Forefoot pain often originates from the long metatarsal bones in the foot down and down towards the toes as welll as pain under the ball of the foot. The more common gradual onset injuries include metatarsal stress fracures, bunions and mortons neuroma. Sudden onset or acute injuries result from direct trauma or impact and inlcude fractures and ligament sprains.
A metatarsal fracture is a break to one of the five long metatarsal bones in the foot and is usually caused by a direct impact or trauma.
A metatarsal stress fracture is a fine fracture in one of the long metatarsal bones in the foot. A stress fracture can occur through overuse or poor foot biomechanics.
Morton's neuroma or Morton' s syndrome is a condition resulting in pain between the third and forth toes cause by compression of a nerve.
Metatarsalgia can be a bit of an umbrella term used to cover any forefoot pain, particularly metatarsal pain. Usually the term refers to inflammation which occurs in the joints between the metatarsal bones in the foot and phalanges bones of the toes.
Gout is a form of arthritis caused by a build up of uric acid within the body which is a waste product of metabolism.
A bunion is a painful swelling of the soft tissue with bone enlargement over the inside of the big toe. Often the big toe will look as if it is bent in towards the other toes or even can lie across them.
Turf toe can occur after a very vigorous upward bending of the big toe causing a sprain to the ligaments under base of the big or great toe.
Sesamoiditis is an inflammatory condition affecting the sesamoid bones of the 1st metatarsophalangeal joint causing pain in the forefoot, particularly on weight bearing.
When should I see a doctor?
When should you see a doctor with your foot pain? Often people do not want to bother their GP or A & E department but if you have any of the following symptoms you should seek further medical assistance.
- Severe pain, especially on walking
- Severe swelling (oedema)
- Altered sensation in the foot – such as a feeling of “pins and needles” (paresthesia) or a “loss of feeling” (anaesthesia) in the foot.
- Unable to complete normal daily activities after the initial 72 hours.
Further medical assistance can be sought through either your local GP or a private clinician such as a podiatrist, physiotherapist, sports therapist, osteopath or chiropractor. If you have followed the P.R.I.C.E. principles (see below) and are still unable to walk after 72 hours or still have severe pain that is not subsiding after the first 72 hours you should visit your local A&E department for further assessment.
Secondly, if you have applied for P.R.I.C.E. principles and still have weakness that lasts a long time (more than 2 weeks) or have ongoing discomfort in your foot or heel, you are highly recommended to seek advice from a specialist expert - such as a podiatrist or physiotherapist, osteopath, or chiropractor - who can provide you with advice and an appropriate and effective recovery and rehabilitation program.