Metatarsalgia – Pain in the ball of the foot when walking
What causes pain in the ball of the foot when walking?
There are a number of possible causes for this. The ‘balls’ of the feet are technically, the metatarsophalangeal joints (MTP joints). Pain in this area can mean that one of these joints, or the structures or surrounding structures of the joints are unhappy.
Increasing the load in this area can lead to overloading of the structures and the development of pain. Commonly, a sudden increase in activities can bring this on.
Do shoes cause pain in the ball of the foot?
Shoes per se do not bring on pain but they certainly can exacerbate things. A high heeled shoe for example, lifts the heel and forces increased load at the front of the foot. Wearing this type of shoe for long periods can increase the risk of damage to structures in the forefoot.
What activities aggravate pain in the ball of the foot?
Walking long distances wearing high heeled shoes, or high impact activities such as running and jumping. High intensity interval training (HIIT) is a classic activity that will not help.
Symptoms you might experience alongside pain in the ball of the foot
When someone develops pain in part of the foot they will often adapt a different walking pattern. This is what we call altered gait, and can lead to overuse of other tendons and muscles. Depending on how someone is walking will depend on which muscle groups are being used more. Commonly this can affect under the arch, side of the foot and leg, or even hip!
Treating pain in the ball of the foot
Types of treatment depend on the level of pain and what structures are causing pain. Conservative treatments can include taping the toe down, wearing foot orthoses (insoles), and activity modification. More invasive treatments may involve therapeutic injection (corticosteroid or platelet rich plasma), or surgery. Occasionally, imaging of the foot may need to be requested to help identify the problem and tailor the treatment plan.
When to see a specialist
You should see a specialist if the symptoms are affecting your normal day-to-day activities or if not improving, or worsening, over a short period of time.