Ball of the Foot Pain
Metatarsophalangeal Joint Pain [Causes, Symptoms & Best Treatment]
Metatarsarsophalangeal joint pain is also know as ball of the foot pain or metatarsalgia. 95% of the time this can be improved by offloading pressure.
- Ball of the foot pain & big toe joint pain can be improved with a few simple treatment changes.
- We are foot doctors & we see this problem get better almost every day.
- The goal is to solve this problem without medication or surgery if at all possible.
So, let’s GO!
- Metatarsalgia: which means generalized foot pain without a specific cause.
- Second toe capsulitis: this is the inflammation of the second toe joint capsule.
- Capsulitis is related to hammertoe formation, and can lead to a plantar plate tear. There is some overlap between these three disorders. As they get worse tearing and ligament damage can occur.
- Morton’s neuroma: this is the damage and inflammation to the nerves between and underneath the metatarsal joints.
- Fat pad atrophy of the ball of the foot: this is the loss of cushioning in the ball the foot.
So, click on the photo gallery to see the specific causes of your ball of the foot pain!
Click on the photo gallery to see the specific causes of your ball of the foot pain!
Overview of Metatarsalgia & Ball of the Foot Pain:
- Metatarsal joint pain usually occurs at the prominent part of the forefoot where the toes connect to the metatarsal bones.
- The most common site of metatarsal joint pain is the second metatarsal but it can spread over to the third, fourth and fifth toes as well.
- The most common causes of metatarsal joint pain are detailed below.
- Pain in the forefoot that is worse with weight bearing.
- Pain usually begins the longer you are on your feet vs some conditions that get better the more you walk.
- If you move the toe up and down to its extreme range of motion, it should usually hurt more.
- If you push on the foot from the bottom, see if a metatarsal is longer or somehow more prominent than the other metatarsal heads.
- A flat foot which spreads out the forefoot as well as putting more pressure on it
- Over pronation of the foot.
- A previously broken, bent or rigid big toe joint that then relies on the other four joints to carry a greater load.
- Tight footwear- make sure you use a brannock device to properly measure your shoe size.
- Long 2nd toe.
- Short 1st toe.
- Previous fractures that may have healed improperly and lead to osteoarthritis.
- Morton’s neuroma or Morton’s Neuralgia.
- Metatarsalgia is the generalized ball of the foot pain.
- This means that there is too much pressure on the front of your foot.
- The bones the tendons the nerves in the tissue surrounding the site could all get bruised up.
- This is one of the most common causes of ball of the foot pain that we see.
- Click on the link to see how to take care of this common problem!
- A Morton’s neuroma is the irritation of nerves in the ball of the foot.
- This can result in sharp, shooting and tingling pain.
- This is also a very common condition, it can feel as though if your foot is clicking and popping by the third and fourth toe.
- You can also feel like you have a bunched up sock and the ball of the foot.
- Capsulitis in the ball the foot is due to the ligaments and tendons getting irritated in the foot.
- This is very common around the second and the third toe joints.
- These are the longest metatarsal bones in your foot, and if there is tightness through the ankle and increase pressure on the foot, these tendons can very easily get agitated.
- Click on the above link to find out how to treat this very common condition.
- Ball of the foot pressure can frequently result in bruising.
- This can result in calluses corns and pressure buildup.
- This is a very common injury, click on the above link to see how to take care of this very important problem.
- The planter plate is a ligament that holds the metatarsal phalangeal joints together.
- This is a very important ligament as it has to support your body weight prevent your toes from coming apart.
- If this starts to tear, become inflamed or injured, it can cause you significant pain.
- This is a very common problem with solutions available.
Non-Surgical Best Treatment:
- Taping: Low Dye Taping is a taping technique that can recreate the foot arch and can be attempted to maintain supination rather than pronation.
- Splinting: An offloading pad can be made for your forefoot that has a second toe cutout that is amazing for relieving pain.
- Ice: This is not just about pain! It will decrease the inflammation and the time needed to heal the forefoot. Put ice in a bag (wrapped with cloth) and apply it for 15-20 minutes until the area starts to become numb. This decreases the effect of inflammatory cells and at the same time boosts the rebound blood flow to the area after the ice is removed.
- Elevation: Recline in a chair and elevate our foot while watching tv. Like the Ice principle, it flushes the inflammatory cells out of the area and is very important immediately after running or standing for a long time.
- Pain medication: Ibuprofen or other anti-inflammatories. The goal is to continue it regularly for 1-2 weeks not for pain but to raise anti-inflammation enzyme levels in your blood so that the area has a chance to heal. This is not just for pain!
- Tight Calf Muscles – Stretching your calves is essential and the cheapest possible cure. This may be the single most important component of reducing pain due to overpronation!
- Use a Brannock device to properly measure your shoe size: It is essential to measure the foot length, the arch length and the foot width. It is possible that you have longer toes or longer metarsals that require a wider Toe box than you think you need.
- Combine icing, elevation, non-weight bearing and pain medication gives you the best chance at healing as quickly as possible.
- Corticosteroid injection at the podiatrist office is highly recommended as it is shown to slightly decrease pain, but greatly increase motion and time of recovery.
What can a podiatrist do for Metatarsophalangeal Joint Pain?
- X-rays, MRI’s or Ultrasound scans can be used to look inside the foot to view any damage.
- Blood tests may be taken to diagnose any underlying medical causes such as diabetes or gout.
- A podiatrist may assess your foot position and gait (walking pattern).
- If necessary custom orthotics (insoles) can be made.
- A doctor may inject a corticosteroid injection into the foot.
For more on Metatarsophalangeal Joint Pain.
Ball of the Foot Pain Treatment Infographic:
Ball of the Foot Home Treatment:
- Consider taping, orthotics and great shoes as a combination to fix your foot problem.
- Products are not always necessary to fix your problem.
- The key is correcting the biomechanics that are leading to forefoot overload. Foot overload means too much pressure in the ball of the foot.
- Generally something called ankle joint equinus can lead to a too much pressure in the ball of your foot. This means your ankle is not flexible enough to move up and down.
- Ball of the foot pain treatment consists of two phases, first is control inflammation, next is to control bio-mechanics.
Remove Control Inflammation:
Massage & Ice Products:
- The metal ball is one of my personal favorites.
- This works great for your arch, less for the ball of the foot.
- These can help relax the arch or heel ligaments, leading to less pressure in the ball of the foot.
- Pills, creams and ice will never completely fix your problem alone. What they will do is reduce the pressure on the area.
Menthol Based Gels:
- Biofreeze is one of our favorites.
- These gels have been studied to work 2x as long as ice.
- This works great for the ball of the foot.
- Consider using these as options when resting on the couch or going to sleep at night.
- These can work great for loosening your muscles.
- This is means for your hamstring and calf muscles. This can loosen the ankle tightness putting pressure on the ball of your foot.
- This allows less tightness and pressure on the ball of your foot.
Ball of the Foot Stress Relief.
- The key is to prevent future pain.
- If you can get rid of the pain and swelling, this will let you start walking normally.
- If you can walk normally, the vast majority of your pain should gradually start to go away.
- This means proper cushion, proper stability and pressure relief from the front of your foot.
- This will relieve pressure from your big toe, your 2nd toe, your Morton’s neuroma, your plantar plate, hammer toes and joint capsules.
Best Metatarsalgia Shoes:
- Getting a great supportive pair of shoes will make sure that there is pressure removed from the ball of your foot.
- This is especially important if you have a metatarsalgia, a Morton’s neuroma, 2nd metatarsal overload syndrome and capsulitis!
- Consider shoes combined with a good supportive orthotic for best pain relief!
- The following link will show you what our favorites are.
Best Ball of the Foot Insoles:
- These are our recommended orthotics & insoles.
- There are different types for different shoes.
- Women’s shoes usually need a less bulky orthotic, but allow for less correction.
- A full length orthotic requires a running shoe, boot or comfortable walking/dress shoe.
Best Full Length Orthotics:
- Full length orthotics are the most recommended type for ball of the foot pain.
- Be aware that if they are too uncomfortable, it might be worth starting with a less corrective pair.
- Eventually you can then work your way up to these.
Best Dress Shoe Orthotics:
- These are a stronger option for shoes with tight dress shoes.
- Just be aware that less corrective orthotics & tight shoes are usually not a good combination.
Best 3/4 Length Orthotics:
- These may be a good option for ball of the foot if the full length orthotics are too tight or too uncomfortable.
Get A Great Dynamic Stretch:
- It is possible to stretch on your own, but these products can also really help!
- Personally I have the stationary block set up in my kitchen to stretch every day multiple times while getting my coffee!
- This will take pressure off of the ball of your foot.
Ball of the Foot Pain