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What Causes Pain In The Ball Of The Foot?

Pain in the ball of the foot is a common condition that we see and one that we get many questions about here at West Pennant Hills Physiotherapy and Sports Injuries Centre.


Pain in the ball of the foot can also be referred to as metatarsalgia. It is a condition in which the ball of the foot becomes painful and inflamed. The area affected involves the bones at the bases of the toes, which are called the metatarsals. There are many different causes of metatarsalgia such as incorrect footwear, overuse with activities that involve running or jumping, or foot deformities.

Symptoms of metatarsalgia include:


  • Sharp, burning pain in the ball of your foot

  • Pain in the ball of foot when walking, running, standing, especially barefoot on a hard surface

  • Pain relieved with rest

  • A feeling of having a pebble in your shoe

So what causes pain in the ball of the foot?


Intense training or activity, especially with running or jumping. This is because the front of the foot absorbs more force during these activities. Participating in high impact sports can put you at risk, particularly if you have poor footwear or have worn through your shoes.

Certain foot shapes can also predispose you to developing pain in the ball of your foot. For example, having your second toe longer than the big toe, or small curled up toes also known as hammertoes. Having a high arch can put more pressure on the front of your foot and put you at risk of developing metatarsalgia.


Footwear is a key risk factor that can cause pain in the ball of the foot. For example, wearing high heels transfers extra weight to the front of your foot. Shoes that have a narrow toe box can also contribute to the problem as they squeeze the toes together causing pain. Athletic shoes that lack arch support are also detrimental.

Excess weight. As you move, most of your body weight transfers from the heel to the forefoot. A risk factor of developing this condition is being overweight or obese. Extra weight means more pressure on the front of the feet (metatarsals). Losing weight may help to reduce or eliminate symptoms.

Pain in the ball of the foot may not always be metatarsalgia. Other possible diagnoses for pain under the ball of foot include:

Morton’s neuroma

This is a a noncancerous growth of fibrous tissue around the nerve. It most commonly occurs between the third and fourth metatarsal heads. This thickening of the tissues can contribute to excess stress on the metatarsals and result in symptoms very similar to that of metatarsalgia. It may cause pain or pins and needles or numbness between the toes.

Stress fractures

Stress fractures are caused by repetitive force, such as repetitive jumping or long distance running. It is often an overuse injury. Most stress fractures occur in the bone of the foot and lower leg, which carry the weight of the body. To determine whether the pain in the ball of your foot is due to a stress fracture, you will need a bone scan or MRI.

How to treat pain in the ball of your foot


Ice and rest can help to reduce inflammation and relieve symptoms. Take anti-inflammatories to help reduce pain and inflammation. Rest from any aggravating activities such as running or jumping to avoid further stress to the foot. You can continue to do low impact exercise such as swimming or cycling to maintain your fitness while you recover. Ensure that you are wearing proper footwear with enough arch support and shock absorption will help to prevent recurrences of the condition. Avoid shoes that are too tight around the toes, and limit wearing high heels.


Your physiotherapist will provide targeted stretches and exercises to help increase flexibility and strength. These exercises are also designed to help with pain relief. We will also use modalities such as ice, heat, TENS or ultrasound to help alleviate your pain. We can also fit you with orthotics to help correct any contributing poor foot biomechanics.


If left untreated, you may develop pain in other parts of the body such as the lower back or hip, especially if you are limping. Other muscles begin to overcompensate and work harder than they should be. This is why it is important to address the issue as soon as possible. In order to prevent ball of foot pain it is important to wear comfortable shoes and maintain a healthy weight.


Most cases can be resolved with conservative treatment. In very rare cases surgery may be indicated to correct the toe alignment or remove a neuroma.


If you are suffering from pain in the ball of your foot, and would like some further information or treatment, contact us today on 9875 3760 or info@wphphysio.com.au. We would be more than happy to help and assist you in your recovery.

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