The most common source of Ball of Foot pain is Metatarsalgia. The metatarsal bones are designed to equally share the weight of a person during walking and daily activities. When this delicate balance between bones is disrupted, the result can be mild to intense foot pain. The term Metatarsalgia refers to the number of problems people can experience in this area.
Causes:
- Overuse – Which can cause mild to severe inflammation in the Metatarsal heads and nearby joints.
- Wearing high-heeled shoes or footwear that is poorly fitted or too tight – This can place extra stress on the Metatarsal heads.
- Having a stiff ankle or Achilles tendon – This can affect the way that pressure is distributed across the foot and may lead to extra stress on the metatarsal heads.
- Morton’s neuroma – It is a condition that affects one of the nerves that run between the Metatarsal bones in the foot.
- Claw foot (pes cavus) – In pes cavus, your foot has a very high arch which does not flatten when you put weight on your foot. It occurs due an imbalance in the muscles of the foot. Most people with pes cavus also have a neurological problem.
- Hammer toe / claw toe – With a claw toe you have an abnormal position of all three of the joints in the toe. One of the joints is bent upwards and the middle and end joints of the toe are bent downwards. The toe resembles a claw. With a hammer toe, your toe is permanently bent at its middle joint so that it looks like a hammer. Toe deformities can mean that extra stress is placed on the ball of the foot.
- Bunion (hallux valgus) – A bunion is a deformity of the base joint of the big toe, causing the big toe to be angled towards the second toe. This causes a bump and thickening of the skin and tissue on the side of the foot at the base of the big toe. The thickened skin and tissues may become inflamed, swol- len and painful. Because of the bunion, extra stress is put on the ball of the foot.
- Stress fracture of a Metatarsal – A stress fracture is a type of incomplete fracture in a bone and tend to occur as a result of overuse.
- Freiberg’s disease –This is a rare disease characterised by osteonecrosis (disease caused by re- duced blood flow to bones in the joints. With too little blood, the bone starts to die and may break down) of the second metatarsal, most commonly seen in teenage girls.
- Arthritis or gout – This can cause inflammation of the joints in the ball of the foot or of the big toe and can be a cause of Metatarsalgia.
- Diabetes –This can cause damage to the nerves.
- Being overweight – This can put extra stress on the feet in general.
- Ageing – This tends to thin out or shift the fatty tissue of the foot pad.
Treatment:
If you have Metatarsalgia, your health practitioner will initially focus on establishing the cause of your pain. They may be able to identify the cause just by listening to you, asking you questions and examin- ing your foot. It may be necessary to have further investigation/s which may include blood tests, an x- ray, bone scan, ultrasound or MRI.
Treatment will depend on the underlying cause of your Metatarsalgia, sometimes simple measures may be enough to relieve your symptoms and this may include:
- Well fitting, supportive shoes
- Metatarsal pads or orthotics in your shoes to provide support and correct foot alignment
- Medication – analgesics and anti-inflammatories
- Weight loss
- Physiotherapy – Involves a comprehensive examination to determine the cause of your pain and the
optimal treatment plan, both for short term relief and long term maintenance - Exercises which are specific for your condition
- Addressing any health issues identified such as diabetes and gout
If you are experiencing pain in the ball of your foot, contact one of our friendly staff at Whittlesea Physiotherapy to make an appointment on 03 9716 2250.