Forefoot Pain: Why Do I Have Pain at The Balls Of My Feet?

Have you ever found that at times the balls of your feet throbs and aches? Does this usually happen after you’ve been standing all day at work or when you’re exercising? 

What are the common symptoms?

The intensity and severity of forefoot pain can vary, however the most common symptoms are: 

• Sharp, aching, or shooting pain in the balls of your foot
• Referred pain to your toes 
• Pain that worsens when you stand, run, flex your feet or walk — especially bare foot on a hard surface — and generally improves when you rest.
• Numbness, burning or tingling in your toes.
• A feeling of having a pebble in your shoe.

What causes forefoot pain?

There are multiple reasons why forefoot pain can occur.

The common causes that we have seen in the clinic are: 

• Wearing ill-fitting shoes: High heels transfer extra weight to the front of your foot and put extra pressure on the balls of your foot which exacerbates the pain.  Sneakers that are old and have worn down in the soles can cause increased pressure on the forefoot.  Narrow fitting footwear can also put extra pressure on the balls of your foot as well. These types of footwear intensify and increase the chances of getting forefoot pain and should be avoided.
• Intense training or activity: Anyone who participates in a high intensity sport is at risk too.   For example, a netballer can put excessive pressure on the forefoot when swivelling and changing directions.
• Individual foot shapes: A high arch can put extra pressure on the metatarsals or if you have a second toe that is longer than the big toe, which can cause more weights than normal to be shifted to the second metatarsal head.
• Excess weight: Because most of your body weight transfers to your forefoot when you move, extra kilos mean more pressure on your feet.
• Aging: With age, the fatty pad on the balls of the feet can deteriorate which in turn reduce the protection that it normally gets . 

What Are The Medical Names for Forefoot Pain?

Since there are many structures that make up the forefoot, when you have pain in that area it could mean that you may have one of the following conditions.

• Morton’s Neuroma: A benign growth of an interdigital nerve. Usually, a collapse of the metatarsal arch or tight-fitting shoes can worsen the symptoms. 

• Bursitis: is an inflammation of small sacs called a bursa which are located near a joint, tendon or bone. Due to repetitive motions, bursas can become irritated and become inflamed.

• Capsulitis: is caused by the overuse of the ligaments around the joint capsule where your metatarsal connects with the toe in the ball of your foot. Capsulitis does not improve on its own, so early detection is important to best prevent any further damage. 

• Synovitis: is an inflammation of the tissue that lines the joints. Symptoms may include swelling, pain, redness and warmth or a burning sensation. 

• Plantar plate tear: Injury or tears to the plantar plate can either be caused by a sudden trauma which overloads the plantar plate or can be caused by degeneration to the plantar plate over a long period. The most common location of a plantar plate injury is in the 2nd toe. 

What Can I Do At Home To Help My Forefoot Pain? 

• Rest. Protect your foot from further injury by giving it a break. Keep your feet elevated after long periods of standing or walking. Avoid those high impact sports and stick to more gentle exercise such as swimming or cycling. 
• Use ice. Apply ice packs to the affected area for about 20 minutes at a time several times a day. To protect your skin, wrap the ice packs in a tea towel.
• Wear the right shoes. Avoid too-tight or too-loose shoes and limit your wearing of high heels. Wear shoes that give you the right support for the sports you play.

How can a podiatrist help me? 

Our podiatrist will do a full gait and biomechanical assessment to determine the cause of your pain and create the appropriate treatment plan to help you.  

Your comprehensive treatment plan that may include:

• Imaging: Imaging such as an X ray or ultrasound can be performed to rule out stress fractures and/or to identify the severity of joint and soft tissue degeneration. 
• Taping and Padding: help to cushion and reduce the excessive pressure 
• Customised Orthoses: help to improve your posture and biomechanics of the foot to again reduce and redistribute the excessive pressure that contribute to your pain 
• Change in Footwear: We will recommend the right shoes for your feet.  Supportive and appropriate fitted footwear can make a difference to your pain if you stand or walk on feet for long hours. 
• Strength & Stretching exercises: help to improve any muscle weakness that may contribute to your forefoot pain. 

Pain in the ball of your foot can be debilitating and really cause a strain on your day to day life, however by taking a few simple steps you can help ease the pain and reduce the risk of it flaring up again. 

Of course, if your pain is constant and won’t respond to treatments you’ve tried at home then we strongly suggest you come and speak to us in the clinic so you can get back to doing the things you enjoy sooner rather than later.