of—the sesamoid bones. These two small bones (about the size of a pea) are connected to the tendons. They function like pulleys, improving the ability of the tendons to lift the big toe and for the ball of the foot to withstand the weight. 

learn about pain from sesamoid bone fractures and inflamed tendons

These sesamoid bones can be fractured or the tendons around the bones can become inflamed. The inflammation of the tendons around the sesamoid bones is known as sesamoiditis and is a form of tendonitis.

How does this type of injury to ball of foot occur? Activities that put a lot of pressure on the forefront of the foot are typically the culprit. For instance, this is one of the more common ballet foot injuries. It is often seen fairly frequently among catchers in baseball or softball. This can also be the cause of ball of foot pain from running.

In the case of a fracture, ball of foot swelling and pain will come on suddenly, while in instances of sesamoiditis, the pain will generally develop gradually over time. This foot pain at the ball of foot generally is located just behind the big toe where the bones are located. Other possible symptoms of a sesamoid bone injury include bruising and difficulty bending the big toe.

Treatment for sesamoiditis involves stopping the problematic activity, resting and applying ice to the injured foot and using orthotics for the ball of foot pain. This might include wearing a foot pad under the toe and wearing low-heeled, comfortable shoes with a soft sole. In some instances, a steroid injection or taping the big toe in a slight downward flexion may be helpful.

If this does not take care of the foot pain at the ball of the foot, one may need to wear a short foot fracture brace for a period of time.

Treatment for ball of foot pain stemming from a fractured sesamoid entails wearing either a stiff-soled shoe or a short leg fracture brace or taping the joint to limit the movement of the big toe. Inserting a pad in the shoe under the affected region can also help with the pain, as can taking over the counter pain relief medication.

View all of BraceAbility's treatments for foot conditions.

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