Pain in the ball of the foot can have several possible causes, from a trapped nerve to broken bones. People can treat some causes at home, but others require medical treatment.
Some people refer to pain in this area as metatarsalgia.
Injuries or conditions that cause pain in the ball of the foot can affect a person’s mobility. In most circumstances, a person will need to rest for a period to allow healing. The most severe injuries may require surgery to prevent lasting damage.
This article outlines some possible causes of pain in the ball of the foot, along with their associated treatments. It also provides advice on when to see a doctor for foot pain.
Pain in the ball of the foot may differ between individuals depending on the cause.
In many cases, a person will feel a dull, persistent ache that becomes more noticeable when standing or walking. In some cases, other sensations, such as burning or tingling sensations, may accompany the pain. Some people may even experience numbness in the toes.
Pain in the ball of the foot may range from mild to severe. The pain will usually worsen during physical activities that put additional pressure on the area. Such activities may include walking, running, or dancing.
According to an older reference in the American Academy of Orthopaedic Surgeons (AAOS), pain in the ball of the foot can occur due to Morton’s neuroma, where tissue surrounding a nerve in the foot thickens.
The AAOS indicate that although Morton’s neuroma most often develops between the third and fourth toes, it can cause a burning pain in the ball of the foot that may spread to the toes.
This pain may get worse with physical activity or when the person wears shoes.
Treatment
In most instances, people can treat Morton’s neuroma at home. Potential treatment options include:
- Rest: Resting the foot will help the healing process. Rest may involve temporarily avoiding physical activity, and keeping the foot elevated to reduce swelling.
- Applying ice: Applying ice packs to the affected area several times a day can help reduce inflammation.
- Taking nonsteroidal anti-inflammatory drugs (NSAIDs): These drugs can help to reduce inflammation and alleviate pain.
- Wearing foot support: A doctor may recommend wearing supportive pads or insoles to reduce pressure on the foot while walking.
- Avoiding wearing ill-fitting shoes: People should avoid wearing tight shoes or heels while their foot is healing.
- Losing weight: A person who has overweight or obesity may benefit from losing some weight. Doing so can help to reduce pressure on the feet.
In severe cases, a doctor may recommend steroid injections to minimize pain and inflammation in the foot. If these treatments are not effective, a doctor may recommend surgery to remove or reposition some of the nerve or tissue in the foot.
A bunion is a bony growth that can develop at the base of the big toe. Bunions occur when bones in the front of the foot move out of alignment, causing the big toe to bend toward the other four toes. This causes the bone at the base of the big toe to jut outward, resulting in a bunion.
A bunion may lead to changes in how a person places weight on their foot while standing or moving. These changes may cause pain in the ball of the foot.
Treatment
Home treatments will not get rid of bunions. However, they may help to alleviate bunion pain while slowing the progression of bunions.
Some home treatment options include:
- taking over-the-counter (OTC) pain relievers, such as acetaminophen and ibuprofen
- applying an ice pack to the bunion for up to 5 minutes at a time
- wearing wide shoes that have a low heel and a soft sole
- inserting bunion pads into shoes to prevent shoes from rubbing on the bunion
- trying to lose weight if overweight
Doctors do not usually recommend surgical treatment for bunions. However, surgery may be the last resort for people who experience one or more of the following:
- severe foot pain that limits daily activities
- chronic swelling and inflammation of the big toe
- toe deformity in which the toes cross over one another
Foot sprains are another possible cause of pain in the ball of the foot. These injuries occur when a person stretches or tears the ligaments in their foot. Ligaments are thick, fibrous bands of tissue that connect bone to bone.
A sprain that occurs in the midfoot can cause pain in the ball of the foot.
Doctors classify sprains into the following three groups, according to their severity:
- Grade 1: The injury is relatively mild, involving stretching or microscopic tearing of the ligament.
- Grade 2: The injury is moderate, involving severe stretching or partial tearing of the ligament.
- Grade 3: the injury is severe, and the ligament is completely torn. The foot may be unstable and unable to bear weight.
Treatment
Mild midfoot sprains may take several weeks to heal. A doctor will typically recommend following the RICE procedure to reduce pain and swelling in the affected foot. RICE is an acronym which stands for the following:
- Rest: Resting the foot
- Ice: Applying ice to the foot
- Compression: applying a compression bandage to the foot
- Elevation: Elevating the foot
More severe midfoot sprains may take up to 2 months to heal. In some cases, a doctor may immobilize the foot in a cast to prevent further injury. A person may later require rehabilitation therapy to help stretch and strengthen the foot.
A Lisfranc injury refers to a torn ligament or broken bone in the midfoot. These injuries are more severe than a simple sprain and require specialist treatment.
The AAOS state that Lisfranc injuries typically occur as a result of a simple twist or fall. They often happen when a person trips over the top of their foot when the foot is in a flexed downward position.
Some potential symptoms of a Lisfranc injury include:
- pain and swelling in the top of the foot
- bruising on both the top and bottom of the foot
- pain that worsens when standing, walking, or attempting to push off on the foot
Treatment
A person who has a suspected Lisfranc injury will require medical imaging to determine the severity of the damage.
If there are no joint fractures or dislocations present, and the ligament remains intact, a doctor may recommend nonsurgical treatment. This will involve wearing a cast or boot for 6 weeks to prevent weight-bearing on the affected foot.
If the joints of the midfoot are fractured or positioned abnormally, a doctor will likely recommend surgery to correct the issue.
Some possible risk factors for pain in the ball of the foot include:
Following a period of rest, gentle stretching exercises for the foot and ankle may help improve mobility. The type of stretching exercises a person should perform will depend on the type and severity of their injury and the type of surgery they had.
A person should always consult with their doctor or physical therapist before exercising during or after recovery.
As symptoms improve, a person may be able to undertake more intense forms of activity. Initially, people should stick to exercises that put less pressure on the foot. Examples include cycling and swimming.
People can treat many causes of pain in the ball of the foot at home. However, a person who experiences any of the following should make an appointment with their doctor:
- severe or persistent pain
- visible bruising or swelling that does not improve 2–5 days after a foot injury
- tingling, numbness, or burning sensations, especially in the bottom of the foot
- pain in both feet
- an underlying medical condition that could affect the feet, such as diabetes or arthritis
People who experience any of the following symptoms should seek urgent medical treatment:
- an open wound on the foot
- pus coming out of the foot
- inability to walk or put weight on the foot
There are several possible causes of pain in the ball of the foot. People can often treat and manage this symptom at home.
Sometimes, a severe injury, such as a bone break or ligament tear pain, may cause pain in the ball of the foot. These injuries require prompt medical diagnosis and treatment to prevent further damage.
It can sometimes be difficult for a person to determine the cause of their foot pain. People should see a doctor if they experience severe, persistent, or worsening pain in their foot. Sensations of numbness, tingling, or burning also warrant medical investigation.