The forefoot (ball of the foot) is the area just behind your toes and when pain is present it is called metatarsalgia. It can feel like aching, burning, stabbing, or tenderness and may worsen with walking, standing, or wearing shoes.

This area of the foot bears a lot of weight, so problems here can be painful and limit activity.

  • Overuse or high-impact activity – running, jumping, or prolonged standing

  • Improper or tight footwear – narrow shoes or high heels that compress the forefoot

  • Foot structure issues – high arches, flat feet, long second toe, or bunions

  • Excess weight – increases pressure on the forefoot

  • Aging – fat pad thinning reduces natural cushioning

 

Common Forefoot Conditions

Metatarsalgia

  • General pain in the ball of the foot

  • Symptoms: aching, burning, or sharp pain under the metatarsal heads, worse with walking or standing

 

Morton's Neuroma

  • Thickening of tissue around the nerves between the toes (commonly 3rd & 4th)

  • Symptoms: burning, tingling, numbness, or feeling like walking on a pebble

 

Sesamoiditis

  • Inflammation of small bones (sesamoids) beneath the big toe

  • Symptoms: pain under the big toe, swelling, and tenderness, worse with push-off

 

Capsulitis

  • Inflammation of the ligaments around the toe joints

  • Symptoms: pain in the ball of the foot, toe may feel stiff or swollen

 

Bursitis

  • Irritation of small fluid-filled sacs that reduce friction around joints

  • Symptoms: localized swelling, tenderness, or a “soft spot” under the ball of the foot

 

Calluses or Corns

  • Thickened skin caused by repeated pressure or friction

  • Symptoms: hard, painful spots on the ball of the foot

Big Toe Pain

The big toe joint is called the 1st metatarsophalangeal joint (1st MTPJ). Pain in this joint can make walking, running, or even standing uncomfortable. This area is prone to injuries, arthritis, and structural deformities.

 Common signs of 1st MTPJ pain include:

  • Pain at the base of the big toe

  • Stiffness when bending the toe

  • Swelling, redness, or tenderness around the joint

  • Difficulty or discomfort wearing shoes

Causes of 1st MTPJ pain can include:

  • Bunions (hallux valgus)

  • Arthritis (hallux rigidus)

  • Tendon inflammation (sesamoiditis, turf toe)

  • Post-surgical changes

Common Conditions That Affect the 1st MTPJ

Bunions (Hallux Valgus)

A bump at the base of the big toe caused by the toe drifting toward the others.
Symptoms:

  • Difficulty fitting footwear

  • Swelling

  • Redness

  • Pain

 Big Toe Arthritis (Hallux Rigidus)

Degenerative arthritis of the 1st MTPJ.
Symptoms:

  • Pain during push-off

  • Stiffness

  • Swelling

 Gout

Uric acid crystals in the joint causing inflammation.
Symptoms:

  • Sudden, severe pain

  • Redness

  • Warmth

  • Often occurs at night

 Sesamoiditis

Inflammation of small bones under the big toe joint.
Symptoms:

  • Pain under the ball of the foot

  • Worse during push-off

  • Swelling 

 

Turf Toe

Sprain of ligaments supporting the 1st MTPJ.
Symptoms:

  • Pain and swelling after hyperextending the big toe

  • Stiffness

 Hallux Limitus

Early-stage arthritis or stiffness of the 1st MTPJ.
Symptoms:

  • Pain during push-off

  • Mild swelling

  • Reduced motion

 Bursitis

Inflammation of the bursa near the joint.
Symptoms:

  • Pain

  • Tenderness

  • Swelling at the base or side of the big toe

 Post-Surgical Conditions

Pain or stiffness following bunion surgery or osteotomy.
Treatment:

  • Custom Foot Orthotics

  • Footwear modifications

  • Pedorthic management

When To Seek Our Care

  • Your physician has recommended pedorthic care

  • Persistent or worsening pain in the heel, arch, ball of foot, or toes

  • Pain that interferes with walking, standing, running, or daily activity

  • Swelling, redness, or warmth around joints or tendons

  • Numbness, tingling, or burning sensations in your feet

  • Recurring injuries or pain that keeps coming back

  • Changes in foot shape (e.g., bunions, fallen arches, high arches)

  • Pain after a recent injury or surgery that limits mobility

 

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