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, as opposed to a diagnosis in and of itself.
Those with metatarsalgia experience pain and inflammation in the padding directly below the toes, which is where we place the most pressure when standing and moving.
The pain is usually present in the metatarsal heads — the joint that is just under your toes — or the big toe. You may also experience shooting pain, numbness, and pain with flexing the toes. The pain may ease when you are off your feet and return when you resume your normal activities.
Ball of foot pain is relatively common and treatable in most cases, especially when the cause has been determined.
A person can develop metatarsalgia due to a number of factors, and it’s important to narrow down the cause in order to implement the best treatment. Metatarsalgia may be caused by:
- intense physical activity
- having a high arch or a second toe longer than the big toe
- stress fractures
- wearing high heels or shoes that are too small
- hammer toe and bunions
- being overweight
- metatarsal joint pain or arthritis
In addition, there are some specific conditions that can cause ball of foot pain. In Morton’s neuroma, the area by the third and fourth toe is affected. This is caused by a thickening of the tissues around the nerves leading to the toes.
Freiberg disease can also be a cause. With this condition, part of the metatarsal head loses structural integrity, leading to collapse in the head of the second metatarsal and nearby joint.
Metatarsalgia can also be caused by sesamoiditis. Sesamoiditis is broken or inflamed pulley-like bones that are connected to tendons instead of other bones (like the knee cap). This condition is common in those with high physical activity, like ballet dancers or runners.
Sometimes metatarsalgia goes away on its own after a few days. If your pain persists for more than two weeks, or if the pain is severe and accompanied with swelling or discoloration, be sure to see your doctor.
Your doctor will examine your foot, both while you’re standing and sitting. The doctor will ask you questions about your lifestyle, including how long you have to be on your feet each day, what type of shoes you generally wear, and if you’re involved in any new activity.
The doctor may also order an X-ray to determine whether you have a stress fracture. As with any foot injury or issue, let your doctor know if you have diabetes.
There are many home remedies for metatarsalgia. If your symptoms aren’t caused by a larger issue, such as Freiberg disease or diabetes, your doctor will probably recommend some or all of the following. You should experience relief in a matter of days.
Rest your foot when you can, especially after periods of activity. Use an ice pack for 20-minute intervals, followed by 20 minutes off. The ice will help alleviate inflammation and reduce swelling.
Wear comfortable shoes. If you wear high heels, your doctor will probably recommend that you change your footwear. You’ll also want to make sure that your shoes fit properly. Tight shoes can cause your feet to not align properly while you stand and walk, creating improper balance.
Exercise. While you won’t want to participate in running or certain high-impact sports during this time, targeted stretches can ease pain and increase flexibility and strength. You’ll likely want to practice your stretches a few times a day until the pain is relieved.
Use orthotic inserts. Depending on the level of severity, your doctor may prescribe orthotic inserts or recommend commercial shoe inserts. Orthotic inserts can help align the foot and provide extra cushioning. A pad under the ball of the foot can ease pain as well.
Manage your body weight. Excess weight can put extra pressure on the balls of your feet, and lowering your weight can help relieve this strain. Your doctor can recommend management based on your lifestyle and any other health complications.
Take pain medication. Your doctor may suggest taking a nonsteroidal anti-inflammatory drugs (NSAIDs) or another type of painkiller. If your case of metatarsalgia is severe, the doctor may also prescribe injectable steroids which you will receive in-office.
If your metatarsalgia is caused by a hammer toe, a pinched nerve, or a similar type of complication, an orthopedic surgeon or podiatrist may decide if corrective surgery is the best course of action. However, the treatments above cure ball of foot pain in most cases.
Certain conditions will require additional treatment. If you have Freinberg’s disease, treatment includes using stiff inserts to put under the metatarsal pad, or rock-bottom shoes. If you have Morton’s neuroma, you’ll also use foot pads. In severe cases of this condition, your doctor may use injections or surgery on the affected area to relieve nerve pain.
Most cases of ball of foot pain can be resolved with treatment. Wearing comfortable shoes and maintaining a healthy weight can help prevent ball of foot pain. If your metatarsalgia is a result of physical exercise, let your foot rest as much as possible until the pain subsides.
In all cases, seek the advice of a medical professional. This will speed up your recovery, as you’ll be receiving cause-specific care.