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What is ball of the foot pain?

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

People with ball of foot pain experience an aching pain and inflammation in the padding directly below the toes, which is where we place the most pressure when standing and moving.

The aching is usually present in the metatarsal heads — the joint that is just under your toes. You may also experience a shooting pain, numbness, and immediate pain with flexing the toes. The aching may ease when you are off your feet and return when you resume your activities.

Ball of foot pain is relatively common and treatable in most cases, especially when the cause has been determined.

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Illustration by Jason Hoffman

Ball of foot pain occurs just below your toes. It can feel like:

  • burning, aching pain
  • shooting pain
  • numbness or tingling in your toes
  • having a small pebble in your shoe
  • immediate pain that gets worse when you run, walk, exercise, or otherwise flex your foot

Ball of foot pain may also occur with:

A person can develop pain in the ball of their foot due to a number of factors, and it’s important to narrow down the cause to implement treatment. Ball of foot pain may be caused by:

  • intense physical activity
  • having a high arch or a second toe longer than the big toe
  • stress fractures or inflammation
  • wearing high heels or shoes that are too small
  • hammer toe, bunions, or calluses
  • having 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’s disease can also be a cause. This condition is caused by a lack of blood supply to the second, third, or fourth metatarsal. With this condition, part of the metatarsal head loses structural integrity, leading to collapse in the head of the second metatarsal and nearby joint.

Pain in the ball of the foot can also be caused by sesamoiditis. Sesamoiditis is inflammation of the sesamoid bones, which are pulley-like bones that are connected to tendons instead of other bones (like the knee cap). This condition is common in people who are highly physically active, like ballet dancers or runners.

Pain in the ball of your foot can affect anyone, regardless of age or gender. But you may have a higher chance of developing this condition if you:

  • are an athlete or participate in high impact sports that involve running or jumping
  • often wear high heels, too-small shoes, or unsupportive shoes
  • have a high foot arch
  • have a second toe that is longer than your big toe
  • have hammertoe or bunions
  • have overweight
  • have an inflammatory condition such as rheumatoid arthritis, gout, or psoriasis
  • are an older adult, as the foot pads tend to wear with age

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 lower back and hip.

Pain in the ball of the foot typically does not have a high chance of complications with proper treatment and rest. But if your pain is severe or lasts longer than a few days, it may be best to get examined by a doctor for the course of treatment that’s right for you.

Sometimes pain in the ball of your foot goes away on its own after a few days. If your pain persists for more than a few days after resting and changing your footwear, or if the pain is severe and accompanied by swelling or discoloration, be sure to make an appointment with a doctor.

The doctor will examine your foot, both while you’re standing and sitting, to look for what is causing pain in the ball of your foot. They may also want to see the way you walk. They 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
  • if you’re involved in any new activity

The doctor may also order an X-ray to determine whether you have a stress fracture or muscle tear. As with any foot injury or health concern, let your doctor know if you have diabetes. Ball of foot pain may require more immediate attention for people with diabetes.

The doctor may also order additional tests to check for gout, arthritis, bursitis, or Morton’s neuroma.

There are many home remedies for ball of foot pain. If your symptoms aren’t caused by a larger health condition, such as Freiberg’s disease or diabetes, your doctor will probably recommend some or all of the following. You could 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 every 2 to 3 hours. The ice may 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 misalign while you stand and walk, creating improper balance.

Exercise. While you may not want to participate in running or certain high impact sports during this time, targeted stretches might ease pain and increase flexibility and strength. You may want to practice your stretches a few times a day until you feel pain relief.

Use orthotic inserts. Depending on the level of severity, your doctor may prescribe orthotic inserts or recommend commercial shoe inserts. Orthotic inserts are made to help align the foot and provide extra cushioning. A pad under the ball of the foot may ease pain as well.

Manage your body weight. Excess weight can put extra pressure on the balls of your feet, and managing your weight may help relieve this strain. A doctor can recommend weight management based on your lifestyle and any other health complications.

Take pain relief medication. A doctor may suggest taking nonsteroidal anti-inflammatory drugs (NSAIDs) or another type of pain reliever. If your case of ball of foot pain is severe, the doctor may also prescribe injectable steroids, which you will receive at your medical appointment.

If your ball of foot pain 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 course of treatment for you. However, the treatments above may relieve ball of foot pain in most cases.

Certain conditions will require additional treatment. If you have Freiberg’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 may be resolved with treatment and rest. Wearing comfortable shoes and maintaining a moderate weight might help prevent ball of foot pain. If your pain 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 receive cause-specific care.

Aching pain in the ball of your foot (metatarsal pain) can occur with inflammation, bruising, numbness, and the pain may get worse during activity. It can be caused by injury, unsupportive footwear, or the shape of your foot.

Metatarsal pain can often be treated at home with rest. However, certain conditions may require additional treatment. Receiving diagnosis information from a doctor can help you effectively treat your pain.