Physiotherapy for Ball of Foot Pain

Ball of foot pain or Metatarsalgia refers to pain and inflammation in the ball of the foot.  People who are physically active are more likely to experience ball of foot pain due to their activities involving a lot of running and jumping. People may also have Metatarsalgia due to the over-usage of improper fitting shoes.

Metatarsalgia is generally not a cause for alarm. Luckily, there are conservative treatment methods for ball of foot pain such as rest, ice therapy, and other effective techniques that may resolve symptoms of the condition. You must also ensure that you wear proper shoes with shock absorbing arch supports or insoles to ensure that you do not suffer from future complications associated with metatarsalgia.

Signs and symptoms

Signs and symptoms of ball of foot pain include:

  • Sharp burning or aching pain in the ball of the foot
  • Pain in the region around the big toe only or the second, third, or fourth toes of the foot
  • Worsening pain with weight bearing activities such as standing, running or walking
  • Pain improves with rest
  • Numbness or tingling in the toes of the foot
  • Sharp pain in the toes
  • Worsening pain when the feet is flexed
  • Feeling of walking on pebbles while wearing shoes
  • Increased pain when you walk barefoot

Symptoms may sometimes develop suddenly. This is more likely going to take place if you increase the intensity of your walking, running, jumping or any other high-impact activity. However, problems usually take some time to develop in most cases.


Conservative measures are usually effective in treating ball of foot pain. Follow these treatment steps to resolve symptoms of metatarsalgia:

  • Protect the affected foot against further injuring it by reducing the amount of stress you apply to it. This may require you to avoid certain sports activities, however, if you can keep yourself fit and healthy with low-impact activities as well such as cycling or swimming. Perform lower body strength training activities and stretching exercises, making sure that you do not experience pain while doing so.
  • Ice the affected foot. Apply ice packs or ice wrapped in a towel on the affected region for 15-20 minutes each time, several times per day. Avoid applying ice packs directly to the skin if you want to protect your skin, ice packs wrapped in a thin towel is advisable for use.
  • Take over-the-counter pain medication. Take nonsteroidal anti-inflammatory drugs such as ibuprofen or naproxen to control pain and inflammation
  • Wear appropriate footwear. Your doctor may advise wearing certain shoes that are suitable for your foot type and size and also the sports you indulge in
  • Wear shock-absorbing insoles. Prescription or custom made insoles or arches supports may be made or cork, rubber, plastic or a gel-like substance and are to be fitted inside your shoes to absorb shock
  • Use metatarsal pads. Your doctor may recommend using metatarsal pads that should be placed in your shoes, right ahead the metatarsal bone region of the foot to ward off stress on the injured area
  • Use arch supports. If insoles are not effective, your doctor may advise you to use arch supports to reduce stress to the metatarsal bone, to minimize pain and improve the functioning of the foot. Prescription arch supports are available in many sizes and can be fitted easily. You can use custom made arch supports from a plaster cast of your foot or a foam mold.

Durable and rigid arch supports are manufactured using a firm substance such as carbon fiber or plastic. These arch supports are designed to control motion of the major joints in the foot, below the ankles. Semi-rigid arch supports are made with softer materials like cork (with silicone) and leather. Arch supports to treat ball of foot pain may also include metatarsal pads as well.

If conservative treatment measures fail to improve symptoms, surgery may be required to realign the metatarsal bones – but this is rarely needed.

For world class foot care and prevention of future ball of the foot pain,  talk to any of our Perth physiotherapist for help.  Call Happy Physio today at 927 27359!