Ball of foot pain is a common problem with around a quarter of all cases of foot pain affecting the ball of the foot.
Pain in the ball of the foot is often linked to high impact sports involving lots of running and jumping but also affects people who regularly wear tight, narrow shoes, particularly high-heels.
In most cases, ball of foot pain comes on gradually due to overuse or repetitive impact but in some cases it comes on suddenly.
There may be tingling, numbness, stiffness and inflammation alongside pain in the ball of the foot, and in most cases, symptoms get worse with activity and ease with rest.
Here we will look at the most common causes of ball of foot pain, how they present and how to treat them. If you pain is more in the bottom of the foot rather than the ball of the foot, then check out the Foot Arch Pain article.
Let’s start by looking at the five most common causes of ball of foot pain and the common features of each, then we’ll go on to look at some of the other possible causes.
The most common cause of pain in the ball of the foot is metatarsalgia.
Metatarsalgia is an overuse injury that causes inflammation and pain in one or more of the metatarsal bones in the foot.
The metatarsals are the long bones in the forefoot that connect to the toes. Repetitive pressure or overloading through the metatarsal heads leads to irritation and swelling resulting in ball of foot pain.
Common causes of metatarsalgia include high-impact sports involving lots of running and jumping, walking for long periods, wearing high heels or tight fitting footwear, foot deformities and various medical conditions.
Metatarsalgia typically causes a burning or aching pain in the ball of the foot that develops gradually over time rather than suddenly. There may also be associated tingling or numbness in the toes and a shooting pain through the foot, but there isn’t usually any noticeable swelling or lumps. Symptoms tend to extend across the entire ball of the foot, typically get worse with activity and ease with rest.
Another common cause of ball of foot pain is a Morton’s Neuroma. One of the classic features of a Morton's neuroma is the feeling that you are standing on a pebble when you walk.
With a Morton’s neuroma there is thickening around one of the nerves in the ball of the foot, usually between the 3rd and 4th toe.
Often, the first symptom of a Morton’s neuroma is tingling and numbness around the nerve which spreads down into the toes. This then progresses to a sharp, stabbing, burning pain in the ball of the foot as the nerve gets more irritated. There may also be a small lump under your foot that you can feel in-between the toes.
Morton’s neuromas are usually caused by wearing tight, narrow or high-heeled shoes, foot deformities e.g. flat feet, sports involving running and jumping and various foot conditions and injuries e.g. arthritis or ligament sprain. They typically affect middle aged people and are much more common in women than men.
Ball of foot pain from a Morton’s neuroma usually improves with a combination of medication, ice, steroid injections, appropriate footwear and orthotics but in some cases, may require surgery.
You can find out all about pain in the ball of the foot from a Morton’s neuroma and how to treat it in the Morton’s Neuroma section.
Another common cause of pain on the ball of the foot is a metatarsal stress fracture.
Stress fractures are small, subtle fractures, often caused by sudden changes in activity levels e.g. increasing the intensity, frequency or duration of exercise, or changing the surface you work-out on e.g. from a treadmill to roads or soft clay tennis court to a hard court.
Metatarsal stress fractures usually occur when the foot is repetitively overloaded which over time places so much force through one or more of the bones that they break. Metatarsal stress fractures are particularly common during adolescence when the bones are still developing, and in people with osteoporosis. Abnormal foot biomechanics, unsupportive footwear and previous foot injuries also increase the risk of foot stress fractures.
Metatarsal stress fractures usually start off by causing mild ball of foot pain which gradually gets worse and worse. There is often swelling in the ball of the foot and there may be a hard lump over the fracture site. The area is often tender to touch and activities like walking and running become increasingly painful.
If your ball of foot pain is from a stress fracture, then it is really important to rest from any aggravating activities. This may mean using a special walking shoe, splint and/or crutches for a few weeks. Over time, the bone will gradually heal. Regularly applying ice and taking pain-relieving medications and anti-inflammatories will help to reduce the pain in the ball of your foot.
You can find out all about the causes, symptoms, diagnosis and treatment options for this cause of ball of foot pain in the Foot Stress Fractures section.
Sesamoiditis can also cause ball of foot pain around the bottom of the big toe.
The sesamoid bones are two small pea-sized bones that sit inside the tendons that run directly underneath the base of the big toe.
Sesamoiditis is characterized by inflammation and pain in the sesamoid bones, which can be caused by overuse, repetitive stress, or injury. Athletes and dancers are particularly susceptible to sesamoiditis due to the high impact and pressure placed on the balls of their feet.
Symptoms of sesamoiditis include tenderness and pain in the ball of the foot, swelling, difficulty bending or straightening the big toe, and difficulty walking or bearing weight on the affected foot.
Treatment for sesamoiditis typically involves rest, icing, and anti-inflammatory medication to reduce ball of foot pain and inflammation. Taping, padding or orthotics may also be used to provide support and relieve pressure on the affected area. In severe cases, immobilization with a cast or walking boot may be necessary to allow the sesamoid bones time to heal properly.
The best way to prevent pain in the ball of the foot from sesamoiditis is to avoid high-impact activities or gradually increase their intensity over time, wear properly fitting, flat shoes with adequate support and cushioning, and maintain good foot flexibility with stretching exercises.
You can find out all about sesamoid ball of foot pain including the causes, symptoms, diagnosis and treatment options in the sesamoiditis section.
Bunions are a common foot condition that can cause pain in the ball of the foot, especially in the area near the big toe.
A bunion is a bony bump that develops on the joint at the base of the big toe, which can push the big toe inwards towards the other toes and cause the ball of the foot to become wider.
The pressure and friction caused by bunions can result in ball of foot pain, as well as other symptoms such as redness, swelling, stiffness and difficulty moving the big toe. The exact cause of foot bunions is unknown but it is thought that a variety of factors including genetics, arthritis, and wearing shoes that are too tight or don't provide proper support increase the risk. Bunions are a progressive condition and early intervention is essential to prevent the condition from worsening.
Treatment for bunions may include wearing properly fitted shoes with a wider toe box, using orthotics or other devices to relieve pressure on the affected area and correct the toe position, strengthening and stretching exercises, and taking over-the-counter pain medication to reduce ball of foot pain. In more severe cases, surgery may be necessary to remove the bunion and realign the affected joint.
You can find out loads more about pain in the ball of the foot from bunions including the causes, symptoms, diagnosis and best treatment and prevention options in the Foot Bunions section.
There are a number of other less common causes of ball of foot pain:
Treatment for pain in the ball of the foot will depend on the underlying cause but will usually involve a combination of:
You can find out more about specific treatment for the different causes of ball of foot pain in the following articles:
Pain in the ball of the foot is a common problem that can affect people at any age.
Ball of foot pain typically affects people who play high-impact sports that involve lots of running and/or jumping or wear tight-fitting or high-heeled shoes.
Treatment for pain in the ball of the foot usually involves a combination of rest, ice, orthotics, exercises, steroid injections, medication and wearing appropriate footwear. In more severe cases, surgery may be necessary.
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Page Last Updated: 11/13/23
Next Review Due: 11/13/25