Ball of Foot Pain

Some of the most common ball of foot pain conditions we diagnose include:

• Morton’s neuroma. This typically occurs between the bases of the third and fourth toes, when tissues thicken around the nerves there. This causes pain in the ball of the foot which is often compared to “standing on a pebble,” as well as tingling and numbness. In severe cases, surgery may be necessary.
• Capsulitis. This occurs when the ligaments around a toe joint become inflamed. These ligaments form a “capsule” that help the toe joint move, so if they’re inflamed, movement is painful. This happens mostly in the second toe and can be caused by structural issues such as a second toe that is larger than the big toe, an unstable arch, a severe bunion, or a tight calf muscle. If the second toe starts moving toward the big toe, the condition has progressed to the point where surgery will need to be considered to restore the toe to its normal position.
• Stress fractures. Because the metatarsal bones do a significant amount of weight-bearing, they can develop tiny cracks along the surface due to repetitive wear and tear. Pain is typically first noticeable as mild aching during and after activity, but as the fractures worsen, pain becomes more constant and severe.
• Sesamoiditis. This is a painful condition that occurs when the two small sesamoid bones and/or the tendon they are embedded in near the base of the big toe become inflamed.  
• Nerve injuries or conditions. Ball of foot pain is a common result when nerves get compressed, pinched, or even accidentally damaged via surgery. If your pain can be described as tingling, burning, shocking, or “zinging,” nerve damage may be to blame.
• Plantar plate tear. This is a serious injury to the strong ligament on the bottom of the foot that protects the heads of the metatarsal bones and stabilizes the second toe. In addition to ball of foot pain, you may notice the toe “popping up” or drifting out of alignment. It’s especially important to diagnose and treat this injury early to reduce your risk of more severe long-term complications and deformities.

• Inferior metatarsal bursitis. Bursae are fluid-filled sacs that act as cushions between your bones. When these sacs become inflamed, you suffer from bursitis. Metatarsal bursitis involves the bones that connect your toes to your feet, so pain is felt with every step you take.
• Lesser metatarsal overload syndrome. Continuous stress on the metatarsal joints can result in chronic inflammation.

A diagnosis alone is not enough. We also need to understand the root causes of your condition to provide the best possible personalized treatment plan. Many factors can cause pain in this area of your foot, including:

• Intense training. Track and field participants are the most common group to put a lot of stress on the ball of the foot, in addition to dancers and football, tennis, soccer, and baseball players.
• Your job. Office workers whose dress code demands hours in heels, or workers who spend time on ladders or crouching on their haunches, are all at risk.
• Foot deformities. Those who already have bunions, hammertoes, claw toes, flat feet, high arches, or other deformities are very prone to ball of foot pain.
• Your shoes. Even if everything else in your feet is normal, cramming them into shoes that don’t fit your foot shape, or high heels that put pressure on the metatarsal heads, can lead to pain in the ball of your foot.
• Obesity. The heavier you are, the more weight you place on the front part of your feet as you walk and stand.