Forefoot pain includes injuries to the long metatarsal bones in the foot, inside, outside and under the ball of the foot. Here we explain the causes of forefoot pain including skin conditions.
Has your injury occured suddenly or developed gradually over time?
Chronic injuries causing forefoot pain
Chronic injuries are gradual onset, often caused by overuse and include tendonitis, stress fractures, and joint inflammation.
A bunion, also known as hallux valgus, is a painful swelling of the soft tissue, with bone enlargement over the inside of the forefoot at the base of the big toe (MTP joint).
- Often the big toe will look as if it is bent in towards the other toes, or even can lie across them in some cases.
- Pain is normally gradual and gets worse over time.
- Bunion pain is often relieved by removing your shoes off or wearing soft, comfortable, wide fitting shoes.
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Hallux Rigidus/Hallux Limitus
Hallux Rigidus is a common cause of big toe pain. It can be caused either by a direct impact or from overuse. Symptoms include:
- A stiff big toe with swelling and inflammation in the joint
- Pain in the MTP joint, particularly when walking.
- As it progresses, you may also experience loss of movement in the joint, or walk with a limp.
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Morton’s neuroma or Morton’s syndrome is a condition resulting in pain between the third and fourth toes. It is caused by compression of a nerve. Symptoms typically include:
- Pain between the third and fourth toes.
- Numbness, tingling or pins and needles.
- Symptoms are usually felt on the outside of the third toe and the adjacent side of the fourth toe.
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Metatarsal Stress Fracture
A metatarsal stress fracture is a hairline 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.
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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.
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Sesamoiditis/Synovitis of the MTP
Sesamoiditis is an inflammatory condition affecting the small sesamoid bones in the foot. Most common is the 1st metatarsophalangeal joint under the base of the big toe. Symptoms include:
- Pain in the forefoot.
- Swelling and inflammation.
- Pain will normally come on gradually.
It is caused by overuse and repetitive impacts, particularly if there is an increase of weight on the forefoot, like in dancing.
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Gout is a form of arthritis caused by a build-up of uric acid within the body, which is a waste product of metabolism.
- It is more common in men aged 40-60.
- Symptoms normally appear suddenly.
- Pain, swelling, and itchiness in the big toe (MTP) joint.
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Acute injuries causing forefoot pain
Acute injuries are sudden onset, traumatic injuries and include fractures, sprains and strains.
Turf toe can occur after a very vigorous upward bending of the big toe. As a result, ligaments under the base of the toe sprain (stretch or tear). Symptoms consist of:
- Pain in the MTP joint at the base of the big toe.
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Jones fracture is a fracture of the 5th metatarsal bone on the outside of the foot. It can be caused by either overuse or suddenly through twisting/sprained your ankle.
- The main symptom is a pain on the outside of the foot.
- You will have difficulty in putting your weight on it.
- Medical help and x-rays will be needed to heal this foot injury.
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A metatarsal fracture is a break of one of the five long metatarsal bones in the foot.
- It is usually caused by a direct impact or trauma.
- Symptoms of sudden pain and rapid swelling.
- Seeking medical help is key to recovering from this foot injury to ensure the bones heal.
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Skin conditions causing forefoot pain
Corns & Calluses
Corns and calluses occur when there is excess or thickening of the skin, usually on the soles of the feet.
- Calluses form on weight-bearing parts of the body.
- Corns form on non-weight-bearing areas.
- Applying gels to reduce friction and applying plasters can help ease any pain and protect the area.
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- Athlete’s foot, also known as Tinea Pedis, is a skin infection which is commonly thought to occur amongst athletes, and those who wear trainers and other non-breathable footwear.
- It is caused by a fungus that grows in warm, moist environments, just like a sweaty trainer!
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A blister is caused by friction between the skin and the inside of a shoe or clothing.
- Heat builds up causing a swelling under the skin which may or may not have blood in it.
- Redness on the skin is the first sign of a blister and is particularly common on the heel, instep, and toes.
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A verruca is also known as a plantar wart and appears on the sole of the foot.
- They are the same as warts on any other body part and are caused by a virus, known as human papillomavirus (HPV).
- They vary in size and are not normally something to worry about, although care should be taken as they can be contagious.
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