A stone bruise is a pain on the ball of your foot or the pad of your heel. Its name has two derivations:

  1. If you step down hard on a small object — such as a stone or pebble — it’s painful, and often the pain lasts long after your foot is off the pain-causing object.
  2. When you put weight on a painful area on the bottom of your foot, it feels like you are stepping on a small stone or pebble.

The term stone bruise tends to be a nonmedical catch-all name for pain symptoms that feel like there’s a stone in your shoe, jabbing the bottom of your foot every time you take a step.

The most common cause of a stone bruise is an impact injury to the bottom of your foot caused by stepping down hard on a small hard object such as a rock.

Runners, who have many hard foot impacts when they run, are likely to occasionally find themselves with a stone bruise, especially if they run on rocky terrain.

When your foot makes contact with an object, you might feel the pain immediately, or it may take 24 to 48 hours for the bruise to materialize.

Because we spend so much time on our feet, a bone bruise from an impact injury can be annoyingly persistent, affecting every step we take.

There are a number conditions that produce symptoms that may be mistaken for a stone bruise during self-diagnosis. These include:

Metatarsalgia is inflammation and pain in the ball of your foot and is commonly considered an overuse injury.

It’s characterized by a burning, aching, or sharp pain in the area of your foot just behind your toes. The pain intensifies when you stand, flex your foot, walk, or run.

Causes of metatarsalgia include:

Treatment for metatarsalgia includes:

  • properly fitting shoes
  • shock-absorbing insoles or arch supports
  • rest, elevation, and ice
  • over-the-counter (OTC) pain medication such as aspirin, naproxen (Aleve) or ibuprofen (Advil)

The plantar fascia is band of tissue that connects your toes to your heel bone. When that tissue becomes inflamed, the condition is called plantar fasciitis. Plantar fasciitis is usually characterized by a stabbing pain in the sole of your foot, typically near the heel.

The pain from plantar fasciitis tends to be more intense after exercise than during it.

Treatment for plantar fasciitis includes:

  • OTC pain relievers such as ibuprofen (Advil) or naproxen (Aleve)
  • physical therapy and stretching
  • a splint to be worn while sleeping
  • orthotics, custom-fitted arch supports
  • steroid injections
  • surgery

A heel spur is a bony protrusion (osteophyte) that typically grows on the front of your heel bone and extends toward your foot’s arch.

To relieve the pain associated with a heel spur, your doctor might suggest an OTC pain reliever, such as acetaminophen (Tylenol). Other treatments might include:

  • physical therapy
  • orthotics
  • shoe recommendation
  • night splint
  • surgery

Repetitive force from overuse — such as long-distance running — can cause tiny cracks, called stress fractures, in the bones of the foot. Surgery for foot stress fractures are rare.

Treatment typically focuses on reducing the amount of weight on the area until it can heal. This weight reduction is often accomplished with:

  • crutches
  • a brace
  • a walking boot

Morton’s neuroma occurs when the tissue surrounding the digital nerve leading to your toe bones (metatarsals) becomes thicker. This occurs most commonly between the third and fourth toes and is far more likely to affect women than men.

With Morton’s neuroma, you might feel a burning pain in the ball of your foot. Often, you’ll also feel pain in the toes. The pain is typically more prevalent when wearing shoes or participating in an activity that includes running or walking.

Treatment for Morton’s neuroma might include:

  • changing to a different style of shoe (wide, low heal, soft sole)
  • receiving a corticosteroid injection
  • using orthotics
  • receiving a steroid injection

If every step you take feels like you’re stepping on a rock causing pain on the ball or heel pad of your foot, you might have a bone bruise. You might also have another condition such as metatarsalgia, plantar fasciitis, a heel spur, a stress fracture, or Morton’s neuroma.

If you’re experiencing this type of pain, try to stay off your feet and keep that foot elevated. If after a few days the intensity of the pain doesn’t lessen, visit your doctor for a full diagnosis, which may include an X-ray.