Ball of foot pain can be caused by a variety of conditions, the most common of which is metatarsalgia. This is a condition which makes the heads of the metatarsal bones become inflamed due to too much pressure. Other common causes include capsulitis, which is an inflammation of the ligament on the bottom of the foot. Morton’s neuroma is a nerve irritation which occurs between the third and fourth metatarsal space. It can cause sharp pain, burning, and numbness. A fracture of the metatarsal bones or toes is another common cause of ball of foot pain, occurring after an acute injury or from stress fractures. A bunion may also cause pain in this area as it progresses and worsens.
What is ball of foot pain? Because we are constantly using them, this makes us susceptible to foot pain. One common ailment that affects the feet is ball of foot pain. This occurs in the area between the arch of the foot and the toes. It can present as sharp, aching, or burning pain. It can limit your ability to move, make it difficult to stand, and create problems in finding comfortable footwear.
Our feet are what we use to get from point A to point B. They support our body, take the brunt of bearing the weight, and are an essential mode of transportation. Because we are constantly using them, this makes us susceptible to foot pain. One common ailment that affects the feet is ball of foot pain. This occurs in the area between the arch of the foot and the toes. It can present as sharp, aching, or burning pain. It can limit your ability to move, make it difficult to stand, and create problems in finding comfortable footwear.
What is Ball of Foot Pain?
Morton’s neuroma is a condition that causes an irritating mass to form on one of the nerves that lead to the toes. The pain is felt in the ball of the foot or at the base of the toes. In some cases, the sufferer will have the feeling of a small stone in the shoe. This condition can also cause sharp shooting pains to radiate into the toes.
Metatarsalgia is a general term used to denote a painful foot condition in the metatarsal region of the foot (the ball of the foot). This is a common problem that can affect the joints and bones of the metatarsal region. The pain can affect the area around the joints at the base of the toes, the joints in the middle of the foot and at the base of the big toe. Pain is usually increased with activities that put weight on the foot such as walking or running. Other symptoms that may occur are tingling or numbness in the toes.
Capsulitis is a condition that occurs when the ligaments of the foot become inflamed. It is a condition that occurs secondary to other conditions such as bunions or bone dislocation. There is pain in the sole of the foot and sometimes an associated swelling. It can be difficult to distinguish capsulitis of the foot from a stress fracture of the metatarsal so an X-ray might be required.
Ball of foot pain is pain that occurs in the ball of the foot. It is positioned on the sole of the foot and is usually localized to the area just behind the toes. Ball of foot pain is a common problem, affecting people from all walks of life. Pain in the ball of the foot can be a result of a wide range of conditions. The most common conditions that cause pain in the ball of the foot are capsulitis, metatarsalgia, and Morton’s neuroma.
Common Causes of Ball of Foot Pain
Pain Metatarsalgia can have several potential causes including overuse and repetitive stress, especially if there is poor foot mechanics. Sometimes a single traumatic event such as a foot injury or stress fracture can trigger metatarsalgia. Other factors that can cause this condition include callus formation under the metatarsal heads (often because of a gait pattern with high pressure in specific areas of the ball of the foot), being overweight, certain styles of footwear, foot deformities or diseases and conditions such as arthritis and diabetes. High arched or cavus foot types can increase the pressure on the metatarsals and cause metatarsalgia with or without callus formation.
Excessive, continuous pressure on the area behind the toes (the ball of the foot) can cause discomfort, pain, and injury. Probably the most common cause of discomfort in the ball of the foot, metatarsalgia is a condition characterized by pain and inflammation under the heads of the metatarsal bones. The pain is often a burning discomfort and is located under the 2nd, 3rd, and 4th toes or isolated around the big toe. People with metatarsalgia may experience shooting pain, tingling, or numbness in the toes. Often there is no outward sign of this condition, such as swelling or a bony protuberance, although long-term metatarsalgia can cause callus or a single hard skin build-up (which is not the same as a plantar callus).
The Importance of Seeking Treatment
Pain in the ball of the foot usually occurs as a result of overuse, often because of physical activities. It’s quite common for people to ignore the pain and attribute it to the idea that “feet are meant to hurt.” However, pain is a protective response by the body and is an indication that something is wrong. Ignoring the pain could make the problem worse and turn a simple ailment into a complex issue. This is why it’s important to seek medical treatment. If the problem is mild, it can usually be treated with simple care measures. Ignoring the problem will often make it worse and treatment more involved. However, if the problem is more significant to begin with, getting early diagnosis and treatment can be quite important. Many problems can be managed with simple measures but have the potential to progress into something more serious if they are ignored. This is especially true if the pain is limiting activity. If foot pain prevents someone from staying active, it is likely that other health issues will ensue. Seeking a diagnosis from a healthcare professional is important to maintain overall health.
Ball of Foot Pain Treatment Options
Rest and Ice
Rest and ice are often used in treating common sports-related injuries and are the first step in ball of foot pain treatment options. Rest is important to protect the affected area from further damage and allows the injury to heal. When resting, try to keep off your feet or at least try not to walk too much, as walking can cause added stress to the forefoot. Icing is an effective pain reliever and reduces inflammation. Icing a chronic injury for 10-15 minutes after an activity can decrease the development of inflammation. For more acute pain, ice the affected area every 1-2 hours to further reduce the inflammation. Icing is best done with an ice pack; however, a frozen package of vegetables will also suffice. Make sure to wrap whatever you are using as an ice pack with a cloth or paper towel to prevent frostbite on your skin.
Stretching and Strengthening Exercises
Stretching and strengthening exercises are the most effective ways to reduce the pain of metatarsalgia and prevent the condition from occurring. When a particular activity started the pain, it is worthwhile identifying whether there was simply too much too soon. Maybe the activity at the time was not supplemented with enough appropriate strengthening exercise. For example, cycling and stepping are now very popular as gyms have introduced special classes. Both produce considerably more force under the forefoot than traditional cycling or exercising. Step machines are notorious for causing metatarsalgia. Cycling should be encouraged as there is less force under the foot during this activity. The cyclist can still maintain fitness on the road, using a static trainer set up indoors. However, certain adjustments need to be made to reduce the forefoot force. This would involve dropping the saddle height slightly and moving the saddle forward on the seat rail. Static machines allow the saddle to be set at a very low position which requires the forefoot to press harder on the pedal. Often, metatarsalgia pain can reduce significantly if weight-bearing activity is substituted with cycling in patients with appropriate bike set up. Static cyclists can add in more specific training on the bike by undertaking intervals of high cadence. This would be done more effectively if they have a road bike with a wind trainer. The same principles apply for professional cyclists.
Footwear Modifications
Orthoses can be another helpful intervention. Prefabricated or custom orthoses that include a metatarsal pad can lift and separate the metatarsal bones from each other, thus reducing the pressure and pain in the forefoot. Modifications to the orthoses such as a cut-out area or a pad just proximal to the painful area can also help offload the painful structures. Those with significant structural abnormalities or biomechanical faults may require a custom orthosis to correct their specific problems.
Appropriate shoes can help alleviate forefoot pain. Several types of shoes are available. Most people do best with a shoe with a rocker sole. This type of sole reduces the load on the ball of the foot. Wider and deeper shoes allow more room for the toes, thus reducing cramping and pressure. Stiffer or softer soles may be helpful. In general, those with pain from rheumatoid arthritis do better with a softer sole, while those with metatarsalgia often do better with a somewhat stiffer sole. A visit to a podiatrist or orthotist can be helpful in determining what shoe and what type of shoe insert (discussed below) would be most appropriate.
Pain Medications and Topical Treatments
In the instance of a mechanical problem, your foot and ankle surgeon will examine the way you walk and move your foot. This examination may disclose a high amount of pressure under the ball of the foot. Special attention will be placed on the way you transfer weight when standing and during push-off while walking. X-rays are at times taken to examine the bones of the foot. In most cases, problems can be treated using orthotic devices and shoe recommendations. An orthotic device is a shoe insert which is made from a mold of your foot. The goal of the orthotic is to transfer weight away from the problem area to remove pain and prevent further damage. Using an orthotic is commonly successful in avoiding and remitting callous build-up under the ball of the foot. When the area is not painful, padding placed in the shoe may decrease pressure and act as a preventative measure.
The occasional use of over-the-counter nonsteroidal anti-inflammatory medications such as ibuprofen or prescription anti-inflammatories may provide added relief for ball of foot pain. At times, topical anesthetics may be applied to decrease pain. Your foot and ankle surgeon will recommend the best treatment for you.
Managing Burning Pain in the Ankle
Understanding ankle pain and its causes The ankle joint is formed by the interaction of the upper ankle joint and the heel. The primary function of the ankle is an up and down motion. It is this motion that takes the brunt of body weight during activity. There are a number of causes of ankle pain, which include sprains, which is an injury to the ligaments in the joint and causes difficulty in motion of the joint and results in swelling and pain. Another cause of ankle pain is a medial or lateral fracture, in which the bone will be either broken on the inside or outside of the ankle joint. This will cause the inability to bear body weight and a chance of the joint becoming deformed. Usually, with a fracture, there is lots of bruising, pain, and swelling to the joint. A stress fracture is a small break in the bone usually caused from overuse of the joint. This may cause pain and swelling similar to a sprained ankle, and the only way to be diagnosed is from an x-ray. Tendonitis is an overuse of the ankle joint that causes the tendons to become inflamed and painful. This is caused by excessive walking or running on a hard surface, wearing high-heeled shoes, and this is usually found in people who have flat feet or a high-arched foot. The most common cause of pain in the ankle joint is a deformity in the joint causing arthritis. Arthritis is an inflammation of the joint that causes pain and swelling. It is usually seen in people over 50 and most commonly in women. Treatment options for burning ankle pain The initial treatment for acute ankle pain would include the R.I.C.E rule, which stands for rest, ice, compression, and elevation. Rest is most commonly understood that the patient must limit any physical activity on the injured ankle joint. Ice is used to limit the swelling and should be applied to the ankle for 20-minute intervals. Compression is used with a bandage to limit the pain and swelling of the joint, and elevation is used to limit swelling. All these treatments of acute ankle pain should make sure the swelling and pain of the ankle joint is reduced. After these treatments, the patient may begin to do pain-free exercises to increase strength and be able to perform everyday activities with ease. An ankle brace may be needed to decrease movement of the joint during recovery from the acute ankle pain. With chronic ankle pain, the treatment is usually non-surgical with the use of anti-inflammatory drugs and exercise therapy to increase strength and flexibility of the joint. An injection of corticosteroids may be used in severe cases of chronic pain, and in some cases, the injection of a local anesthetic to cut off a group of nerves is used to stop the feeling of pain in the joint. Any bearable procedure to treat burning pain in ankle. The degree of pain is increased now, and with the continuous catabolic process, the articular cartilage will undergo more damage and the subchondral bonelets to undergo continued microfracture and osteophyte formation. The damage may reach a point where the pain is too great, and an artificial joint replacement is needed for the treatment of arthritic ankle pain.
Understanding Ankle Pain and Its Causes
Ankle pain has many causes. At the mechanical level, it may be due to damage to soft tissue (ligaments and muscles) resulting from a sprain or strain. At the tissue level, it may be due to damage to the cartilage that lines the joints, following an injury or as a result of a chronic degenerative process such as osteoarthritis. Damage to the joints themselves can cause pain due to inflammation, and in the short term, this is useful for diagnosing joint problems as the only cause of joint pain that can be seen on X-ray is inflammation. Nerve pain can be felt at any level from the back of the spine to the brain. Ankle pain localized to the area may be due to malfunction of the nerves that innervate the ankle joint, or it may be referred pain from the lower back and rarely from the brain. Inflammatory joint disease can involve any of the joint tissues and cause pain in a number of ways. Finally, pain in the ankle originating from a systemic process such as gout or rheumatoid arthritis may be due to crystals or immune complexes forming within the joint.
Treatment Options for Burning Ankle Pain
Diagnosis and Physical Therapy – For more severe and chronic ankle pain, it might be time to consult a medical professional to get a proper diagnosis for the underlying conditions and talk about options for physical therapy. With a physical therapy routine, there are specific stretching and strengthening exercises for the ankle that physical therapists can provide. This will not only help with rehabilitating sprains, but it can improve balance and prevent future ankle injuries. A therapist can offer treatment options based on your specific condition and will guide you to recovery.
Medications – Taking anti-inflammatory painkillers can decrease pain and reduce swelling. Next, after icing, the best way to relieve immediate pain is by taking ibuprofen. Whether you take over-the-counter medication or prescribed, make sure to consult a doctor so they can guide you to the best medicine to fit your conditions.
Rest – If you have a mild sprain, the best thing to do is rest your ankle. Icing the affected area will not only help reduce swelling, but by icing for periods of 10-15 minutes with at least a full hour in between icings, it will also help numb the area, decreasing the pain. Icing will help the most for the first 48 hours following the injury. If your ankle has some swelling or tends to swell after running or standing, ankle brace supports for a week during activities is a cheap means of support. Try not to continue activities that irritate the ankle and foot until the condition improves. Resuming activities that involve ankle pain with no treatment can actually cause more harm and prolong your recovery.
Ankle pain affects most everyone at some point in our lives, and can be as mild as a nagging pain to being so bad that it affects your ability to walk. If you suffer from chronic ankle pain, keep reading to learn the treatment options that are available and find the relief you deserve.
Rehabilitation and Physical Therapy for Ankle Pain
Physical therapy and exercise are an important aspect of rehabilitation of ankle pain. People with chronic pain or instability often need the supervised expertise of a physical therapist. In some cases, people are given exercises to do on their own, and the progress is followed by periodic appointments. Exercises of the lower leg muscles may be the most important focus of an exercise program. This not only strengthens the muscles which support the ankle, but it also increases flexibility. Increased flexibility can help to prevent reinjury. Range of motion exercises for the ankle are also important to maintain or regain function. The therapist and in some cases the athletic trainer will decide what specific exercises are appropriate for each person. This will depend upon the type of injury, the person’s level of activity, and the present state of the ankle. A therapist may also use other technology to help ease pain of chronic ankle pain. Transcutaneous electrical nerve stimulation, ultrasound, bracing, and in rare cases, steroid injections may also be used as methods to reduce pain in addition to other treatments. A functional progression is then used to advance the patient to the next level. This means that the patient will gradually be allowed to return to higher levels of activity provided there is no increase in pain or swelling and there is functional improvement. This will allow the person to safely return to activity without the possibility of reinjury. A therapist may also use other technology to help ease pain of chronic ankle pain. Transcutaneous electrical nerve stimulation, ultrasound, bracing, and in rare cases, steroid injections may also be used as methods to reduce pain in addition to other treatments.
Ball of Foot Pain and Ankle Pain in Singapore
This high prevalence of foot pain in Singapore means a large proportion of the population is seeking medical care for their foot and ankle pain. Accessing specialized foot and ankle care in Singapore is relatively easy and is comparable to care in the West. With a large number of people being increasingly active in sports, there has been a rise in the number of sports-related foot and ankle injuries. These patients can easily access care through the sports medicine physicians, most of whom are trained in Western countries. There are also well-trained physiotherapists who work closely with podiatrists and orthopedic surgeons in providing care for musculoskeletal pain. With regards to the rheumatoid patients who have foot pain, there is a good service provided by the specialist nurses who work in the polyclinics under the care of the rheumatologists. This ensures that patients can be easily referred to the hospital when in need of care from the relevant healthcare professionals. At the hospital level, patients have access to podiatrists who work in the polyclinics and the National University Hospital and Singhealth have specialist foot and ankle units. Finally, for those seeking private care, there are a number of Western-trained podiatrists, physiotherapists, and orthopedic surgeons who are able to provide care to the foot pain patient.
Ball of foot and ankle pain in Singapore is a common ailment. A study on the prevalence of chronic pain in the Asian population reported by Tai et al. showed that 37% of the adult Singapore population suffered from chronic pain, while another local study by Maniam et al. on the prevalence of pain in the Singapore population showed that 75% of those suffering from chronic pain had recurring foot pain. In a community survey on rheumatoid arthritis and pain in Asian countries, the proportion of patients with foot pain was 56%. This is high when compared to the proportions in Sweden and UK, which were 40% and 29% respectively. Another study of 1074 adults with a mean age of 63 years, from 9 primary care clinics being seen for a variety of foot and ankle complaints, were recruited to participate in a cross-sectional survey designed to characterize older persons with foot and ankle complaints in primary care reveals that foot pain is a common source of morbidity that affects mobility and quality of life among adults in Singapore.
Prevalence of Foot and Ankle Pain in Singapore
According to a population survey conducted in 2014 involving 4,000 respondents, it was found that foot pain is prevalent in about 21% of adults over the age of 20 in Singapore. Foot pain was found to be more common in females than males, and the prevalence of pain increased with age. Among those who reported having pain, chronic pain lasting more than 3 months was found in 60% of the respondents. With reference to location of pain, the most common site reported was at the forefoot. More recent studies in 2016 have also shown similar results about the prevalence of foot pain and its association with increased age. Ankle pain prevalence in Singapore however, is less documented. Ankle pain can be associated with foot pain and studies involving both foot and ankle pain have reported that from the 4,000 respondents, 17.9% had foot pain only, 3.5% had ankle pain only, and 6.3% had both foot and ankle pain. High ankle sprains are also a common injury in Singapore due to the uneven ground surfaces, commonly occurring in the elderly and those who are more physically active. These statistics indicate that foot and ankle pain is a common issue in Singapore, and may become more of a prevalent issue with the increasing population of elderly in recent years. This is an important finding as foot pain can affect one’s quality of life and mobility, and is associated with many systemic medical conditions.
Accessing Specialized Foot and Ankle Care in Singapore
Then, find a skilled podiatrist who can provide an in-depth assessment to discover the reason for your soreness and set up a treatment plan. Ask your family doctor for a referral to a podiatrist who is well skilled and experienced in treating this kind of problem. If your insurance requires a referral, have your doctor refer you to a podiatrist. Come to your podiatry appointment with the necessary information you need to get the most out of your visit. Writing out a list of questions will help you schedule follow-up visits if necessary. Foot and ankle healthcare is fast becoming an increasing part of the healthcare community. After all, your feet have to last a lifetime. Changes in healthcare insurance have prompted society to become more informed of options available to them. Patients who are seeking treatment from a specialist should ensure they are seeing someone who is licensed in their specific area of concern. This holds true for those who are seeking a Singapore foot and ankle doctor. With the advancement of new and improved orthopedic implants, technology, and techniques, it is essential to ensure you are seeing a qualified physician who is skilled at specifically treating your condition.
Promoting Foot Health in Singapore
The sheer volume of literature indicates a high prevalence of foot and ankle pain in many countries. A study conducted in 1998 suggested that 20.7% of those over 65 years were suffering from disabling foot pain. Another study of the general population reported that in the UK, 15% of those over 45 years had pain in the last month. A slightly lower figure of 13% was documented in a robust study of over 5000 men and women from the United States of America. However, in sharp contrast is a recent Swedish study documenting just 1% prevalence of foot pain in 18 year olds. Unfortunately, no such data exists for the general population in Singapore. In a study of 50 individuals aged 16-40, 12% complained of foot pain in the last week. Unfortunately, more specific epidemiological data evaluating foot and ankle pain is not available in Singapore, and is essential in order to understand the extent of the problem. Promising news is that the provision of specialized healthcare for musculoskeletal conditions in Singapore has expanded over the last decade. The existence of several orthopaedic departments, a podiatry clinic in a tertiary hospital, and a chiropractic wing in a sports medicine facility attests to this. However, a study of allied health professionals including podiatrists, conducted in 2007, cited musculoskeletal prevention and management as highly important in Singapore, with potential for improvement. Transmission of medical knowledge to primary healthcare practitioners and the general population is essential in order for appropriate foot healthcare strategies to be put into practice.
