Pain around the ball of your foot? Does it feel like you’re walking on a pebble? Do your toes feel numb? If you’ve answered ‘YES’ to any of these questions, then it’s time to see a Podiatrist.
Pain around the front part of your foot (the forefoot) is a very common problem that people seek help from a Podiatrist for. Let’s talk about it.
What Causes Forefoot Pain?
There are several causes of forefoot pain. The most common we see is called Morton’s Neuroma.
Morton’s Neuroma is an irritation of the digital nerves that travel between your long metatarsal bones. This causes pain, numbness, and tingling in the balls of the feet that can radiate into the toes. It is most common between the 2/3 and 3/4 metatarsal bones, affecting the 2/3/4 toes.
There is also a fluid-filled sac called a bursa that sits between the metatarsal bones. This bursa may also become irritated and inflamed, adding to the symptoms of Morton’s Neuroma. This is often referred to as intermetatarsal bursitis.
Why Does Forefoot Pain Occur?
Morton’s Neuroma is most likely to present around ages 40-50 and is more common in females than males. There are many reasons why you may develop a Morton’s Neuroma, including:
- Tightly fitting and/or high-heeled footwear
- Participating in high-impact activities without appropriate footwear
- Thinning of the protective fatty padding under your feet
- Morphology of the feet- ie. differences in the lengths of the metatarsal bones
- Biomechanical factors such as tight calf muscles, toe deformities, and foot structure
How is Forefoot Pain Diagnosed?
Morton’s Neuroma can often be diagnosed by clinical presentation. Clinical presentations vary, but will often include one or several of the following symptoms:
- Pain on weightbearing in the ball of the foot
- Shooting pain that radiates into the toes
- Feeling like walking on a pebble
- Burning, numbness, and tingling
Your Podiatrist will perform a clinical examination and may find the following signs that indicate Morton’s Neuroma:
- Pain when the bottom of the foot is palpated
- Pain when the foot is compressed and the bottom of the foot is pressed
- Skin changes (including callus) may be present
- Swelling may be present. There is rarely redness or loss of movement
Your Podiatrist will also observe your footwear and how you’re walking to determine what could be causing your forefoot pain.
Imaging may also be used to diagnose a Morton’s Neuroma. Ultrasound is accurate for diagnosing Morton’s Neuroma. X-ray will not show a Morton’s Neuroma but may be used to rule out other bony conditions.
How Can I Improve My Forefoot Pain? 
The first step to improving your forefoot pain is to book an appointment with a Podiatrist! Your Podiatrist will conduct a biomechanical assessment including watching you walk and performing a set of functional exercises. From there, they will develop a management plan with you and guide you through your treatment options. Treatment for forefoot pain may include:
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Activity Modification
- Your Podiatrist may recommend that you decrease or change any activities you are doing that may be flaring the pain. This is usually for a short period until the pain has settled. They will then work with you to reintroduce that activity in a safe way.
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Footwear Changes
- Your Podiatrist may recommend changing your footwear depending on your foot posture, what you are currently wearing, and the activities you are doing.
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Offloading
- Your Podiatrist may recommend padding, insoles, or orthotics to help offload the area that is sore. This will allow the damaged part of your foot to heal while allowing you to walk with less pain.
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Shockwave Therapy
- Shockwave therapy is a soft tissue treatment that can increase blood flow to the problem area, encouraging healing and strengthening of the damaged tissues.
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Strengthening and Stretching Exercises
- Your Podiatrist will likely give you a series of strengthening and stretching exercises to help reduce the forces that are leading to your forefoot pain and to strengthen the tissues that have been damaged.
Forefoot pain is a condition that is well-managed with conservative treatments and rarely involves surgical intervention.
Book a Podiatry Appointment
If you’re ready to take the first step in treating your forefoot pain, book an appointment online or call us (02) 6771 9142. We’d love to help you walk away from foot pain!