The Foot Clinic

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Ball of foot pain treatment and relief

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Pain in the balls of the feet is what doctors refer to as Metatarsalgia. It is a general term used to denote a painful foot condition in the metatarsal region of the foot or the area under the foot, just before the toes, commonly referred to as the ball of the foot. Metatarsalgia is especially common in women wearing tight fashion shoes with medium to high heels. Metatarsalgia causes a burning sensation in the ball of the foot and it is often combined with excess callous forming under the foot. Sometimes a tingling sensation is felt between 3rd and 4th toe. This is a condition called Morton's Neuroma. Ball of Foot Pain occurs when the metatarsal bones collapse (the transverse arch) and the surrounding ligaments and tissue weakens. The forefoot structure collapses leading to excess pressure and friction under the ball of the foot. In some patients inflammation at the metatarsal heads is present. An estimated 70 percent of women who wear heels will suffer from Metatarsalgia, podiatrists tell us. With this common foot condition one or more of the metatarsal heads become painful and inflamed because of continuous excessive pressure over long periods of time. The patient will experience acute or chronic pain in the balls of the feet. Metatarsalgia is often caused by wearing thigh-fitting high-heeled fashion shoes. In addition to the heel height, especially shoe with a narrow toe box forces the forefoot into a minimal amount of space, squeezing the bones and ligaments. Plus, wearing heels means most of your bodyweight is concentrated in the forefoot area leading to excessive pressure in the ball-of-foot area. Pain present in the ball of the foot can have various other causes including poor circulation, (osteao-) arthritis, injury or trauma, pinched nerves or disease. Metatarso-phalangeal joint mis-alignment is a type of ball of foot pain caused by rheumatoid arthritis or osteoarthritis, and the result of this condition is commonly referred to as hammer toes.  This may occur when fat tissue that normally cushions the joints during weight-bearing is pushed forward. The loss of cushioning may lead to nerve damage in the ball of the foot. Metatarso-phalangeal joint pain usually begins in the area of the big toe and often people suffering from this condition display an abnormal gait pattern.  This condition can be very debilitating and very painful. Treatment for this type of joint misalignment includes foot orthotics designed to redistribute body weight away from the affected joint.  Sometimes surgery is necessary when the use of orthotics has no or little effect.

Freiberg’s disease

Another common cause of ball of foot pain is a medical foot condition referred to asFreiberg’s Disease. It is actually necrosis or tissue death in some of the joints that make up the forefoot. Usually the second metatarsal head is affected by this disease.  Freiberg’s Disease may be caused by injury to the bone in this area. Pain is often worsened when the patient puts their weight on the area, for example when wearing certain types of footwear, like high heels.  The joints in the ball of the foot often become very stiff and swollen. Treatment for this type of ball of foot pain consists of cortisone-steroid injections and the use of a cast or splint. Your foot specialist or GP probably recommends to wear only shoes with low heels in combination with orthotic insoles to shift the weight and pressure away from the toe joint. Orthotic treatment can be very successful for Metatarsalgia, as well as Morton's Neuroma. In some cases the podiatrist will place a metatarsal raise on top of the orthotic device to lift the forefoot bone structure up even further, thus releasing any pressure on these foot bones.