This a complaint we hear from patients on a regular basis. This is characteristic of a condition called bursitis or metatarsalgia. The pain experienced with this condition is generally in the ball of the foot, the area toward the bottom of the foot underneath the toes. It can occur underneath any of the toes, but is most common underneath the second toe. Patients commonly describe the pain as feeling like walking on a lump, ball or rock in their shoe.
The condition is usually caused by an excessive amount of pressure in a given area of the foot over a period of time. Several factors can be involved in the development of this problem including poor unsupportive shoe gear, high heeled shoes, being overweight and foot deformities such as bunions and hammertoes, which can lead to increased pressure when walking to the ball of the foot. When excessive pressure is applied to an area over a period of time the body will attempt to form a protective cushion or sac called a bursa to the area. If pressure to the area continues this sac can become inflamed and painful to walk on, a condition called bursitis.
When patients present with these symptoms, x-rays and a diagnostic ultrasound test may be needed to rule out other conditions. Treatment is usually geared toward reducing pain and inflammation to the area and alleviating pressure to the region. This may include anti-inflammatory pills or injections to the area to reduce pain. Custom made foot orthotics and padding can help alleviate pressure to the area, so this condition does not become chronic. Most patients with this condition will respond well to conservative treatment, but in rare cases surgery may be required.