Ball Arch and Top of Foot

Pain in the ball, arch, or top of your foot should not be ignored. The cause of your pain could be something as simple as wearing the wrong type of shoes, or there is a chance it could be something more serious that needs immediate medical attention. The following are common problems associated with pain in the ball, arch, or top of your foot.

Arch Pain

"Arch pain" is a general term referring to pain that runs along the bottom of the foot, concentrated between the heel and the base of the toes. Arch pain develops when the structures of the feet start to wear down. The result is pain and tenderness that will increase when the arch is stretched.

Though arch pain is relatively common, especially following any type of intense physical activity, it is important to see a doctor if the pain persists for more than a few days.

Causes of arch pain

The arch of the foot is responsible for absorbing impact and providing support when you are on your feet. The primary structures of the arch are easily strained by everything from overuse to injury.

Arch pain can be caused by a structural imbalance of your foot or even a direct injury, including a fracture. In most cases, arch pain is caused by strain to the plantar arch, or plantar fascia, which is the ligament that runs from the heel to the base of the toes.

Common causes of arch pain include:

  • Arthritis of the joints in the midfoot.
  • Overpronation (excessive inward rolling of your foot).
  • Strain from overuse (running, walking, and standing on your feet all day).
  • Stress fracture.
  • Tarsal tunnel syndrome.
  • Use of non-supportive footwear.

Arch pain symptoms

Arch pain most often manifests as a burning pain that runs down the sole of your foot. The location of the pain can be a helpful diagnostic tool, as pain in a specific area along the arch can indicate which structure of your foot is strained.

Pain may also increase or decrease when your arch is stretched. In mild cases of strain to the ligament, pain may be intense in the morning and will decrease as the foot "warms up" throughout the day. In more severe cases, pain will increase with movement, making physical activity difficult, if not impossible.

Treatment of arch pain

Arch pain is a common foot condition that can be treated at home or under the guidance of a physician. At the onset of pain, treatment should begin with the R.I.C.E guidelines of rest, ice, compression, and elevation. Any physical activity that aggravates soreness should be limited.

Pain can be managed with over-the-counter medications. If the soreness and pain persists for several days, it is best to see a foot doctor. Your physician may recommend anything from physical therapy and stretching to the use of orthotics.

Capsulitis

The inflammatory condition of capsulitis can affect virtually any joint in the body. Capsulitis in the foot is an inflammation of the ligaments near the toe joints, brought on by excessive force to the forefoot. It is characterized by sharp or aching pain near the ball of the foot or the base of the toes, experienced with movement of the toes or pressure on the toes.

Foot capsulitis is a condition that can be managed with proper care; however, if left untreated, it can weaken the ligaments near the toe, making dislocation or deformity more likely.

Causes of capsulitis

Capsulitis is caused by too much stress on the foot joints, which can result from trauma, inappropriate footwear, or from deformities within the foot.

Climbing ladders and engaging in activities that require stooping, like gardening or working low to the ground, can overstretch the ligaments near the toes and produce inflammation. Wearing high heels or unsupportive shoes can also cause excessive bending of the toes and inflammation.

People with certain medical conditions, including arthritis, are predisposed to inflammation within the joints, putting them at a higher risk of developing capsulitis and related conditions.

Capsulitis symptoms

Most patients with capsulitis complain of a nagging pain in the forefoot. Pain can develop on either the top side or bottom side of the foot, and any type of stretching of the toes up or down will produce discomfort.

Other symptoms of capsulitis include:

  • Swelling and redness near the toe joints.
  • Difficulty walking.
  • Stiffness of the forefoot.
  • Pain near the ball of the foot.

Symptoms of capsulitis can mirror other foot conditions, including neuroma, so it is best for you to see a physician for a proper diagnosis.

Treatment of capsulitis

The goal of treatment for capsulitis is to reduce stress to the forefoot. Most physicians will initially recommend conservative treatment to accomplish this, like icing your foot, wearing foot pads and cushioned orthotics, and avoiding high heels or shoes that lack support.

If these conservative methods fail to eliminate pain, cortisone injections can be used to reduce inflammation and swelling. If trauma to the joints continues, the risk of rupture to the joint capsule increases.

In cases where capsulitis can be attributed to abnormalities of your foot, surgery may be necessary to reposition or shorten the bones relating to the issue.

If you are experiencing pain in the forefoot, visit a doctor for a complete diagnosis.

Flat Feet (Pes Planus)

People with flat feet have a very low foot arch or no arch at all. The soles of their feet lay flat on the ground and the feet may point outward when standing or walking.

Pes planus, normally referred to as flat feet, is a common foot type variation that most people experience no pain or problems with. However, because flat feet can affect the body's alignment, the condition can eventually contribute to or exacerbate other foot problems.

Causes of flat feet

Having flat feet during childhood is normal because the arches only develop with age; however, some people simply never develop arches. Arches can also "fall" over time. Fallen arches are caused by everything from pregnancy to normal wear and tear. Overuse of the tendon supporting the arch also causes the foot to flatten.

Risk factors for flat feet include:

  • Arthritis.
  • Family history (flat feet tend to run in families).
  • Foot abnormalities.
  • Other medical conditions (including cerebral palsy and muscular dystrophy).
  • Pregnancy.
  • Weak arches.

Signs of flat feet

Standing upright, people with flat feet have little or no space between the ground and the soles of their feet.

People with flat feet also tend to roll their feet to the inside when standing or walking. Because of this, you can sometimes tell if you have flat feet by looking at a pair of your used running shoes. Flat feet will cause more wear on the inside of the shoe soles near the heel, and the shoe will easily rock side to side.

Treatment of flat feet

Flat feet will not necessarily produce any problems, but if you are experiencing pain in the inner side of the ankle or in the foot period, your flat feet may be to blame.

Most foot pain can be remedied with orthotics. For example, insoles can quickly relieve pressure from the arch releasing some tension caused by flat feet. Your doctor may also recommend inserting a wedge along the inside edge of the shoe to reduce pressure on the tendon. In rare cases, the tendon along the arch can rupture and surgical intervention may be required.

There is no need to be concerned with flat feet unless you are experiencing foot pain or any other foot problems that could be aggravated by flat feet. See a doctor if you have any questions about how flat feet may be affecting any other foot conditions you suffer from.

Foot Fracture (Broken Foot)

A foot fracture, or broken foot, refers to a break in any one of the 26 small bones in your feet. Minor foot fractures involve a tiny crack in the bone, while more serious breaks extend through the bone and can pierce the skin, requiring surgery.

Since the feet are very vulnerable to slipping, twisting, and other types of injury, foot fractures are extremely common. About 10 percent of all broken bones occur in the feet.

Causes of foot fracture

Foot fractures are caused by trauma to the bone. Most fractures occur following an accident or injury, but occasionally, small cracks form in the bone from overuse; these are known as stress fractures.

Common causes of a broken foot include:

  • Missteps and severe twists.
  • Motor vehicle accidents.
  • Overuse, including overtraining.
  • Slips and falls.
  • Something heavy dropped on the foot.

Foot fracture symptoms

Foot fractures are not always easy to recognize. Symptoms vary depending on the location and extent of the break in the bone. Not all foot fractures are sudden and produce immediate pain.

Symptoms of a broken foot include:

  • A protrusion near the fracture.
  • Bruising and swelling.
  • Inability to walk or place weight on the foot.
  • Sharp, severe pain.
  • Tenderness at the surface of the bone.
  • Visible redness.

At times, you might mistake a fracture for a sprain; many times an x-ray will be the only way to determine if you are suffering from a bad sprain or a broken foot. Sharp pain on the top and side of the foot is not normal. If you feel pain on the outside of your foot, you should see a physician as soon as possible.

Treatment of foot fracture

Course of treatment for fractures depends on the severity of the broken bone. Fractures can be treated by either immobilizing your foot (to allow the bone to heal on its own) or putting the bone back into proper position with surgery or a process called reduction.

Immobilization

Minor fractures can heal without surgery. Immobilizing your foot with a brace or cast allows the bone to fuse together over time. In some cases, you may only need crutches and a splint to protect the fracture.

Reduction

If the fractured bone is displaced, a doctor can manipulate the pieces back into the proper position. This is known as reduction. Typically you would be prescribed a muscle relaxant or sedative prior to the reduction to minimize discomfort.

Surgery

Severe fractures often require surgery. Your doctor can use a variety of tools, including pins and screws, to stabilize the position of bones while healing takes place. Following surgery a cast or splint is placed on your foot. You will need crutches to walk.

Delaying treatment of a broken foot could cause additional injury. If you are experiencing severe pain in your foot, visit your doctor as soon as possible for diagnosis and treatment.

High Foot Arch (Pes Cavus)

In simple terms, high arch (or pes cavus) means the arch along the bottom of the foot is abnormally high. High arches are less common than flat feet, but this condition is a relatively harmless variation in foot type.

There is always a risk of the uneven weight distribution from high arches contributing to inflammation in the feet. If you are experiencing pain in your feet, consult a physician.

Causes of high arches

High arches generally run in the family. Most people with high arches simply developed them naturally.

It is important to be aware that the development of high arches may also be indicative of some kind of underlying neurological disorder. Neuromuscular diseases that affect muscle tone (including muscular dystrophy) can lead to the development of high arches.

High arches signs

There are several visible signs of high arches:

  • The arch will appear higher off the ground than normal.
  • The toes may curl under in a claw like fashion.
  • The heel of the foot may tilt forward.
  • There may be calluses and corns under the base of the toes from the pressure exerted on the forefoot.

People with high arches often have difficulty finding shoes that fit correctly. High arches can also contribute to stiffness and lack of mobility in the feet.

Treatment of high arches

Treatment for high arches will vary depending on the severity of the condition and whether it interferes with normal activities. Orthotic therapy is usually very effective for anyone with high arches. Corrective shoes can reduce pressure on the arch and relieve any pain or soreness. Proper fitting of all footwear is critical.

It is important to see a doctor if you are experiencing foot pain or arch pain. A physician can rule out any neurological disorders that could be contributing to the condition and help alleviate pain associated with this foot type.

Metatarsalgia

Metatarsalgia is a term used to describe pain and inflammation in the metatarsal region of the foot, or the "ball" of the foot. This type of pain is common among active individuals and tends to affect people who wear ill-fitting footwear on a daily basis.

Though metatarsalgia is not usually indicative of a serious problem, it can interfere with daily activities. Conservative treatments can help relieve metatarsalgia symptoms; in most cases, a change in footwear can ease the pain.

Causes of metatarsalgia

Metatarsalgia develops when something alters the normal function of the foot, causing excessive pressure on the ball of the foot. The pain can result from any number of sources, including the following:

  • Age - As you age, the fat pads in your feet tend to thin out, increasing the risk of metatarsalgia.

  • Foot shape - High arches can lead to increased pressure placed on the ball of the foot.

  • Improper footwear - Women who wear shoes with high heels and narrow toe boxes often suffer from pain in the ball of the foot. This type of restrictive footwear forces the ball of foot into a compressed space and can alter the way we walk, leading to inflammation.

  • Intense physical activity - Anyone who participates in high-impact athletics, particularly running, is at risk for metatarsalgia.

  • Other foot conditions - Everything from arthritis to a foot fracture can cause changes in the way you walk. Anything that alters your step can compromise the mechanics of the feet and cause pain in the ball of your foot.

  • Weight - The more weight that is brought down on the feet during physical activities, the greater the pressure on the feet. Maintaining a healthy body weight can help reduce pressure on the feet.

Metatarsalgia symptoms

Metatarsalgia symptoms can develop suddenly (especially if you have become more active) or over time. Pain can be centralized in the metatarsal heads, which are the areas just before the second, third, and fourth toes, or pain may be localized in the area near the big toe.

Symptoms of metatarsalgia include:

  • General pain in the ball of the foot when bearing weight.
  • Shooting pain in the "ball" when the foot is flexed.
  • Shooting pain, tingling, or numbness in the toes.

Some people with metatarsalgia describe the condition as a feeling that they are walking over pebbles. Metatarsalgia may also feel like a bruise to the ball of the foot.

Treatment of metatarsalgia

Treatment of metatarsalgia will depend on the cause of the pain. If improper footwear is leading to pain and inflammation, treatment may be as simple as switching to shoes with a wide toe box. It is also helpful to be proactive; losing weight can reduce pressure on the ball of the foot and ease metatarsal pain.

Your doctor will make treatment recommendations based on the severity of your condition. Recommendations may include:

  • Arch supports.
  • Metatarsal pads or bandages.
  • Over-the-counter pain relievers.
  • Rest and ice.
  • Shoe inserts.

If you are experiencing recurrent pain in the ball of the foot, consult a physician. Your doctor can help determine the source of the pain and rule out more serious foot conditions.

Plantar Fibromas

A plantar fibroma is a benign mass that grows along the plantar fascia, which is the band of connective tissue that supports the arch of the foot. Plantar fibromas are commonly found in the mid-arch region but they can develop anywhere along the bottom surface of the foot.

While not initially painful, plantar fibromas can cause significant discomfort if left untreated.

Causes of plantar fibromas

The exact cause of plantar fibromas is unknown, but there are several factors that could play a role in the development of these growths:

  • Trauma: Damage to the plantar fascia can lead to the formation of plantar fibromas. In fact, the development of excess tissue may actually be an aggressive healing response following injury from overuse or trauma (including puncture wounds).
  • Plantar Fasciitis: A common condition among runners, plantar fasciitis causes tightening of the plantar fascia, which can eventually lead to tears in the connective tissue. Plantar fibromas may develop in response to these small tears of the plantar fascia.
  • Genetics: Some people are simply predisposed to fibrotic diseases and overdeveloped tissue.
  • Other Conditions: Beta-blockers, anti-seizure medications, and certain supplements may contribute to the development of plantar fibromas following trauma to the plantar fascia.

Plantar fibroma symptoms

Plantar fibromas are easy to recognize; they start as one or more small lumps on the bottom of the feet that feel firm to the touch. The masses can occur in one or both of your feet and may enlarge over time.

Plantar fibromas can develop anywhere along the bottom of your feet and are felt just under the skin. The growths themselves are not usually painful, but as they increase in size, they will start putting pressure on the structures of your feet. This can make walking and standing for long periods very painful.

Treatment of plantar fibromas

Plantar fibromas do not generally go away or decrease in size on their own; treatment is necessary to reduce the discomfort associated with these growths.

Non-invasive treatment of plantar fibromas can include:

  • Change in shoes
  • Orthotics
  • Steroid injections
  • Physical therapy and stretching

While these non-surgical treatments can relieve some of the pain caused by plantar fibromas, they will not cause the growths to disappear. Surgical treatment to remove the growths is sometimes necessary. Consult your physician to learn more about surgical and nonsurgical treatment of plantar fibromas.

Sesamoiditis

Sesamoiditis is a general term describing irritation or inflammation of the tendons surrounding the sesamoid bones (the two small bones within the tendons that run to the big toe). This condition causes sharp pain in the ball of the foot, directly beneath the big toe joint.

Sesamoiditis is common among active individuals, particularly runners and ballet dancers. Treatment is generally nonsurgical; in most cases, pain can be reduced by resting the feet and relieving pressure on the sesamoid bones.

Causes of sesamoiditis

Sesamoiditis is basically an overuse injury. The sesamoid bones are located directly beneath a weight-bearing area of the foot, which means that every time you push off from the ground the sesamoids and surrounding tendons are involved. This constant pressure on the tendons eventually takes its toll, causing inflammation and discomfort.

Sesamoiditis usually occurs following an increase in any type of activity that puts excessive pressure on the foot, including running and jumping. People with high arches naturally put more pressure on the balls of their feet and are consequently at an increased risk of developing sesamoiditis. The condition is also common in people with bony feet who have thinner fat pads protecting the tendons surrounding the sesamoid bones.

Sesamoiditis symptoms

The primary symptom of sesamoiditis is pain beneath the big toe on the ball of your foot. The pain can be mild and intermittent, brought on by walking, or it can be more severe and persistent, making it difficult to flex your toe or put pressure on the ball of your foot.

The pain may also be accompanied by swelling, bruising, and discoloration. Walking in bare feet and wearing thin-soled shoes can further irritate the tendons surrounding the sesamoids.

Treatment of sesamoiditis

The first step in treating sesamoiditis is to reduce pressure on the ball of your foot. This can be achieved by modifying activity, switching to comfortable shoes, and icing the toe joint.

If these steps fail to relieve the pain associated with sesamoiditis, further treatment may include:

  • Cortisone injections.
  • Custom orthotic shoe inserts.
  • Immobilizing the joint with tape or a foot brace.
  • Physical therapy and stretching.

In rare cases, surgery may be necessary.

Treatment of sesamoiditis will depend on the extent of damage to the tendons; it is best to see your doctor for proper diagnosis and treatment recommendations.

Stress Fracture of the Foot

A stress fracture is a small crack in a bone caused by overuse and repetitive impact. In the feet, stress fractures most often occur in weight-bearing bones, primarily the metatarsal bones (the long bones in the forefoot).

While stress fractures may begin as a small crack in the bone, they can progress quickly if left untreated. Consult a physician as soon as possible if you are experiencing sharp pain in your foot.

Causes of stress fractures

Stress fractures in the bones of the feet are generally caused by overuse. When muscles are fatigued during physical activities, they are no longer able to absorb as much impact from running or jumping. As a result, the stress of impact is transferred to the bones of the feet. This type of repetitive stress can produce small cracks and slivers in the bone.

Stress fractures are a common sports injury that can occur following any type of high impact activity, including running on hard surfaces, gymnastics, volleyball, and basketball. However, anyone who suddenly increases the intensity of a workout, whether they are new to exercise or are a seasoned athlete, is at risk of developing a stress fracture.

Other factors that can increase the risk of developing a stress fracture include:

  • Decreased bone density (osteoporosis).
  • Flat feet.
  • Foot malformation.
  • Obesity.

Stress fracture symptoms

Stress fractures have one primary symptom: pain on top of the foot or outside of the ankle. The pain will increase with any type of weight-bearing activity or bending of the feet. Swelling and bruising may also occur.

Because stress fractures are caused by overuse and not any kind of definitive trauma to the foot, they can be difficult to recognize right away. It is important to see your doctor if you are experiencing any type of recurring sharp pain in the feet.

Treatment of stress fractures

Treatment of stress fractures in the feet will depend on the extent of damage to the bone. The first step is always to rest the foot.

Nonsurgical Treatment

If a stress fracture is diagnosed right away, it can often be treated with nonsurgical options, including immobilization of the foot with protective footwear, crutches (to keep weight off the foot), or a foot cast.

Surgical Treatment

Severe stress fractures may require surgery. The goal of the procedure will be to keep the bones together with pins, screws, or plates to allow proper healing.

To determine the best course of treatment, you should visit your doctor at the first signs of a stress fracture in your foot.

If you are suffering from severe pain in the ball, arch, or top of your foot, you should visit your doctor for an examination and treatment.