Pain at the Ball of the Foot

Are you experiencing pain at the ball of one or both of your feet?  You might not know but there are several possible causes for that pain.  The purpose of this blog is to give you a quick run down of some of the more common reasons for the pain you may be experiencing:

Neuroma:  A neuroma is a swollen/inflamed portion of a particular nerve that divides at the ball of the foot.  The nerve splits in this area of the metatarsal heads.  One portion provides sensation to one toe and the other portion to the adjacent toe.  Some people with this condition might have numbness, burning or shooting pain to one or more toes.  They also might feel like they are walking on a pebble or their sock is balled up beneath their foot. 




Plantar plate Injury:  The plantar plate is a thick ligament that connects the bottom of the toe to the bottom of the metatarsal bone.  This ligament can be damaged or torn after an injury or it can become inflamed and partially torn because of abnormal forces to the ball of the foot.  

Capsulitis:  Just like every other joint in your body, your toes have a joint capsule that connects the toe bone to the metatarsal 360 degrees.  Like other joints, this capsule can also become inflamed because of abnormal wear and tear to the joint. 




Stress fractures:  Stress fractures can occur at the neck of the metatarsal which is close to the ball of the foot.  This can occur from an actual injury or from overuse on a weaker bone. 

Bone cysts:  Bone cysts can occur in the head of the metatarsal from multiple causes.  These can include benign and metastatic cancers as well an AVN.  An AVN develops after the head of the metatarsal looses blood supply and then begins to die. Just like everything else in your body, your bones need adequate blood flow to function properly. 

Arthritis: This type of pain could be due to osteoarthritis (overuse, degenerative joint disease) as well as autoimmune diseases (rheumatoid and psoriatic arthritis).

Gout: Gout can affect many joints in the body but has a high incidence in the foot.  The most common area that gout affects is the big toe joint.  This pain is usually described as 10/10 pain with even the lightest pressure, like bed sheets, touching the foot.  The area is usually red, hot and swollen as well. 

Bunion: A bunion is an abnormality at the big toe joint.  The 1st metatarsal begins to splay towards the center of the body as the big toe points outward.  This then forms an apex of overgrown bone that can become painful with range of motion of the big toe as well as pressure against shoes. 




Sesamoiditis:  The sesamoids are two pea sized bones that sit below the big toe joint.  They can become painful after an injury if they become sprained or fractured.  They can also become painful after overuse like any other type of arthritis because they articulate with the big toe joint.




Plantar Warts:  These can occur anywhere on the bottom of the foot as well as the ball of the foot.  This is a virus that develops in the skin that the body is not able to fight off.  The hallmark of a plantar wart is pinpoint bleeding during trimming of the wart.  This is because the warty tissue lives in the same level of your skin as the small blood vessels. 


Plantar Wart


IPK- This is an abbreviation for the term called intractable plantar keratosis.  This is a discrete callus that forms beneath the ball of the foot due to abnormal pressure from the overlying metatarsal head.  Sometimes the metatarsal head is pointed in a more downward angle than the remaining metatarsal heads.  It can also be due to a shorter or longer than usual metatarsal and sometimes it is because the bottom of the overlying metatarsal head is just too big and causes pressure. 

Porokeratoma: This is similar in appearance to an IPK but instead of being caused by pressure, it is caused by a clogged sweat gland on the bottom of the foot.  This can also cause a very pinpoint, discrete pain like an IPK. 

Neuropathy: This is usually described as burning/tingling pain that occurs during activity and at rest.  This can be from a pinched nerve from higher in the body or diseased nerves from complications of diabetes or other nerve disorders.

As you can see, there are a lot of potential causes for pain to the ball of the foot.  Because of this, it is important to have your feet properly examined to ensure that no serious issues are developing or you're not making a matter worse by not treating it. 

If you have any questions regarding this or any other foot/ankle issue.  Please call us at 972-542-2155