The causes of foot pain are often hidden or complex. Although the headline—My feet hurt!—is the same, the culprit could be one or more of a host of issues, from injury to illness to shoes to structural defects, and more. Pain in the ball of your foot, more formally known as metatarsalgia since it usually involves inflammation or damage to the metatarsal bones or surrounding tissues, is no exception.

A Closer Look at Ball of Foot Pain

Although not an exhaustive list by any means, some of the most common causes of ball of foot pain we see at our office are listed below. Sometimes the problem is a specific medical condition or injury, while in other cases one of a number of explanatory factors could be contributing to general swelling and pain in the area. A full evaluation of your symptoms and lifestyle will help us root out a main cause, as well as develop a treatment plan.

Troublesome Foot Structures

Certain foot shapes can predispose a person to be more susceptible to developing metatarsalgia. For example, high arches place a lot of extra stress right at the front of the foot when you step, while an unusually long second toe (particularly one longer than the big toe) might cause you to shift more weight than normal to the base of said toe. Existing foot problems like hammertoes or bunions also can lead to pain in the ball of your foot, too.


Shoes are important! If you have a habit of wearing shoes that fit poorly, cramp your toes inside a too-narrow space, or hoist your heel high to the sky, you significantly increase your risk of developing metatarsalgia. This isn’t limited to high heels, either—athletic shoes that don’t provide enough support or aren’t for the right sport can cause the same problems.

Frequent Force

Your feet are designed to handle and support a lot of weight, but they’re not invincible. Two common ways that people overload their “carrying capacity” are by carrying a few too many extra pounds, or by intense, high-impact physical activity. In the former case, it’s simply that heavier people put more force on their metatarsals in all situations as a consequence of their weight. In the latter, running or jumping can exert forces many times greater than one’s body weight on the ball of the foot with each impact.

Stress Fractures

Runners and athletes, especially ones who train too hard too fast, may often wind up with stress fractures, or small cracks in bone that form in response to overuse—it’s a particularly bad form of the “intense training” scenario described above. The metatarsals are a frequent hotspot for stress fracture formation, leading to potentially significant walking pain that may alter your gait.

Morton’s Neuroma

Repeated stresses—either from overuse, structural deformities, wearing poor shoes, or other factors—can lead to a growth of fibrous tissue surrounding one of the nerves in the ball of the foot, usually between the third and fourth toes. That mass of tissue can press painfully against the nerve when you step, and may feel like you’re constantly caught walking on a pebble or bunched-up sock.

Managing Metatarsal Pain

While ball of foot pain can in cases be quite painful and significantly reduce your quality of life, the good news is that most cases can be managed or treated without need for surgery or other invasive procedures. Depending on the root cause, your best bet may be switching to better shoes, losing a little weight, making sure you get adequate rest between training sessions, finding a good pair of arch supports or custom orthotics, or some combination of these and other factors.

The best decision you can make is to call the experts at Carolina Podiatry Group. A good podiatrist to carefully evaluate your symptoms and situation and help you find the best way to address your pain and get you moving and walking without discomfort again. We are dedicated to giving our patients freedom from foot pain, and the earlier you seek help, the more likely any treatment course will be swift, conservative, and successful.

To schedule an appointment at one of our three offices, give us a call at 888-569-9559. You can also request an appointment online using our contact form.

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