What causes pain in the ball of the foot. How can you relieve metatarsalgia symptoms at home. When should you see a doctor for foot pain. What are the most effective treatments for ball of foot discomfort.

Understanding Metatarsalgia: Pain in the Ball of the Foot

Metatarsalgia refers to pain in the ball of the foot, specifically the area just behind the toes where the metatarsal bones are located. This common foot condition can cause significant discomfort and impact daily activities. While often treatable at home, persistent or severe metatarsalgia may require medical attention.

What are the main symptoms of metatarsalgia?

The primary symptom of metatarsalgia is pain in the ball of the foot. This pain may:

• Feel sharp, aching, or burning
• Worsen when standing, walking, or running
• Improve with rest
• Be accompanied by numbness or tingling in the toes
• Feel like you’re walking on a pebble

Common Causes of Ball of Foot Pain

Several factors can contribute to the development of metatarsalgia:

• High-impact activities like running or jumping
• Ill-fitting shoes, especially those with high heels or tight toe boxes
• Foot deformities such as bunions or hammertoes
• Being overweight, which increases pressure on the feet
• Aging, as the fat pad on the ball of the foot thins over time
• Certain medical conditions like arthritis or diabetes

Is sports activity a common trigger for metatarsalgia? Yes, high-impact sports and repetitive motions can strain the metatarsal area, leading to pain and inflammation in the ball of the foot.

Self-Care Strategies for Relieving Metatarsalgia

Many cases of metatarsalgia can be managed at home with simple remedies:

1. Rest and elevate the affected foot
2. Apply ice to reduce inflammation
3. Wear properly fitting shoes with good support
4. Use cushioned insoles or metatarsal pads
5. Take over-the-counter pain relievers like ibuprofen or paracetamol
6. Perform gentle foot and ankle stretches

Can changing footwear alleviate ball of foot pain? Absolutely. Opting for shoes with a wider toe box, lower heels, and good arch support can significantly reduce pressure on the metatarsal area and provide relief.

Exercises to Strengthen and Stretch the Foot

Incorporating specific exercises into your routine can help alleviate metatarsalgia symptoms and prevent future occurrences:

• Toe stretches: Gently pull each toe back towards the ankle
• Toe curls: Curl your toes downward, then release
• Ball rolls: Roll a tennis ball or frozen water bottle under the arch of your foot
• Ankle rotations: Slowly circle your foot in both directions
• Calf stretches: Lean against a wall with one leg behind, keeping the back leg straight

How often should you perform these exercises? Aim for 2-3 sessions daily, holding each stretch for 15-30 seconds and repeating 5-10 times.

When to Seek Medical Attention for Ball of Foot Pain

While many cases of metatarsalgia improve with home care, certain situations warrant professional medical evaluation:

• Severe pain that interferes with daily activities
• Symptoms that persist or worsen despite self-treatment
• Noticeable changes in foot shape or structure
• Numbness or tingling in the foot or toes
• Pain accompanied by redness, swelling, or warmth in the foot

Are there any red flags that require immediate medical attention? Yes, severe pain, inability to bear weight on the foot, or signs of infection (such as fever or spreading redness) should prompt an urgent visit to a healthcare provider or emergency room.

Professional Treatment Options for Metatarsalgia

If home remedies prove insufficient, a healthcare provider may recommend additional treatments:

• Custom orthotics to redistribute pressure on the foot
• Physical therapy to improve foot strength and flexibility
• Corticosteroid injections to reduce inflammation
• Modification of activities or sports techniques
• In rare cases, surgery to address underlying structural issues

How effective are custom orthotics in treating metatarsalgia? Custom orthotics can be highly effective, as they are tailored to an individual’s foot structure and gait, providing targeted support and pressure redistribution.

Preventing Recurrence of Ball of Foot Pain

Taking proactive steps can help prevent future episodes of metatarsalgia:

1. Maintain a healthy weight to reduce foot pressure
2. Choose footwear that fits well and provides adequate support
3. Gradually increase intensity when starting new exercise routines
4. Use shock-absorbing insoles during high-impact activities
5. Regularly stretch and strengthen your feet and legs
6. Replace athletic shoes before they become worn out

Does alternating between different types of shoes help prevent metatarsalgia? Yes, rotating shoes can help distribute pressure differently across your feet, potentially reducing the risk of developing or exacerbating metatarsalgia.

Understanding Related Foot Conditions

Several foot conditions can cause symptoms similar to metatarsalgia or occur alongside it:

Morton’s Neuroma

This condition involves thickening of tissue around a nerve between the toes, often causing burning pain in the ball of the foot.

Stress Fractures

Tiny cracks in the metatarsal bones can cause localized pain and swelling in the ball of the foot.

Sesamoiditis

Inflammation of the small bones under the big toe joint can cause pain in the ball of the foot, especially during activities like running or dancing.

Plantar Fasciitis

While primarily causing heel pain, plantar fasciitis can sometimes lead to discomfort in the ball of the foot as well.

Can metatarsalgia be mistaken for other foot conditions? Yes, the symptoms of metatarsalgia can overlap with other foot problems, which is why a proper diagnosis from a healthcare professional is crucial for effective treatment.

The Role of Footwear in Metatarsalgia Management

Proper footwear plays a crucial role in both preventing and managing metatarsalgia. Consider the following when selecting shoes:

• Adequate toe room to allow for natural foot movement
• Good arch support to distribute weight evenly
• Cushioning in the sole to absorb shock
• Low to moderate heel height to reduce pressure on the ball of the foot
• Breathable materials to prevent moisture buildup

Are there specific shoe brands recommended for metatarsalgia? While individual needs vary, brands known for their supportive and comfortable footwear include New Balance, Brooks, and Vionic. However, the best shoe is one that fits your foot shape and provides adequate support for your specific needs.

The Impact of High Heels on Metatarsalgia

High-heeled shoes can significantly increase pressure on the ball of the foot, exacerbating metatarsalgia symptoms. If you must wear heels, consider:

• Limiting wear time to short periods
• Choosing lower heel heights (2 inches or less)
• Opting for wider toe boxes and platforms for better weight distribution
• Using metatarsal pads or cushioned insoles for added support

How can you mitigate the effects of high heels on foot health? Alternating between heels and more supportive shoes throughout the day, and performing foot stretches after wearing heels can help reduce strain on the metatarsal area.

Lifestyle Modifications for Managing Metatarsalgia

Beyond footwear and exercises, certain lifestyle changes can contribute to better foot health and metatarsalgia management:

Weight Management

Maintaining a healthy weight reduces the overall pressure on your feet, potentially alleviating metatarsalgia symptoms.

Activity Modification

Consider low-impact activities like swimming or cycling to give your feet a break while staying active.

Foot Care Routine

Regularly moisturizing your feet, trimming nails properly, and addressing any calluses or corns can prevent additional stress on the metatarsal area.

Nutrition

A balanced diet rich in calcium, vitamin D, and omega-3 fatty acids supports overall bone and tissue health.

Can dietary changes impact foot health and metatarsalgia symptoms? While not a direct treatment, a nutritious diet supports overall musculoskeletal health, potentially contributing to better foot function and reduced inflammation.

The Role of Technology in Metatarsalgia Treatment

Advancements in technology have introduced new options for managing metatarsalgia:

3D-Printed Orthotics

These custom-made insoles offer precise support tailored to an individual’s foot structure and gait pattern.

Wearable Sensors

Devices that analyze your walking or running patterns can help identify issues contributing to metatarsalgia.

Telemedicine

Virtual consultations with foot specialists can provide expert advice and treatment recommendations without the need for in-person visits.

Smart Insoles

These tech-enabled insoles can provide real-time feedback on foot pressure and gait, helping users make adjustments to reduce strain on the metatarsal area.

How effective are technological solutions in treating metatarsalgia? While research is ongoing, many patients report significant improvements with tech-assisted treatments, particularly when combined with traditional therapies and lifestyle modifications.

Understanding the Anatomy of the Foot in Relation to Metatarsalgia

To better comprehend metatarsalgia, it’s helpful to understand the foot’s structure:

Metatarsal Bones

The five long bones in the midfoot that connect to the toes. The heads of these bones form the ball of the foot.

Plantar Fat Pad

A cushion of fatty tissue under the metatarsal heads that acts as a natural shock absorber.

Sesamoid Bones

Two small, pea-shaped bones under the big toe joint that assist with weight-bearing.

Plantar Fascia

A thick band of tissue running from the heel to the toes, supporting the foot’s arch.

How does the foot’s anatomy contribute to the development of metatarsalgia? Imbalances or abnormalities in any of these structures can lead to increased pressure on the metatarsal area, potentially causing pain and inflammation.

The Psychological Impact of Chronic Foot Pain

Persistent metatarsalgia can have significant effects on mental health and quality of life:

• Reduced mobility leading to social isolation
• Anxiety about pain or future foot problems
• Depression due to limitations in daily activities
• Sleep disturbances from nighttime discomfort
• Stress from managing chronic pain

How can individuals cope with the psychological effects of chronic foot pain? Strategies such as mindfulness meditation, cognitive-behavioral therapy, and joining support groups can help manage the emotional challenges associated with chronic pain conditions like metatarsalgia.

The Importance of a Holistic Approach

Addressing both the physical and psychological aspects of metatarsalgia is crucial for comprehensive treatment. This may involve:

• Working with a multidisciplinary team including podiatrists, physical therapists, and mental health professionals
• Exploring pain management techniques beyond medication, such as acupuncture or biofeedback
• Engaging in activities that promote overall well-being, like yoga or tai chi
• Setting realistic goals and celebrating small improvements in foot health and mobility

Can a positive mindset influence the recovery from metatarsalgia? While not a cure in itself, maintaining a positive outlook and actively engaging in treatment can contribute to better outcomes and improved quality of life for those dealing with metatarsalgia.

Future Directions in Metatarsalgia Research and Treatment

The field of podiatry continues to evolve, with ongoing research into new treatments and preventive measures for metatarsalgia:

Regenerative Medicine

Studies are exploring the use of stem cell therapy and platelet-rich plasma injections to promote healing in the foot.

Advanced Imaging Techniques

High-resolution ultrasound and specialized MRI protocols are improving diagnosis and treatment planning for metatarsalgia.

Biomechanical Analysis

Sophisticated gait analysis tools are helping clinicians better understand individual foot mechanics and tailor treatments accordingly.

Novel Materials

Research into new materials for shoes and orthotics aims to provide better shock absorption and pressure distribution.

What promising developments are on the horizon for metatarsalgia treatment? Emerging technologies like 3D-printed custom orthotics and smart wearables for real-time gait analysis show potential for more personalized and effective management of metatarsalgia.

In conclusion, metatarsalgia, while common, can significantly impact daily life. Understanding its causes, symptoms, and treatment options empowers individuals to take proactive steps in managing their foot health. From simple home remedies to advanced medical interventions, a range of strategies exists to address ball of foot pain. By combining proper foot care, appropriate footwear, and professional guidance when needed, most people can find relief from metatarsalgia and maintain healthy, pain-free feet.

Pain in the ball of the foot

Pain in the ball of your foot is known as metatarsalgia. You can usually ease the pain yourself. But see a GP if it does not improve.

How you can ease pain in the ball of your foot yourself

If you see a GP about pain in the ball of your foot, they may suggest you try these things:

Do

• rest and raise your foot when you can

• put an ice pack (or bag of frozen peas in a towel) on the painful area for up to 20 minutes every 2 to 3 hours

• wear shoes with plenty of room for your feet, which have a low heel and soft sole

• use soft insoles or pads in your shoes

• try to lose weight if you’re overweight

• try regular, gentle foot and ankle stretching exercises

• use painkillers such as paracetamol or ibuprofen gel (or ibuprofen tablets if needed)

Don’t

• do not do any sports or other activity that you think is causing the pain

• do not walk or stand for long periods

• do not wear high heels or tight pointy shoes

A pharmacist can help with foot pain

You can ask a pharmacist about:

• the best painkiller to take
• insoles and pads for your shoes
• if you need to see a GP

Video: exercises to reduce pain in the ball of the foot

This video shows exercises that can help reduce pain in the ball of the foot.

Media last reviewed: 17 April 2022
Media review due: 17 April 2025

See exercise video safety information

The exercises in this series of videos are suitable for most people in good health with a reasonable level of fitness.

Unless stated otherwise, they are general exercises only and are not aimed at treating any specific cause of pain or condition. Video titles and descriptions can give more information on how difficult the exercises are and who they are for.

Get advice from a healthcare professional before trying them if:

• you are not sure if the exercises are suitable for your current level of fitness
• you have a health problem, an injury, any symptoms, are feeling unwell, or you have had a recent health event such as a heart attack or operation
• you have any other concerns about your health
• you are pregnant or have recently given birth

Stop the exercise immediately if you feel any pain or become unwell. If you are concerned about any symptoms, or they do not go away, get help from 111 online or call 111 for advice.

Non-urgent advice: See a GP if:

• pain in the ball of your foot is stopping you doing normal activities
• the pain is getting worse or keeps coming back
• the pain has not improved after treating it at home for 2 weeks
• you have any tingling or loss of sensation in your foot
• you have diabetes and a foot pain – foot problems can be more serious if you have diabetes

Immediate action required: Go to an urgent treatment centre or A&E if:

• you have severe pain in the ball of your foot
• you are not able to walk
• your foot has changed shape
• you heard a snap, grinding or popping noise at the time of injury
• you feel faint, dizzy or sick from the pain

These might be signs of a broken bone after an injury.

What we mean by severe pain

Severe pain:

• always there and so bad it’s hard to think or talk
• you cannot sleep
• it’s very hard to move, get out of bed, go to the bathroom, wash or dress

Moderate pain:

• always there
• makes it hard to concentrate or sleep
• you can manage to get up, wash or dress

Mild pain:

• comes and goes
• is annoying but does not stop you doing daily activities

Common causes of pain in the ball of your foot

Pain in the ball of your foot is often caused by exercise, such as running, wearing shoes that are too tight or a condition such as arthritis.

Some people also have a foot shape that puts extra pressure on the ball of the foot. Hard or cracked skin or a verruca can also cause this type of pain.

Your symptoms might also give you an idea of what’s causing your pain.

Information:

Do not worry if you’re not sure what the problem is.

Follow the advice on this page and see a GP if the pain does not get better in 2 weeks.

You can also read about pain in other areas of your foot.

Page last reviewed: 21 March 2022

Next review due: 21 March 2025

Plantar fasciitis – NHS

Plantar fasciitis is pain on the bottom of your foot, around your heel and arch. You can usually ease the pain yourself but see a GP if it does not improve within 2 weeks.

Check if you have plantar fasciitis

The main symptom of plantar fasciitis is pain on the bottom of your foot, around your heel and arch.

Credit:

NHSD/Rich Kelly/Turbosquid

It’s more likely to be plantar fasciitis if:

• the pain is much worse when you start walking after sleeping or resting
• the pain feels better during exercise, but returns after resting
• it’s difficult to raise your toes off the floor

How to ease plantar fasciitis yourself

If you see a GP, they’ll usually suggest you try these things:

Do

• rest and raise your foot on a stool when you can

• put an ice pack (or bag of frozen peas) in a towel on the painful area for up to 20 minutes every 2 to 3 hours

• wear shoes with cushioned heels and good arch support

• use insoles or heel pads in your shoes

• try regular gentle stretching exercises

• try exercises that do not put pressure on your feet, such as swimming

• take painkillers like paracetamol and ibuprofen

• try to lose weight if you’re overweight

Don’t

• do not take ibuprofen for the first 48 hours

• do not walk or stand for long periods

• do not wear high heels or tight pointy shoes

• do not wear flip-flops or backless slippers

• try not to walk barefoot on hard surfaces

A pharmacist can help with plantar fasciitis

You can ask a pharmacist about:

• the best painkiller to take
• insoles and pads for your shoes
• if you need to see a GP

Non-urgent advice: See a GP if:

• you have pain in the bottom of your foot that is severe or stopping you doing normal activities
• the pain is getting worse or keeps coming back
• the pain has not improved after treating it yourself for 2 weeks
• you have any tingling or loss of feeling in your foot
• you have diabetes and foot pain – foot problems can be more serious if you have diabetes

What we mean by severe pain

Severe pain:

• always there and so bad it’s hard to think or talk
• you cannot sleep
• it’s very hard to move, get out of bed, go to the bathroom, wash or dress

Moderate pain:

• always there
• makes it hard to concentrate or sleep
• you can manage to get up, wash or dress

Mild pain:

• comes and goes
• is annoying but does not stop you doing daily activities

Treatment for plantar fasciitis from a foot specialist

If plantar fasciitis does not get better, a GP might refer you to a physiotherapist or foot specialist (podiatrist).

A physiotherapist can show you exercises to help ease your symptoms. A podiatrist can recommend things like insoles and the right shoes to wear.

Physiotherapy is available free of charge on the NHS throughout the UK but waiting times can sometimes be long.

Depending on where you live, you may be able to self-refer or you may need to visit a GP or consultant first.

Podiatry may not be available for free on the NHS everywhere and waiting times can sometimes be long.

You can also pay to see a podiatrist or physiotherapist privately.

Read more about accessing physiotherapy.

Common causes of plantar fasciitis

Plantar fasciitis is caused by straining the part of your foot that connects your heel bone to your toes (plantar fascia).

It’s not always clear why this happens.

You may be more likely to get plantar fasciitis if you:

• are 40 to 60 years of age
• recently started exercising on hard surfaces
• exercise with a tight calf or heel
• overstretch the sole of your foot during exercise
• recently started doing a lot more walking, running or standing up
• wear shoes with poor cushioning or support
• are very overweight

Page last reviewed: 07 February 2022
Next review due: 07 February 2025

Pain in the foot between the heel and toe: how to treat, causes of pain

Author of the article: Eduard Svitich – orthopedic traumatologist

The foot is the most durable part of the musculoskeletal system. The weight of the whole body presses on it, and when walking or running, the load on the feet exceeds the weight of the body at times. The complex structure of the sole allows you to withstand loads and maintain active movement.

Content:

• What is between the heel and the toe?
• Why does the foot hurt in the middle
• Plantar fasciitis is usually treated
• How to treat fasciitis correctly

What is between the heel and toe on the foot?

There are about 26 bones in each foot, which are connected to each other by ligaments. The most durable and largest of them is the plantar fascia (aponeurosis). It looks like a wide plate connecting the heel and the base of the fingers. If you imagine that the bend of the foot is the shaft of the bow, the fascia is its bowstring, it keeps the arch from sagging and springs for cushioning.

Why does the foot hurt in the middle

Healthy plantar (or plantar) fascia is quite elastic and only slightly stretches under load. If the height of the arches falls, the attachment points of the fascia diverge, and it is stretched. A tightly stretched ligament, with even greater tension, no longer stretches, but breaks.

Ligament tension can lead to various symptoms. All of them clearly violate the health of the feet and sharply limit activity. Inflammation of the fascia is called plantar fasciitis, and it can manifest itself in several forms:

• Proximal fasciitis. Sharp, sharp or aching pain appears in the depths of the heel region. A “heel spur” on an x-ray is just a sign that the fascia has been tense for a long time. The pain in this case is not caused by a bone spike, but by damage to the ligament fibers.
• Medium shape. Occurs very often. The foot seems to split with every step. The sole aches and hurts, sometimes the discomfort simply makes it impossible to move. Rarely, an extensive rupture of the plantar ligament can occur: the pain becomes unbearable, the foot swells, the arches flatten.
• Distal form. The pain bothers in the area closer to the fingers. It is less common, can mimic the symptoms of transverse flatfoot, Morton’s disease.

How is plantar fasciitis usually treated?

The acute phase of the disease is usually treated symptomatically. The patient is advised to walk less, apply ice packs to the painful area through the tissue. With a significant intensity of discomfort, anti-inflammatory drugs are recommended. These are absolutely correct appointments for a short-term fight against exacerbation.

It is somewhat worse if the doctor begins treatment of fasciitis with rather dangerous and unreliable methods. Although they can quickly eliminate pain, there will be more complications in the long term. Methods that are still actively practiced contrary to international recommendations include:

• Blockade with steroid hormones. This is “heavy artillery”, which suppresses pain well, but often does more harm. Steroids slow down regeneration, reduce the strength of ligaments, and reduce local immunity. The most dangerous side effect is the resorption of the heel fat pad. Sometimes a single injection of the hormone is acceptable, but regular use will certainly lead to complications.
• Radiotherapy. You can also meet patients who by all means try to get on the heel radiograph, believing that it will remove the “heel spur”. In fact, only a special radiation unit, which is used to fight tumors, can eliminate a bone spike. On its way, a concentrated beam of radiation destroys all cells, and its use is justified only in oncology.

How to treat fasciitis correctly

The most effective and lasting treatment is always aimed at eliminating the cause of the disease. The main factors in the development of fasciitis are overload of the foot and a decrease in the elasticity of the fascia. Therefore, actions aimed at unloading the arches and improving the quality of the ligaments lead to the most noticeable results. Most importantly, effective treatments for fasciitis are safe.

Plantar fasciitis is a disease that requires the active participation of the patient himself. Of course, it seems easier to get an injection and forget about the pain. But until the patient himself improves the functioning of his body, the symptoms will return and increase. Below are the most effective methods for permanent relief of pain between the toe and heel:

• Quality orthopedic insoles. It is better if they are individual. The elastic protrusions of the instep supports massage the aponeurosis, improve its blood circulation and elasticity. Proper insoles support the arches well and relieve unnecessary stress from the fascia.

• Physical exercise. A competent rehabilitation specialist will write out a regimen of training and “stretching” that will work most effectively for you. With the help of regular exercises, it is possible to increase the elasticity of the fascia and muscles, which will significantly reduce discomfort.
• Night tires. Durable plates that are worn on the leg during sleep and improve the metabolism of the aponeurosis. During the night period, body tissues are most pliable, which gives the splint the ability to effectively increase their elasticity.

ORTO SMART stores – Medical equipment, orthosalon – professional establishments where you can undergo foot diagnostics and choose the most suitable orthopedic products. A large selection of therapeutic and prophylactic insoles, massagers and splints allows you to individually approach any form of fasciitis. Experienced consultants will help you decide on the best models to improve the work of your feet.

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MBDOU “Kindergarten No. 28”

Parental advice “Health starts from the foot”

Prepared by: physical education instructor – Ryabova G.V.

According to many studies, the foot is a complex vaulted organ that performs support, locomotive and cushioning functions. It is the support, the foundation of the body, so the violation of this foundation is necessarily reflected in the formation of the growing organism. A change in the shape of the foot causes a decrease in its functionality, changes the position of the pelvis, spine, and gait is disturbed. This negatively affects the posture and general condition of the child.

Children’s foot, compared with the foot of an adult, has a number of morphological features. It is wider in the front and narrower in the heel. In preschool children, subcutaneous tissue is highly developed on the sole, which fills the arches of the foot, which often leads to diagnostic errors. Children’s foot is less adapted to static loads: jumping, jumping off high equipment. The feet tire quickly and are easily deformed.

Flat feet is a deformity of the foot. It can be congenital and acquired. The most common causes of the latter are weakness of the musculoskeletal apparatus of the foot.

Insufficient development of the muscles and ligaments of the feet adversely affects the development of many movements in children, leads to a decrease in motor activity, adversely affects the activity of internal organs and can become a serious obstacle to practicing many sports. Thus, strengthening the musculoskeletal system, and in particular the foot, is of great importance.

Early signs of flat feet – fatigue of the legs, aching pain (when walking, standing) in the foot, muscles of the lower leg and thigh, lower back. Children suffering from flat feet, when walking, wave their arms widely, stomp strongly, their gait is tense, clumsy.

The foot is determined by the location of special reflexogenic zones on the plantar surface, which ensure the connection of the foot with various body systems (cardiovascular, respiratory, etc.) organism.

Prevention of flat feet and clubfoot includes wearing the right footwear.

What should be the shoes for a preschooler?

1. Shoes must fit the shape and size of the foot.

2. The sole must be flexible, neither high nor too soft.

3. An important element of footwear for preschoolers is the heel, the height of which should not exceed 5-10 mm.

4. In the prevention of foot deformity, the presence of a fixed back is of particular importance, which allows you to firmly hold the calcaneus and prevents its outward deviation.

5. Shoes must provide a secure fit in the forefoot.

6. A strong fixation of the foot in the shoe is also ensured by appropriate fastenings.

Therefore, dear parents, I ask you to pay special attention to this. Slippers and sneakers with flat, rubber soles only contribute to flat feet.

Flat feet should be prevented from an early age.