Foot pain may develop from certain sports, overuse, or underlying medical conditions. A North West Adelaide Health Study estimated that nearly one in five people were impacted by foot pain.[2] Certain factors such as biomechanical issues or sports that involve running or jumping may increase the risk of developing foot pain.
The feet support the entire weight of the body. A lot of force travels through the foot, so the foot can be vulnerable to injury or pain.
The ball of the foot is the part of the foot between the arch and toes. It is made up of the heads of the metatarsal bones, with supporting muscles, ligaments, and soft tissue. When any of these structures are affected, it can cause pain in the ball of the foot (sometimes known as metatarsalgia). Pain can then impact a healthy gait and lead to compensatory strategies increasing the risk of pain or injury elsewhere.[1]
What are the symptoms of ball of foot pain?
The symptoms of ball of foot pain may vary from person to person, and can be localised to a small or broad area. Symptoms may resolve quickly, or may continue over a period of time.
Symptoms in the ball of the foot may include:
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Aching, dull, or sharp pain
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Shooting or ‘electric’ sensations
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Pain that gets worse with movements, such as running or flexing the foot
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Inflammation or swelling
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Reduced range of motion.
If there are any unexplained symptoms, or the symptoms progressively worsen over time, it is important to speak to a doctor.
What causes ball of foot pain?
Pain in the ball of the foot can develop from various different conditions.
Causes of ball of foot pain may include:
1. Overuse
High-intensity physical activity may lead to foot pain, especially without adequate training or conditioning.
2. Biomechanical issues
Areas of excessive stiffness or mobility may increase pressure on the ball of the foot or surrounding structures, causing foot pain.
3. Injury
Foot pain can be caused by trauma or a sporting accident. It is important that any injuries are addressed appropriately.
4. Stress fractures
A stress fracture (break in the bone) is a condition often caused by repetitive force, without adequate rest or treatment. It is commonly seen in specific sports, such as endurance running or gymnastics.
5. Arthritis
Arthritis can affect the bones and joints in the foot, causing pain. Arthritis can also cause stiffness and reduced mobility.
6. Sesamoiditis
Sesamoiditis is a stress reaction in the sesamoid bone in the ball of the foot, and can cause localised pain. It is commonly seen in highly active sports, such as dancing.
7. Musculoskeletal issues
Various musculoskeletal issues may cause ball of foot pain, including turf toe, hammer toe, or plantar fasciitis.
8. Medical conditions
Specific medical conditions such as Morton’s neuroma or nerve issues may cause foot pain.
Other causes of ball of foot pain can include:
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Bunions
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Calluses
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Foot deformities
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Infection
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Fracture
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Necrosis
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Tumour
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Referred pain.
Risk factors
Risk factors for developing foot pain can include:
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Certain sports, particularly those that involve jumping or running
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Unsupportive footwear, such as high heels or wrong-sized shoes
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Background biomechanical issues
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History of foot injuries
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Medical history
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Inflammatory conditions, such as rheumatoid arthritis or gout
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Age.
Diagnosis
It is important to get the correct diagnosis of foot pain as there are many different causes. Otherwise, treatment may worsen the problem or have no effect.
A health professional can examine the foot and surrounding area. This can include observing walking patterns, movement, range in the joints, and other factors. They will also ask a series of questions to understand the symptoms and medical history.
A doctor may request further testing, such as an x-ray or MRI to get a comprehensive image of the foot and assess the relevant structures. If there are any concerns, a doctor may order other specific tests or refer to a specialist doctor.
Treatment of pain in the ball of the foot
The treatment for ball of foot pain depends on the cause and severity of the symptoms. Mild symptoms can often resolve on their own. In other cases, foot pain may require one or a combination of treatment options.
This may include:
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Rest: Resting the foot can help encourage the healing process. Especially if the cause of the pain is from overuse.
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Ice packs: When used appropriately, ice packs can provide short-term pain relief.
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Activity modification: Reducing or avoiding the triggering activity can help settle any symptoms.
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Physiotherapy: A physiotherapist can recommend specific exercises to target strength, flexibility, or even balance to help alleviate and treat the cause of symptoms. They may also address any sporting technique vulnerabilities and establish a return to sport plan.
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Podiatry: As poorly fitted shoes and biomechanical factors can contribute to foot pain, it is important to get supportive footwear. A podiatrist or foot specialist can assess the foot to prescribe orthotics and fit any footwear properly.
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Medications: Doctors can prescribe pain relief medications. A doctor may recommend non-steroidal anti-inflammatory drugs (NSAIDs) or other types of pain relief for foot pain.
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Lifestyle changes: A doctor may recommend certain lifestyle changes to help reduce symptoms, including diet and activity.
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Surgery: In some cases, a referral to an orthopaedic surgeon may be required to address the cause of the problem. This is usually considered after other conservative treatments have not been successful, unless there is an underlying condition or other problem.
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Specific treatments: If the cause of the pain is related to a specific condition, it will need a specific management and treatment plan. A doctor or specialist will usually be involved in these situations.
Complications
Foot pain can affect walking and movement. It is important to get the correct diagnosis, otherwise the problem or any symptoms may get worse. If left untreated, a limp may develop which can put pressure on other parts of the body including the knees, hips, or spine.
Pain that does not improve, or that is associated with sudden weakness or numbness, bleeding, night pain, or any other unusual symptoms needs to be addressed by a medical professional. A doctor can examine the foot and rule out serious underlying medical issues.
Recovery from foot pain
Symptoms often resolve with treatment and a period of rest. If there are any signs of a problem, it is helpful to speak to a health professional to address them. A health professional can assess the foot and determine specific treatments to get the best outcome.
Key messages
Pain in the ball of the foot can result from overuse or biomechanical factors. It may also be caused by an injury or an underlying medical condition.
Symptoms may resolve with time, however there are several treatment options depending on the cause and severity. A diagnosis from a doctor is important to rule out any medical issues and effectively treat the condition.
