Pain in the Ball of Your Foot

Do you sometimes develop pain in the ball of your foot? What if you have recently developed this pain and it has not improved? There can be many contributing factors to forefoot pain, but the most apparent is ill-fitting shoe gear or no shoe gear at all. It's important to first determine the exact point of pain. In medicine we refer to this as the point of maximum tenderness. Let's review some steps to determining the most likely cause of the pain based on the location.

Pain in the ball of the foot at the base of the second toe

This is one of the most common areas for pain in the ball of the foot. Patient's with this pain will many times describe the recent use of shoe gear with a heel or walking barefoot. The source of pain usually presents from inflammation of the capsule surrounding the 2nd metatarsal phalangeal joint and specifically a thickening of the bottom of the capsule called the plantar plate. Individuals suffering from this type of pain should see a foot and ankle specialist to rule out the presence of a tear in the plantar plate. Delayed treatment of this condition, many times referred to as Predislocation Syndrome, can result in a complete tear of the plantar plate, followed by subluxation of the joint and the second toe overlapping the big toe.

Pain in the ball of the foot and at the base of the big toe

Do you feel pain when pressing the ball of the foot at the base of the big toe? If so, this could be indicative of sesamoiditis, or the two small bones that are present under the end of the first metatarsal. It is important to recall any point of trauma to this area. Although not as common, individuals with pain in this area after landing forcefully on the forefoot can have a sesamoid fracture. It is very important, especially with a history of trauma, to seek medical attention immediately. Fractures of the sesamoids can result in avascular necrosis (the bone dying due to lack of blood supply).

Pain across the entire ball of the foot

As we age, the elasticity of ligaments is compromised along with the integrity of collagen. The ball of the foot requires these structures to secure the fat pad on the plantar forefoot. When there is migration or movement of the fat pad towards the toes, the bones of the forefoot, mostly the metatarsal heads, rest on non-supportive tissue. This will quickly lead to pain in the forefoot when standing on any hard surface. The most simple solution is to wear shoe gear whenever walking or standing. Accommodative orthotics can also be used for the management of this condition.