From the Research
Pain in the ball of the foot is most commonly caused by Morton's neuroma, metatarsalgia, and other conditions such as excessive pressure, improper footwear, and foot deformities. The most frequent causes of pain in the ball of the foot include:
- Excessive pressure on the metatarsal heads from high-impact activities
- Improper footwear, especially high heels
- Foot deformities like bunions or hammertoes
- Being overweight
- Morton's neuroma, which is a thickening of tissue around nerves, as described in 1 and 2
- Stress fractures
- Arthritis
- Sesamoiditis, which is an inflammation of small bones under the big toe
Causes and Treatment
The pain occurs because the metatarsal bones, which connect the toes to the midfoot, bear significant weight during standing and walking. When excessive pressure or inflammation develops in this area, the surrounding nerves and tissues become irritated, resulting in pain, burning, or numbness. Treatment typically involves rest, ice application, over-the-counter pain medications, and wearing proper supportive footwear with cushioned insoles or metatarsal pads. According to 2, infiltrative treatments such as corticosteroid injections and capsaicin have been shown to be effective in reducing pain related to Morton's neuroma. If pain persists beyond 1-2 weeks despite these measures, medical evaluation is recommended as more specific treatments may be needed, as suggested in 3.
Key Considerations
It is essential to note that the treatment of Morton's neuroma can be surgical, conservative, and infiltrative, with different substances used in the injections for MN, as discussed in 2. The evaluation of evidence on outcomes with different types of conservative, infiltrative, and surgical treatment in patients affected by primary MN is crucial, as highlighted in 4. Moreover, the use of more objective outcome parameters, such as foot and ankle outcome scores or foot and ankle ability measures, is recommended for future research, as suggested in 3.
Recommendations
Based on the most recent and highest quality study, 2, the recommended treatment for pain in the ball of the foot includes infiltrative treatments such as corticosteroid injections and capsaicin, as well as rest, ice application, and proper supportive footwear. It is essential to prioritize the single most recent and highest quality study, 2, when making a definitive recommendation, as it provides the most up-to-date and reliable evidence on the treatment of Morton's neuroma and metatarsalgia.