Pain in the ball of your foot can be frustrating and limit you from your normal activities. If you have pain in the ball of your foot you are not alone- this is something that we treat in clinic on a daily basis. There are many conditions that can cause pain in the ball of your foot. Conditions such as sesamoiditis, capsulitis, plantar plate tear, Morton’s neuroma or even systemic conditions such as Rheumatoid or Psoriatic arthritis.
A common cause of pain in the ball of the foot is sesamoiditis. Sesamoiditis causes pain directly under the big toe joint. The sesamoids are 2 small bones that assist the big to function and they can sometimes become irritated and painful. Certain foot shapes can contribute to developing this problem, as can having tight calf muscles or wearing high heeled shoes.
The toe joints are what is known as synovial joints. The joint has a capsule that connects the bones and allows the joint to move. Where the joint capsule is put under too much stress, it can become inflamed and painful. The 2nd and 3rd toe joints are most commonly affected and the pain is localised to the underside of the toe joint.
Plantar plate tear
The plantar plate is a ligamentous like structure that connects the toe to the ball of the foot. A plantar plate tear most commonly occurs at the 2nd and 3rd toes. It can cause a pain in the ball of the foot often described like walking on a stone. It occurs when the plantar plate is put under too much stress by foot mechanics, high heeled shoes or high impact activities. As the condition progresses you may start to see that the affected toe no longer sits flat to the ground.
A Morton’s neuroma is common cause of pain in the ball of the foot. It is a thickening of one of the nerves in the ball of your foot. It causes a burning sensation into either the 2nd and 3rd or 3rd and 4th toes. It is also often associated with numbness in the affected toes. Wearing shoes with a high heel or a tight toe-box will likely irritate the symptoms.
More systemic causes of pain in the ball of the foot are rarer but should not be overlooked. Rheumatoid arthritis can cause swelling, pain and heat in the small joints of the feet. It tends to affect both feet at the same time. Psoriatic arthritis is associated with the skin condition psoriasis, and can cause a sausage like swelling of one of the toes. It tends to happen only on one foot at a time.
How is pain in the ball of the foot treated?
All of the causes of pain in the ball of the foot are treated differently. It is then important that we first have an accurate diagnosis so that we can effectively treat your condition. In clinic we take a detailed history and carry out an in-depth assessment to allow us to accurately diagnose your exact issue. This allows us to put together an individualised treatment plan designed to resolve your pain. This may include stretching exercises, footwear modifications, orthotics or injections. Where the diagnosis is not clear we may refer you for an x-ray, ultrasound or MRI scan to investigate the cause of your pain more thoroughly. If conservative treatment fails or isn’t appropriate, will refer you to a leading foot and ankle surgeons so that you are seen by the most appropriate professional for your issue.