Forefoot pain includes injuries to the long metatarsal bones in the foot, as well as pain to the side and 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 metatarsal fractures and ligament sprains.
On this page:
- Hallux rigidus
- Mortons neuroma
- Metatarsal stress fracture
- Turf toe
- Jones fracture
- Metatarsal fracture
- Skin conditions
Gradual onset/chronic forefoot pain:
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.
Initial treatment for bunions is based on reducing pain and correcting any biomechanical problems of the foot. Later, or in more severe cases, surgery will be required. Sports taping techniques or specific bunion braces can be worn to relieve pain and help correct the alignment of the joints.
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Hallux Rigidus/Hallux Limitus
Hallux Rigidus is a common cause of big toe pain. Symptoms include a stiff big toe with swelling and inflammation in the joint, and pain, particularly when walking. This toe injury can be caused by a direct impact or from overuse. Repetitive stress on the toe, such as when the foot overpronates, or when the toes are dorsiflexed (like in a rugby scrum) can bring on this injury.
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Morton’s neuroma or Morton’s syndrome is a condition resulting in pain between the third and fourth 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.
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Metatarsal Stress Fracture
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.
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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 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.
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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. 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.
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Acute forefoot pain & fractures (sudden onset)
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.
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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 a 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.
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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.
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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 and corns 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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