What Causes Pain on the Ball of the Foot?

Posted by Dr. Jeffrey L. Adler

Mar 30, 2013 4:17:00 PM

Foot Anatomy Lesson Part 1: Causes of pain on the ball of the foot

pain on ball of footHi again everyone! It’s Dr. Jeffrey Adler Podiatrist, Double Board Certified Ambulatory Foot Surgeon. The topic for discussion today is pain on the ball of the foot. People have come to see me for over three decades not sure what is happening on the ball of their foot and why it hurts them so much. This is a two part series where I will explain what is causing pain on the ball of the foot and what you can do about it. First, I want to give you a crash course in foot anatomy.

What is the ball of the foot?

The ball of your foot is the area on the bottom of your foot stretching from the base of the big toe and first metatarsal head to the pinky toe and fifth metatarsal head. The skin underneath the metatarsal heads, known as the ball of your foot, should be thicker than the skin on the rest of the foot (except for the skin underneath the heel bone). One of the reasons it is thicker is due to the fat-pad that is placed beneath the bones of the feet. This fat-pad helps cushion the front of the feet as you walk, but it tends to diminish and eventually disappear the older you get.

A baby has a fat, chubby bottom of the foot due to a very large fat-pad that Mother Nature allows us to start life with. Meanwhile, the elderly have bony feet due to the gradual loss of this pad of fat that causes pain on the ball of the foot. This can be due to loss of arterial blood circulation, as well as the ravages time produces on our feet.

Do you know what a metatarsal is?

The metatarsals are the longest bones of your foot. There are five of them extending from the base of the toes to the middle of the foot. The metatarsals (along with the heel bone) support most of the body’s weight when standing and walking so a change in these bones can cause tremendous problems in the feet. This is especially true, when coupled with loss of the fat pad below the metatarsal heads. This dropped metatarsal produces pain on the ball of the foot due to excess pressures on the skin and nerves beneath these dropped bones.

Bones grow in response to stress. This means if there are forces in the feet pushing the tips of the metatarsal bones down toward the ground, then, the metatarsal bones themselves start to grow towards the ground. This process of a dropped or plantar-flexed metatarsal heads eventually traps the skin and soft tissue between the bone and the ground as weight is put on the foot.

Okay, pop quiz! Just kidding. We’ll let all that sink in. To see how your body reacts to the dropped metatarsal and learn about treatment for pain in the ball of the foot, check back next week or sign up to receive our blog and have Part 2 delivered straight to your inbox.


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Further Causes of Pain in the Ball of the Foot: Part 2


Topics: foot problems, foot pain