# Ball of foot pain > Ball of foot pain (metatarsalgia) is pain under the front of the foot, often burning or stabbing, and several different problems can cause it. Roomy, cushioned shoes, soft insoles or pads and easing off what hurts are the usual first steps. A podiatrist can work out the cause if it doesn't settle. Guide in [Toes and forefoot](https://footanklelowerlimb.com.au/learn/topics/toes-and-forefoot), from Foot Ankle Lower Limb: https://footanklelowerlimb.com.au/learn/ball-of-foot-pain Reviewed by Andrew Schox, BSc(Hons) PGradDipPod MPod (Podiatrist) on 27 October 2026. Next review by 27 October 2027. - **It's called metatarsalgia:** pain under the front of the foot, often burning or stabbing, and sometimes like walking on a pebble. - **It's a symptom, not one condition:** several problems can cause it, so finding the cause guides what helps. - **Self-care comes first:** roomy, cushioned shoes, soft insoles or pads, and easing off what hurts. - **There are options if that isn't enough:** a podiatrist or GP can talk them through. - **Some signs need prompt care,** such as a red, hot, swollen foot or sudden severe pain. ## What is ball of foot pain? Ball of foot pain is called metatarsalgia (pain under the front of the foot, around the long bones behind your toes) [1]. It's usually felt behind the second to fourth toes [2]. The pain tends to come on with standing, walking or running. It's often burning or stabbing, and some people say it feels like walking on a pebble. Tight, hard shoes make it worse [3]. Metatarsalgia isn't a diagnosis in itself. It's a name for the pain, and several different problems can cause it [4]. It's one of the most common complaints in people with foot problems [2], and it's more common in older people and people with diabetes [1]. ## What causes it? The most common causes are thinning of the fatty cushion under the ball of the foot (fat pad atrophy), an inflamed joint capsule at the base of a toe (capsulitis), inflamed fluid sacs between the bones (intermetatarsal bursitis) and an injured plantar plate (the tough band of tissue under the toe joint) [5]. Running and other exercise, tight shoes and arthritis are common triggers. A foot shape that puts extra pressure on the ball of the foot, hard or cracked skin, or a verruca can also hurt [6]. Gout, bunions, hammer toes and stress fractures can be behind it too [1]. Morton's neuroma (a trapped nerve between the toes) often causes a shooting, stabbing or burning pain between the 3rd and 4th toes, and a feeling of a pebble or lump under the foot [7]. Symptoms overlap a lot, so where the pain is and what it feels like are clues rather than proof. ## How is the cause found? A podiatrist works it out mainly by asking questions and examining your foot and lower leg [8]. They may ask when the pain started, how it has changed, whether the foot swells, and whether your toes have changed position [9]. They may press on the foot, check movement and calf tightness, and test how stable your toe joints are [9]. Blood tests or an ultrasound are sometimes needed [8]. An X-ray may be used if something looks unusual or surgery is being planned [10]. Before your visit, note when the pain started, what changed, and how it varies through the day. Bring the shoes you wear most often. ## What can I do at home first? Self-care is the place to start. Try: - **Roomier shoes** with a low heel and a soft sole, and plenty of room for your toes [6]. A wider, deeper toe box can help [9]. - **Soft insoles or pads** in your shoes [6]. - **Easing off what brings it on.** Low-impact activity such as cycling or swimming can replace running or jumping [1]. - **Rest and ice.** Put your foot up when you can, and use an ice pack wrapped in a towel for up to 20 minutes every 2 to 3 hours [6]. - **Gentle foot and ankle stretching,** and working towards a healthy weight if you're overweight [6]. - **Pain relief.** A pharmacist can advise on options such as paracetamol. Anti-inflammatory medicines such as ibuprofen aren't suitable for everyone, so check with a pharmacist or GP if you have other health conditions. > [!tip] Try this > Stand in the shoes you wear most and check that you can wiggle your toes and that there's room across the widest part of your foot. If the soles are worn flat or the cushioning feels squashed, set those shoes aside for a while. Most of this advice is general guidance rather than trial results. For Morton's neuroma, roomier shoes with padding helped some people, and no harms were reported [11]. ## What if self-care isn't enough? Ask your GP or podiatrist about the options. Which one suits you depends on the cause. The best-supported options are for Morton's neuroma. A corticosteroid injection worked better than footwear and padding in one trial, and hands-on foot manipulation or mobilisation (gentle movement of the foot joints) eased pain [11]. No single non-surgical treatment has been shown to be best, and the evidence is limited [11]. For other causes, it isn't clear yet which next step works best. Two operations on the metatarsal bones used for metatarsalgia seem to be equally safe and effective, though better studies are needed [12]. ## Will it get better, and how do I stop it coming back? It isn't clear yet how long ball of foot pain usually lasts or how often it comes back, and no step has been shown to prevent it. What follows is general guidance. Footwear is the most consistent advice. A shoe with a thick, cushioned sole that doesn't squash under the ball of the foot, and a curved front (rocker), can help forefoot symptoms [13]. Wear supportive shoes regularly, indoors too, and replace them when they're worn out [1]. Keep up the stretching and low-impact activity that suit you. ## When to see a podiatrist Most ball of foot pain can be looked after at home to begin with, but some signs need prompt care. Call 000 and ask for an ambulance if you have a wound or infection and become confused, have slurred speech or aren't making sense [14]. Go to the nearest emergency department if a joint suddenly becomes very painful, swollen and hot, with a fever, and you feel unwell [14]. See your GP or a podiatrist the same day if you have: - sudden, very severe foot pain, or a sudden change in the shape of your foot [1]; - a red, hot, swollen foot, a hot, swollen, painful calf, or a deep red or purple foot [14]; - diabetes and a wound, sore, blister or colour change on your foot, or a foot that's red, hot, swollen or suddenly changing shape [14]; - a fever or feeling generally unwell along with foot pain [14]; - no ability to put weight on your foot after an injury, or a foot you think is broken: don't try to treat it yourself [6]. For urgent advice when it isn't an emergency, call healthdirect on 1800 022 222 (24 hours a day), or go to a Medicare Urgent Care Clinic. See your GP soon if you have night pain that disturbs your sleep, pain that keeps getting worse, unexplained weight loss, a lump or swelling that's growing, or a past cancer [14]. Also see them for joint swelling that carries on with no clear cause [10]. See a podiatrist or your GP if the pain hasn't improved after 2 weeks of home care, stops you doing your usual activities, or comes with tingling or numbness [6][1]. If you have diabetes, see your GP for any foot pain, because foot problems can be more serious with diabetes [6]. ## Common questions ### Is metatarsalgia the same as Morton's neuroma? Not quite. Metatarsalgia is the name for pain in the ball of the foot, whatever the cause. Morton's neuroma, a trapped nerve between the toes, is one of several possible causes. It typically gives a shooting, stabbing or burning pain between the 3rd and 4th toes. A podiatrist can help tell the causes apart. ### Can I keep running or exercising with ball of foot pain? It can help to ease off the activity that brings the pain on, such as running or jumping, and swap it for low-impact options like cycling or swimming while the pain settles. Wear cushioned shoes with room for your toes. If the pain isn't settling, a podiatrist can help you plan how to stay active. ### Is ball of foot pain a sign of a stress fracture? Sometimes. A stress fracture is one of several possible causes, along with problems such as capsulitis, a plantar plate injury or Morton's neuroma. Where the pain is, what it feels like and what an examination finds help tell them apart, so it's worth having pain that doesn't settle checked rather than guessing. ## Further reading - [Ball of foot pain on Clindice](https://clindice.com/ball-of-foot-pain) - [Foot pain](https://www.mskdorset.nhs.uk/foot-pain/), NHS - [Foot pain: MedlinePlus Medical Encyclopedia](https://medlineplus.gov/ency/article/003183.htm), MedlinePlus - [Metatarsalgia - My Joint Health Hub](https://myjointhealthhub.bnssg.nhs.uk/foot-ankle-pain/metatarsalgia/), NHS - [Morton's neuroma](https://www.nhs.uk/conditions/mortons-neuroma/), NHS - [Pain in your toe or the ball of your foot - Morton's neuroma - Bradford District Care NHS Foundation Trust](https://www.bdct.nhs.uk/pain-in-your-toe-or-the-ball-of-your-foot-mortons-neuroma/), NHS ## Sources 1. Metatarsalgia · nidirect. https://www.nidirect.gov.uk/conditions/metatarsalgia 2. Metatarsalgia · Espinosa N, Brodsky JW, Maceira E · The Journal of the American Academy of Orthopaedic Surgeons · 2010. https://doi.org/10.5435/00124635-201008000-00004 3. Metatarsalgia · Inglin F, Knupp M · Therapeutische Umschau · 2024. https://doi.org/10.23785/tu.2024.07.002 4. Metatarsalgia and dislocated toe deformities · Chelsea and Westminster Hospital NHS Foundation Trust. https://www.chelwest.nhs.uk/your-visit/patient-leaflets/surgery-services/metatarsalgia-and-dislocated-toe-deformities 5. Metatarsalgia · NHS Lanarkshire · 2022. https://www.nhslanarkshire.scot.nhs.uk/services/podiatry/metatarsalgia/ 6. Pain in the ball of the foot · NHS. https://www.nhs.uk/symptoms/foot-pain/pain-in-the-ball-of-the-foot/ 7. Morton's neuroma · NHS · 2025. https://www.nhs.uk/conditions/mortons-neuroma/ 8. Royal Orthopaedic Hospital - Metatarsalgia Forefoot Pain · Mallard A · Royal Orthopaedic Hospital · 2026. https://roh.nhs.uk/services-information/foot-and-ankle/metatarsalgia-forefoot-pain 9. Forefoot pathologies · NHS. https://www.rightdecisions.scot.nhs.uk/refhelp-nhs-ayrshire-and-arran/orthopaedicsmsk/foot-and-ankle/forefoot-pathologies/ 10. Foot and Heel Problems · South & West. https://southwest.devonformularyguidance.nhs.uk/referral-guidance/western-locality/musculoskeletal/foot-and-heel-problems 11. The effectiveness of non-surgical interventions for common plantar digital compressive neuropathy (Morton's neuroma): a systematic review and meta-analysis · Matthews BG, Hurn SE, Harding MP et al. · Journal of Foot and Ankle Research · 2019. https://doi.org/10.1186/s13047-019-0320-7 12. Weil's osteotomy versus distal metatarsal metaphyseal osteotomy for the treatment of metatarsalgia. A metaanalysis of outcome and complications · Stavrakakis IM, Magarakis GE, Kapsetakis P et al. · Foot (Edinburgh, Scotland) · 2024. https://doi.org/10.1016/j.foot.2024.102101 13. Metatarsalgia - My Joint Health Hub · Muchall R · My Joint Health Hub. https://myjointhealthhub.bnssg.nhs.uk/foot-ankle-pain/metatarsalgia/ 14. Red flags · NHS. https://www.rightdecisions.scot.nhs.uk/ggc-msk-foot-and-ankle/initial-assessment/red-flags/?searchTerm=2024 --- This page is general information, not a diagnosis or a treatment plan for you. For advice about your own feet or legs, see a podiatrist or your doctor. In an emergency, call 000.