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Ball of Foot Pain Treatments - Relief from Metatarsalgia

Treatments to Relieve Ball of Foot Pain

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Our feet play a crucial role in facilitating movement and supporting our entire body. With every step, an intricate system is at work to keep us mobile and balanced. Oftentimes, we don’t realise how crucial the foot is to our well-being. From working out, strolling to the supermarket, and preparing meals, our feet enable us to perform daily duties with ease.

When your forefoot is subjected to too much stress, the ball of the foot may become inflamed. The ball of the foot is located in the cushioned part of your sole between the toes and the arch. In Singapore, ball of foot pain treatment is accessible for people of all ages.

Introduction to Ball of Foot Pain

ball of foot pain treatment

(Image source: https://www.perthfootcentre.com.au/do-you-get-pain-under-the-ball-of-your-foot/)

The base of your foot is made up of long bones called metatarsalgia, which connect the toes to the ankles. Each foot contains five metatarsal bones — one for each of the toes, with the exception of the big toe (Dwyer, 2009). Ball of foot pain is commonly felt in the area under the metatarsal heads, which aid in balance and mobility. There are reasons why we should address ball of foot pain:

  1. Alleviating pain – The ball of the foot bears most of your body weight while you do tasks, which may result in pain, discomfort, and inflammation.
  2. Restoring mobility and function – This condition limits your mobility and quality of life, making it difficult to engage in physical activities.
  3. Prevention of future complications – Patients may develop severe complications such as knee & hip issues if they are not treated immediately. 

Identifying Causes of Ball of Foot Pain

High-impact pressure on the foot is common after a taking part in sports such as football, baseball, and tennis. The main causes are bone related problems of the forefoot, which can be divided into hallux (big toe) and lesser toes.

  • Hallux pain such as hallux valgus or hallux rigidus which refers to big toe and bunion pain.
  • Lesser toe pain such as transfer metatarsalgia or stress fractures.
  • Nerve related conditions such as Morton’s neuroma, which are inflamed nerves between the metatarsal bones.
  • Injurious sources to the ankle or foot and muscle-related issues like tight calf muscles.

The cause is almost always linked to imbalances in the foot alignment or muscles of the foot and lower leg. Hallux valgus is one of the most common causes for forefoot pain. It is a forefoot deformity caused by a combination of genetic susceptibility and the use of tight shoe wear and heels. Rarer causes of forefoot pain include problems with nerves and vessels of the foot (Cleveland Clinic, 2021).

Symptoms of Ball of Foot Pain

The causes include deformities of the foot, injuries to the ankle and foot region and muscle & nerve related ailments. The source of pain in the forefoot includes pain from the bone, pain from ligaments and tendons, and pain from nerve problems. Symptoms can be felt below your toes and it can appear as:

  • Burning and aching pain
  • Shooting, sharp pain
  • Numbness and tingling in the toes
  • Pain that progresses when you walk or perform other activities
  • Inflammation and swelling
  • Bruising on the foot

People may develop symptoms quickly or over a long period of time. This condition, if left untreated, can spread to other areas of the body. The hip and lower back will need to compensate for the foot pain and abnormal walking pattern (Gotter, 2023).

Exploring the Risk Factors of Ball of Foot Pain

Anyone can develop ball of foot pain. There are risk factors that make you susceptible to this condition, including intrinsic and extrinsic sources (Weatherford & Irwin):

  1. Ill-fitting footwear that lacks proper support, cushioning, and shock absorption.
  2. Genetic factors like inward or outward rolling of the foot that affect the foot shape.
  3. Overuse and stress by engaging in intense exercise and repetitive tasks.
  4. Injurious sources that may exacerbate by the affected area and alter biomechanics.
  5. Natural aging process where the fat pad that cushions your foot gets thinner over time.
  6. Certain illnesses such as osteoarthritis and gout which negatively affect mobility.

Seeking Medical Help for Ball of Foot Pain

(image source: https://www.fairfieldpodiatry.com.au/blog/2021/8/3/ball-of-the-foot-pain-from-running)

After a long day on your feet or a particularly strenuous workout, your feet may start to hurt. If your ball of foot pain persists, you should see a doctor (Gotter, 2023). Discomfort after 2 to 3 weeks of the initial injury or start of the pain is a cause for alarm. You should contact an orthopaedic surgeon if you experience:

  • Pain that prevents you from walking or doing daily activities
  • Pain that does not go away even after rest or lifestyle modifications
  • Change in foot shape and appearance of bruising
  • Sharp pain in the ball of your foot and worsening pain over time
  • A sense of tingling or numbness in your foot
  • Nausea or dizziness from the pain

Diagnosis and Treatments for Ball of Foot Pain

(image source:https://www.drscholls.com/ca/symptoms-and-conditions/foot-pain-and-conditions/

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Your orthopaedic surgeon will first conduct a medical interview and clinical examination (Cleveland Clinic, 2021). You may also have to undergo MRI scans and specialised x-rays of the foot & ankle. Afterward, your doctor will recommend a treatment plan which can comprise of:

  1. Non-surgical Treatments
    1. Minimally invasive treatments such as steroid injections provide relief from symptoms.
    1. Over-the-counter drugs like paracetamol and ibuprofen can provide temporary pain relief.
  2. Surgical Treatments
    1. This method is for patients who have experienced little to no results after trying non-surgical treatments. In severe cases, the patient should undergo orthopaedic surgery.
    1. Surgery may involve fixation of broken bones and repair tendons and ligaments.
  3. Alternative Therapies
    1. Physiotherapy is comprised of exercises to alleviate stiffness and strengthen tissues and muscles.
    1. Orthotics are custom devices inserted into the shoe that are used to relieve foot pain.
    1. Acupuncture and acupressure may also help in temporarily relieving pain.

Lifestyle Changes to Manage Ball of Foot Pain

(image source: https://www.freepik.com/free-photos-vectors/woman-stretching/3)

General foot health can be improved by making lifestyle changes, such as switching to proper footwear, watching one’s weight, and engaging in regular stretching and strengthening activities. Athletes should also ensure that they undergo proper training techniques. It is also important to rest, elevate your leg, and use ice packs for acute causes of forefoot pain (Gotter, 2023).

Final Words

Forefoot pain is usually a complex constellation of problems and imbalances in the foot. Focusing on one region of the foot may not be sufficient, and it is often necessary to correct imbalances elsewhere to achieve lasting relief. Oftentimes, we may forget to take care of our feet. If you experience foot pain, remember to take breaks, and contact your orthopaedic surgeon for ball of foot pain treatments if your symptoms do not subside.

Frequently Asked Questions

What is ball of foot pain?

Ball of foot pain refers to discomfort in the area beneath the metatarsal heads, which can result from overuse, injury, or conditions like metatarsalgia and hallux valgus. This pain can affect mobility and daily activities.

When should I seek medical help for ball of foot pain?

You should seek medical help if your pain persists for more than two to three weeks, worsens despite home treatments, or is accompanied by severe swelling or difficulty walking. An orthopaedic surgeon can provide a comprehensive evaluation.

Are there any over-the-counter drugs that provide temporary relief from this condition?

– Paracetamol and ibuprofen are common pain medications which can provide relief, but they are typically not effective for moderate to severe pain.
– See “Diagnosis and Treatments for Ball of Foot Pain” for a list of potential treatments.

What vitamins and supplements may be beneficial in treating ball of foot pain?

– Vitamins and supplements may not be beneficial for this condition. Your orthopaedic surgeon will advise you on the best treatment plan for your unique needs.
– See “Diagnosis and Treatments for Ball of Foot Pain” for a list of potential treatments.

How can athletes prevent themselves from experiencing this condition through proper training techniques?

– Athletes do high-intensity activities during training. They can engage in effective warm-up and cool down exercises and use taping and good shoe wear to prevent traumatic causes of forefoot pain.
– See “Lifestyle Changes to Manage Ball of Foot Pain”for more tips.

Is acupuncture or acupressure a viable treatment option for those suffering from ball of foot pain?

– Depending on the cause of forefoot pain, acupuncture may have a limited role especially if the cause is muscular in nature. Some patients may prefer to utilise this method, but its relief tends to be short-lived.

Are there any home remedies that may provide relief without resorting to medical intervention?

– Proper rest, elevation, icing can be effective for acute causes of forefoot pain if performed immediately after injury. If symptoms persist or worsen, you should book an appointment with your orthopaedic surgeon.

What are the potential side effects associated with taking certain over-the-counter medications to treat this ailment?

– Inadvertent overdosage of over-the-counter medications can happen if pain control is sub-optimal and patients overdose to try and control the pain. Some over-the-counter medications also cause abdominal pains, chest pains, nausea, and headaches.

Is it dangerous to wear high heels if you suffer from this ailment?

– High heels tend to exacerbate forefoot pain and may result in tight calf muscles which can worsen forefoot pain. You can use cushioned footwear to prevent any injury or strain from daily activities.

Should I use cushioned foot orthotics as part of my treatment regimen if I have this condition? 

– Depending on the condition, appropriate shoe modifications can offload areas of the forefoot that experience excessive stress. Your orthopaedic surgeon will recommend a customised treatment plan for you.

What recent research has been done on treatments for ball of foot pain, and what do doctors recommend as the best course of action?

– Forefoot pain may have different causes. The treatment plan for the most common cause of forefoot pain, hallux valgus (bunion pain), involves minimally invasive techniques for treatment of the condition. Forefoot pain is usually a complex area of problems and imbalances in the foot. Addressing only the region that is painful may not be sufficient, and it is often necessary to correct imbalances elsewhere to achieve lasting relief.

Are there any alternative therapies that may help reduce symptoms related to this condition?

– Main adjunctive treatment is in the use of physiotherapy to stretch and strengthen tissues and muscles. The use of appropriate foot orthotics such as custom shoe inserts can effectively support the feet and alleviate pain.

When should surgery be considered as a treatment option for extreme cases where other treatments have failed or are deemed ineffective?

– In general, the type and timing of surgery depends on the severity and clinical presentation of the condition in question. For the most common cause of forefoot pain, which is hallux valgus, surgery can be conducted at an earlier stage to prevent worsening of the condition. As the type of surgery depends on the severity, early intervention typically means that less invasive methods can be recommended for the patient.

Dr Yong Ren profile

Dr Yong Ren graduated from the National University of Singapore’s Medical faculty and embarked on his orthopaedic career soon after. Upon completion of his training locally, he served briefly as an orthopaedic trauma surgeon in Khoo Teck Puat hospital before embarking on sub-specialty training in Switzerland at the famed Inselspital in Bern.

He underwent sub-specialty training in pelvic and spinal surgery, and upon his return to Singapore served as head of the orthopaedic trauma team till 2019. He continues to serve as Visiting Consultant to Khoo Teck Puat Hospital.

Well versed in a variety of orthopaedic surgeries, he also served as a member of the country council for the local branch of the Arbeitsgemeinschaft für Osteosynthesefragen (Trauma) in Singapore. He was also involved in the training of many of the young doctors in Singapore and was appointed as an Assistant Professor by the Yong Loo Lin School of Medicine. Prior to his entry into the private sector, he also served as core faculty for orthopaedic resident training by the National Healthcare Group.

Dr Yong Ren brings to the table his years of experience as a teacher and trainer in orthopaedic surgery. With his expertise in minimally invasive fracture surgery, pelvic reconstructive surgery, hip and knee surgery as well as spinal surgery, he is uniquely equipped with the tools and expertise necessary to help you on your road to recovery.

References

Cleveland Clinic. (2021). Metatarsalgia. Retrieved from
https://my.clevelandclinic.org/health/diseases/15890-metatarsalgia

Dwyer, T. (2009). The Bone School. Retrieved from http://www.boneschool.com/

Gotter,A.(2023).Ball of Foot Pain. Retrieved from

https://www.healthline.com/health/ball-of-foot-pain

Weatherford, B. & Irwin, C. (2020). Footwear Guide. Retrieved

from https://orthoinfo.aaos.org/en/staying-healthy/footwear-guide/

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Sarah Taylor

Obstetrics & Gynaecology