Metatarsalgia, Morton’s neuroma, and sesamoiditis cause ball of the foot pain. There are many conservative treatment options.
What Causes Pain in the Ball of the Foot?
There are many causes for ball of the foot pain. Morton’s neuroma, sesamoiditis, and metatarsalgia are three common causes. In metatarsalgia, inflammation is caused by improper footwear and certain activities. Sesamoiditis affects the big toe area, where tendons are injured. When the tissue around the nerve between the toes is thickened, that is called Morton’s neuroma. In this disorder, there is not only pain, but numbness. Again, footwear is a culprit.1 Activities like jumping and running can trigger metatarsalgia. This disorder is preventable with conservative treatments.2 Another name for metatarsalgia is “stone bruise”. The area of the foot that experiences this is the metatarsal (ball of foot), around the middle toes. The bones and joints are affected by metatarsalgia. The pain can impact only a toe or two, the entire foot, or both feet. Putting weight on the foot increases the pain. Middle aged females are mostly likely affected by metatarsalgia, but anyone can have this disorder. Symptoms can be described as “walking on pebbles”, tingling, numbness, shooting pain, or a burning sensation, and the pain increases when walking on a hard surface. Stress on the foot, being overweight, age, fractures, and poorly fitted footwear can all trigger symptoms. Bunions, diabetes, Morton’s neuroma, and rheumatoid arthritis can also cause metatarsalgia.3 Morton’s neuroma pain has been similarly described as “walking on a marble”. The thickened tissue of the forefoot, by the third and fourth toes, is triggered by trauma, pressure, and irritation. High-heeled shoes aggravate Morton’s neuroma.4 Sesamoiditis pain is also felt on the ball of the foot, but around the big toes. There may be bruising, swelling, or pain in bending the big toe.5
Conservative treatments for metatarsalgia would include losing weight, not engaging in high impact running and jumping exercises, and getting properly fitted footwear. Ice, anti-inflammatory medication, rest, orthotics, metatarsal pads, shock-absorbing insoles, and arch supports are often prescribed. Serious cases of metatarsalgia might be referred for steroid injections or surgery.6 Treatment of Morton’s neuroma also involves orthoses, changes in footwear, anti-inflammatory medication, and corticosteroid injections.7 As in the other two conditions, sesamoiditis is often treated with NSAIDs, rest, ice, wearing a cushioning pad, switching to low-heeled and comfortable shoes, and steroid injections. In addition, patients can try taping the big toe “so that it remains bent slightly downward (plantar flexion)”. In long-term cases, patients may need to wear a special, removable brace for a month or more.8 Chiropractic care can treat patients with ball of the foot pain, as well as other conditions of the feet and musculoskeletal symptoms. Often, chiropractors will help patients with exercises, stretches, and finding appropriate orthotics and footwear. They can also provide gentle adjustments for misalignments in the foot.9 The Activator tool may be used in the adjustment, and chiropractors can work slowly to “take joints through their proper range of motion”. Orthotics, such as Foot Levelers, could also be helpful.10
Learn more about special orthotics.