Almost every day in my clinic I have a patient who complains of ball of foot pain. This is particularly true in the spring and summer with an increase in activities such as walking and hiking. It's also not unusual for a patient to increase their activities to get in shape or lose weight after a long period of not exercising.
Most often ball of foot pain will be in one specific area but sometimes a patient will feel it across the entire ball of their foot. The location will depend on what's causing the pain to begin with.
The following conditions bring on ball of foot pain, however, many of these conditions can have similar causes and are made worse by the same things.
Neuroma (a common ball of foot pain condition)
A neuroma (or Morton's Neuroma) is an inflamed nerve that runs between your 3rd and 4th toes on one or both feet. The inflammation causes a thickening of the tissues around the nerve. Early stage neuromas often feel like a bunched up sock under your toes and are intermittent. In later stages the symptoms are more constant and described as tingling, numbness, burning, or shooting pain.
People most predisposed to neuromas are those who:
- wear pointy or high heeled shoes
- have an abnormal foot structure such as bunions, hammertoes, and flat feet
- have had foot trauma such as dropping a heavy object on their foot
- run or participate in a high intensity sport
Capsulitis is inflammation of the ligament under the bottom of your foot. The pain can have an aching quality to it or can be sharp at times. These conditions are aggravated by walking barefoot, wearing high heels, or after prolonged activity.
People most predisposed to capsulitis are those who:
- have abnormal foot mechanics causing the ball of the foot beneath the second toe joint to take on more of the weight bearing; the second toe is often longer than the big toe
- have a severe bunion deformity
- have an arch that is structurally unstable
- have tight calf muscles
Perhaps you're feeling the pain primarily in your big toe, particularly when you walk or run. Very likely you have hallux rigidus also known at big stiff toe.
People most predisposed to hallux rigidus are those who:
- have faulty foot mechanics such as flat feet
- have structural abnormalities that can cause osteoarthritis of the big toe
- an overuse injury or a stubbed toe
Turf toe is a condition that results from hyperextension of the big toe joint as the heel is raised off the ground. An external force is placed on the big toe, and the soft tissue structures that support the big toe on the top are torn or ruptured. Symptoms include pain, tenderness, and swelling of the toe joint. Turf toe can result in hallux rigidus.
People most predisposed to turf toe are those who participate in team sports such as soccer and football. Football kickers are particularly at risk.
Ball of Foot Pain or Metatarsalgia
Pain in the ball of the foot that occurs on one or more bones is called metatarsalgia. It can be specific such as the pain felt with a neuroma between the 3rd and 4th toes or can involve the entire ball of the foot. It can be experienced as sharp, aching, or burning and feels worse when standing, walking, or running.
People most predisposed to metatarsalgia are those who:
- have a high-arched foot or a foot with very long metatarsal bone
- participate in high impact sports
- wear improper shoes such high heel or rigid soled work boots
- have had a foot injury - from sports, a car accident, or repeated stress
- work on hard surfaces (cement or tile floors)
- are overweight
Summer is a time for outdoor fun. Don’t stand for foot pain. It is not normal and the faster you get it evaluated and treated, the faster you will be able to return to enjoy your spring and summer activities.