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Forefoot Pain (Pain in the ball of the foot)
Common Causes
Pain in the forefoot may be
due to a number of different conditions and the collective term for
forefoot pain is metatarsalgia. Below are some of the most common causes.
Neuroma
Pain in the ball of the foot may be due to a neuroma.
A neuroma is a thickening of the outer covering of a nerve. Nerves can be
likened to electrical wires which carry current. Nerves carry impulses
which among other things provide sensation such as touch or pain. If the
outer covering of the nerve becomes thickened (as in a neuroma) pressure
on the nerve may produce any variety of symptoms including pain, tingling,
burning or numbness. There may be a sensation of a small object such as a
pebble or marble beneath the ball of the foot when standing. Sometimes
controlling the biomechanics of the foot using
arch supports
or orthotics
can be helpful. We can determine this through examination and treatment
modalities. If necessary injection therapy may be used. If non-surgical
methods are not effective in relieving the symptoms, the neuroma can be
surgically removed.
Stress Fracture
A stress fracture, also know
commonly as a "Hairline Fracture" is a condition in which a bone partially
or completely fractures as a result of forces applied to it. Many stress
fractures are due to overuse syndrome in athletes and it is estimated that
about 10% of all sports-related overuse injuries in the lower extremities
may involve stress fracture. Virtually any bone of the foot may be
affected by stress fractures although the most common are the metatarsals
(long bones of the forefoot) and the heal bone (calcaneus). X-rays can be
very helpful in diagnosing a stress fracture although sometimes they are
negative. If x-rays are negative and there is thought to be a stress
fracture, a diagnostic test called a bone scan is very useful helping to
make the diagnosis. Treatment for stress fracture depends upon which bone
is affected.
When exercise walking,
running or simply walking long distances, it is wise to wear a shoe with
good cushioning and support. An arch support (separate from the arch
already present in many shoes) helps to provide even more support by
re-distributing weight bearing pressure.
Arthritis
Arthritis is all too common
and unfortunately the foot bones are not immune to this disease of the
joints. There are different types of arthritis although the result is
common to all types and that is that the cartilage on the ends of the
bones, needed for smooth gliding motion, between the bones becomes
eroded and the result is discomfort with movement of the joints (spaces
between the bones). Virtually any of the joints on the foot may be
affected. The great toe joint is commonly affected.
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