RS Podiatry Clinic

Forefoot Pain

AKA/alternative diagnosis: Morton’s Neuroma, Metatarsalgia, Capsulitis, Plantar Plate Tear, Freiburg’s Infraction, Stress Fracture, and more.

Symptoms: Pain in the ball of the foot, pain in the forefoot during activities or when going on tiptoe, swelling, bruising, tenderness to touch.

Contributing Factors: Overuse, sudden change in activity, ill-fitting footwear, poor biomechanics, lack of shock absorption, diet, improper activity technique, high BMI, poor conditioning, neural involvement, arthropathies/arthritis, sports, repetitive localised stress, Osteoporosis, and more.

Treatment Considerations: Assessing/correcting biomechanics, rest, footwear assessment/change, special insoles, orthotics, treating inflammation, modifying you training programme or activity levels, taping, consistent following of advice and more. 

Foot pain can be a debilitating condition that affects millions of people worldwide. Among the various types of foot pain, discomfort in the ball of the foot is a common complaint. This area, also known as the forefoot, is essential for maintaining balance, supporting body weight, and facilitating movement. Causes of pain in the ball of the foot can vary. Some of the common forefoot pathologies that individuals may hear about include.

  1. Metatarsalgia: Metatarsalgia is simply an umbrella term and not a diagnosis. It can refer to pain and inflammation in the metatarsal region, which comprises the bones of the forefoot. It can be characterised by a sharp, burning sensation in the ball of the foot or the feeling of having a stone in one’s shoe. High-impact activities, ill-fitting footwear, foot deformities (such as bunions or hammertoes), and excessive pressure on the ball of the foot can contribute to this condition. Treatment may include rest, ice therapy, proper footwear, orthotic inserts, and physical therapy exercises.

  2. Morton’s Neuroma: Morton’s neuroma is a painful condition that arises from the thickening of tissues surrounding the nerve that runs between the metatarsal bones. The pain is typically described as a sharp, shooting or burning sensation, often radiating into the toes. Activities that involve repetitive pressure or irritation of the nerve, tight footwear, and foot deformities can contribute to its development. Conservative treatments like wearing properly fitted shoes, padding, orthotics, and in some cases, corticosteroid injections, cryotherapy or surgical intervention, may be recommended.

  3. Sesamoiditis: Sesamoiditis is an inflammation of the sesamoid bones located beneath the big toe joint. This condition often affects athletes, particularly those involved in activities that place excessive pressure on the forefoot, such as running or dancing. Symptoms include pain, swelling, and difficulty in bending or straightening the big toe. Treatment typically involves rest, ice, cushioning pads, orthotics, and exercises to alleviate pain and promote healing.

  4. Freiberg’s Disease: Freiberg’s disease is a condition that primarily affects the second metatarsal head, causing pain, stiffness, and limited range of motion. It is most commonly seen in teenagers and young adults, and the exact cause is still unknown. However, factors such as trauma, genetics, and structural abnormalities are believed to contribute to its development. Treatment options include rest, immobilization, orthotics, exercises, and in severe cases, surgical intervention.

  5. Capsulitis: Capsulitis is the inflammation of the ligaments surrounding the joint at the base of the toes. It is often caused by excessive pressure on the forefoot, typically due to poor footwear choices, biomechanical imbalances, or foot deformities. Symptoms include pain, swelling, and difficulty in walking or bearing weight. Treatment may involve rest, ice, proper footwear, orthotics, physical therapy, and in some cases, immobilization.

Pain in the ball of the foot can significantly impact an individual’s mobility and quality of life. If you are experiencing persistent or worsening pain in the ball of your foot, it is recommended to consult with a podiatrist who can accurately diagnose the underlying cause and create a personalised treatment plan to alleviate your discomfort and promote foot health. Remember, taking care of your feet is essential for maintaining an active and pain-free lifestyle.