What is Ball of Foot Pain?

Ball of foot pain, medically known as metatarsalgia, refers to pain and inflammation in the area just behind the toes—the part of the foot that bears significant weight when walking, running, or standing. It’s a common condition that can affect athletes, people who spend long hours on their feet, or anyone wearing ill‑fitting shoes. While not usually serious, it can interfere with daily activities if left untreated.

Causes

Ball of foot pain can result from a variety of factors, often overlapping:

• High‑impact activities such as running, jumping, or court sports

• Foot shape – high arches, a second toe longer than the big toe, or hammertoes can shift pressure to the forefoot

• Foot deformities such as bunions or calluses

• Improper footwear – high heels, narrow toe boxes, or worn‑out shoes

• Excess weight – added pressure on the forefoot

• Stress fractures in the metatarsal bones

• Medical conditions such as arthritis, gout, Morton’s neuroma, or sesamoiditis

Symptoms

Common symptoms of ball of foot pain include:

• Sharp, aching, or burning pain in the ball of the foot

• Pain that worsens with standing, walking, running, or flexing the toes

• A sensation of having a pebble in your shoe

• Tingling, numbness, or shooting pain into the toes

• Swelling, redness, or bruising in some cases

Diagnosis

Diagnosis typically involves:

• Physical exam – checking for tenderness, swelling, or deformities

• Gait evaluation – observing how weight is distributed when walking

• Imaging – X‑rays to rule out fractures; MRI or ultrasound if soft tissue or nerve involvement is suspected

• Medical history – reviewing footwear, activity level, and underlying conditions

Nonsurgical Treatment

Most cases improve with conservative care, such as:

• Rest and ice to reduce inflammation

• Proper footwear – supportive shoes with wide toe boxes and cushioning

• Orthotic inserts or metatarsal pads to redistribute pressure

• Stretching and strengthening exercises for the foot and calf

• Weight management to reduce stress on the forefoot

• Medications – over‑the‑counter anti‑inflammatory drugs for pain relief

• Callus care – trimming or padding thickened skin to reduce pressure points

When is Surgery Needed?

Surgery is rarely required but may be considered when:

• Pain persists despite months of nonsurgical treatment

• There are structural deformities (such as severe bunions or hammertoes) causing ongoing pressure

• Nerve entrapment (Morton’s neuroma) does not respond to conservative care

• Fractures or severe joint damage require correction

Surgical options may include realigning bones (osteotomy), removing nerve tissue in Morton’s neuroma, or correcting deformities to restore balance and relieve pressure.