Forefoot pain often originates from the long metatarsal bones in the foot, down towards the toes as well as pain under the ball of the foot. The more common gradual onset injuries include metatarsal stress fractures, bunions, and Morton's neuroma. Sudden onset or acute injuries result from direct trauma or impact and include 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. It could also be a stress fracture which comes on gradually from overuse. Seeking medical help is key to recovering from this foot injury to ensure the bones heal.
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. The second metatarsal is the most commonly fractured and will often cause pain in the middle front of the foot. Rest is key to recovering from this foot injury.
Morton's neuroma or Morton's syndrome is a condition resulting in pain between the third and forth toes caused by compression of a nerve. Ill fitting shoes and certain movements can cause this foot injury. Putting weight on the foot will make the pain worse, as will squeezing the forefoot. Read more on how to diagnose Morton's neuroma and how to treat it.
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. The pain is normally gradual and makes the bottom of the ball of the foot tender.
Gout is a form of arthritis caused by a build up of uric acid within the body, which is a waste product of metabolism. Gout is more common in men aged 40-60 and symptoms normally appear suddenly. Pain, swelling and itchiness in the big toe joint can indicate the presence of this condition.
A bunion (also known as hallux valgus) 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. Pain is normally gradual and gets worse over time. Read more on the causes, symptoms, and treatment of bunions.
Turf toe can occur after a very vigorous upward bending of the big toe causing a sprain to the ligaments under the base of the toe. Pain in the toe joint, swelling and tenderness are some of the main symptoms to look out for. Icing the area and not putting any weight on the foot will help it to heal quicker.
Sesamoiditis is an inflammatory condition affecting the sesamoid bones of the 1st metatarsophalangeal joint causing pain in the forefoot. It is caused by overuse and repetitive impacts, particularly if there is an increase of weight on the forefoot, like in dancing. Pain will normally come on gradually and there will often be swelling and inflammation.
Jones fracture is a fracture of the 5th metatarsal bone on the outside of the foot, at the end of the bone nearest the ankle. Overuse or turning the ankle can cause the fracture. The main symptom is pain on the outside of the foot and difficulty in putting weight on it. Medical help and x-rays will be needed to heal this foot injury.
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.