Ball of Foot Pain Egg Harbor Township New Jersey

A very common problem that brings patients to the podiatrists is “the ball of my foot hurts”. This symptom can have many different etiologies. I will take the next couple of blogs to discuss what can cause this type of pain and how it can be treated.

What causes ball of foot pain?

Metatarsalgia, which is defined as pain in the metatarsal region, is known as ball of foot pain. Metatarsalgia is a vague term and therefore it is important for your physician to weed through the symptoms you have in order to diagnose the problem. Many different things can cause metatarsalgia such as a neuroma, stress fracture, tendonitis, capsulitis, fat pad atrophy, gout, rheumatoid arthritis etc. I will discuss each of these disease processes and how to treat them.

What is a neuroma and how can it be treated?

A Morton’s neuroma, which is an enlarged nerve between the third and fourth metatarsals, is a common cause of metatarsalgia. There is a nerve that is “entrapped” and enlarged which sits between the metatarsal. Therefore, shoes and activity can cause compression of the nerve and therefore can cause symptoms. Symptoms typically include sharp, shooting pain, numbness, tingling and burning. The most accurate way to diagnose a neuroma is with an ultrasound. Once it is properly diagnosed usually treatment is via conservative methods. Treatment is aimed at shrinking the size of the overgrown nerve; this includes orthotics and corticosteroid injections. A newer treatment method is a sclerosing alcohol injection; the function of this is to shrink the enlarged nerve. Wearing a wider toe box can also help to relief symptoms.  If conservative treatment fails then surgical removal of the neuroma may be indicated.

What about a stress fracture?

A stress fracture is an incomplete fracture of the bones. Unlike an acute traumatic fracture, this type of fracture may take a few weeks to develop. It is usually caused by over activity and increased stress to the bone. In the foot region the most common bone to have a stress fracture is the 2^nd metatarsal. Many athletes who suddenly increase their activity complain of pain in the ball of the foot. As a podiatrist I am on high alert for a stress fracture in these types of patients. Within the first 10-14 days a stress fracture will not appear on x-ray, and therefore, high clinical suspicion is needed for accurate diagnosis. Applying a tuning fork to the area of concern will cause pain, if there is a stress fracture. Placing a patient in a non-weight bearing immobilizing cast is imperative for healing. Most stress fractures are treated conservatively and do not need surgical correction.

Next week I will discuss other causes of metatarsalgia.

For more information, please visit www.footnj.com