How to treat pain in the ball of your foot and answers to what’s causing it?

Have you been experiencing pain in the ball of foot? Pain in the ball of your foot, may be caused by a variety of factors and is important to have this concern looked at and treated by one of our Podiatrists here at Foot Centre Group. Forefoot pain is common and treatable and isn’t something you need to put up with daily.

The medical term for pain in the ball of the foot is metatarsalgia. It’s an umbrella term for a symptom that can have many possible causes.

Clients with ball of foot pain can experience different types of pain. Most clients find ball of foot pain to be present in either the padding directly below the toes or on the dorsum (top of the foot), which is where we place the most pressure when standing and moving.

The pain that you experience in your forefoot  may ease when you are off your feet, out of your daily shoes and load is reduced, leading to reduce pain.

What are the most common symptoms associated with pain in the ball of the foot?

The most common Ball of foot pain symptoms are:

  • Deep bone ache
  • Shooting pain, numbness or burning pain into to the toes
  • Feels like there’s a stone/wrinkle in your sock under your foot
  • Immediate sharp pain when beginning movement/exercise that does not warm up or get better as time goes on.

These symptoms can be present with or without inflammation or bruising depending on the cause/mechanism of injury and duration of how long the pain has been present for.

What causes this pain in the first place?

Pain in the ball of the foot can be caused by numerous different conditions. This includes morton’s neuroma( inflammation/ irritation of the nerve) other forms of neuromas, bursitis (inflammation of bursa of the foot), stress fractures, bunions, tailor’s bunions, plantar plate tears, turf toe or arthritis.

In addition, there are some specific conditions that can cause ball of foot pain. Freiberg’s disease can also be a cause. This condition is caused by a lack of blood supply to the second, third, or fourth metatarsal head. This condition causes part of the metatarsal head to lose structural integrity, leading to collapse in the head of the second/third/fourth metatarsal and nearby joint and is generally identified through imaging, detailed history and examination.

Sesamoiditis is another main cause of pain in the ball of the foot. It causes inflammation of the sesamoid bones, which are pulley-like bones that are connected to tendons instead of other bones (like the kneecap). This condition is common in people who are highly physically active with pivoting movements such as dancers, soccer players, netballers or runners who are constantly on the ball of the foot (forefoot runners).

Treatment for these conditions can vary and there is not a one size fits all fix.

But what actually causes these conditions? 

Clients can develop pain in the ball of their foot due to a number of factors:

  • Increased physical activity load
  • Foot Shape- Pes Cavus (high Arch), Pes Planus (Flat foot)
  • Second toe longer than the big toe
  • Overuse of joints due to reduced muscular strength
  • Wearing shoes that are incorrectly fitting – wearing high heeled shoes or shoes that are too small or too big, narrow toe box, can all cause significant issues.
  • Digital deformities-hammer toe, Clawed toes, bunions
  • Changes to gait pattern
  • Increased weight/sudden increase in weight
  • Hormone levels
  • Arthritis

How is ball of foot pain diagnosed?

Here at Foot Centre Group, your Podiatrist will take a detailed history of your pain in the ball of the foot. This includes when you first started noticing the pain, was there a sudden movement or action that caused it or did it progressively come on over time.  What makes the ball of foot pain better or worse, previous injury history, medication, current exercise load, footwear that you are in day to day and when you exercise. If

Once our Podiatrist has a detailed history of your pain they will then undertake an in depth physical assessment of your feet – this includes range of motion studies, strength assessment of the foot and lower limb muscles, gait analysis and footwear assessment.

From here they will be able to understand what is going on and whats causing the pain in the ball of your foot and can begin treatment options.

What happens if the ball of foot pain is left untreated?

When left untreated, ball of foot pain can affect the way you walk. You may walk with a limp or avoid placing weight on the part of your foot that bothers you. This can cause pain in other parts of your foot and body, including the knee, lower back and hips.

Pain in the ball of the foot typically does not have a high chance of complications with proper treatment and diagnosis.

How is ball of foot pain treated?

There are many treatment options for  ball of foot pain.

Reduce loading through your foot – don’t stop and take complete rest, just reduce how much time you spend on your feet, instead of your normal activity  try reducing it by around 50%.

If you notice swelling or bruising; icing every 20 minutes for 2-3 hrs may be helpful to reduce inflammation. With any signs or bruising or swelling it is important to book an appointment with one of our Podiatrists straight away.

Taking pain relief medication. The Podiatrist may suggest taking nonsteroidal anti-inflammatory drugs (NSAIDs) or another type of pain relievers (panadol, nurofen).

Change in footwear: The treating Podiatrist will recommend switching out of your high heels, tight/pointed business shoes, runners and flats to a shoes that has a wide toe box and shoes that evenly distributes pressure between your heel and forefoot. Depending on the cause, your Podiatrist will recommend specific brands to you also. It is a good idea to bring your most commonly worn shoes to your appointment so they can be assessed properly and recommendations can be given for alternatives. Tight shoes can cause your feet to misalign while you stand and walk, creating improper balance changes in your gait and deformities to your toes and midfoot.

Exercise: While you may not want to participate in walking, running or certain high impact sports whilst in pain, targeted strengthening might ease pain and increase flexibility and strength in your foot. Your treating podiatrist will give you specific exercises based on your strength from the assessment that they undertake.

Use of orthotic inserts(arch supports) or offloading through strapping metatarsal domes/ padding: Depending on treatment and cause of your ball of foot pain your Podiatrist may prescribe orthotic inserts, metatarsal domes,strapping or padding to help offload and relieve pressure and pain in the ball of the foot.  These treatments are made to help align the foot and provide offloading to the injury.

In some cases imaging may be required to get a detailed look and understanding of what is causing your pain. This can include x-ray, ultrasound and in some cases MRI imaging. Depending on the results and treatment trialled your treating practitioner may recommend further intervention. These interventions can include: cam walker (moonboot), cortisone injections (steroid injections) or  podiatric surgeon input to help alleviate your pain and improve foot function.

When to see a Podiatrist at Foot Centre Group?

In all cases of ball of foot pain, we recommend coming in and seeing one of our trained and skilled Podiatrists. This will speed up your recovery, as you’ll receive cause-specific care and a management plan to reduce and heal your ball of foot pain. Feel free to contact us on 9553 0044 with any questions, you can also book an appointment online.

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