The ball of the foot is part of the sole of the foot, which is formed by the metatarsophalangeal joints and an overlying fat body (cushion).
The ball of the foot is in contact with the ground and carries a large part of the body weight. The ball of the foot is therefore exposed to everyday stress, which can cause pain in the ball of the foot. In addition to a heavy burden, the pain in the ball of the foot can also be based on various diseases, which is why long-lasting pain in the ball of the foot should be clarified by a doctor.


Most often it comes in the context of an overload or overuse of the football, for example, after a hike or after a long time standing, pain in the ball of the foot.
The development of pain in the ball of the foot is favored by wearing the wrong footwear. Even overweight can lead to an overload of the football and to pain in this.

Diseases of the toe joints that form the ball of the foot can also trigger pain in the ball of the foot. These include inflammation of the toe joints, inflammation of the sensitive periosteum, which surrounds the toe joints, as well as wear or fractures of the toe joints.

Furthermore, pain in the ball of the foot can also be caused by a gout or rheumatic disease, by a circulatory disorder of the foot or by damage to the nerves of the football.

In case of long-lasting pain in the ball of the foot, which occur without overloading of the footballing, also a bone tumor can be causative.

In addition, congenital or acquired malformations of the foot can be the reason for pain in the ball of the foot.

The following diseases can cause pain in the footpad:

  • Fatigue break in the midfoot
  • metatarsalgia
  • Morton Neuroma
  • gout
  • Osteoarthritis of the toes
  • Morbus Ledderhose
  • Articulated feet
  • splayfoot
  • midfoot arthrosis


The term metatarsalgia summarizes all diseases of the metatarsus. More specifically, this term refers to pain occurring in the metatarsal or metatarsal in extension of the second to fifth toes. Pain in the area of ​​the big toe is considered separately.
So anyone who feels pain in the metatarsus suffers in fact from a metatarsalgia.

The reasons for this are as varied as the feet of those affected themselves. As a rule, these are foot deformities or deformities that, for example, were not treated correctly in childhood and are now causing problems in later life years. However, overwork, inflammatory processes or, in rare cases, tumors can cause midfoot pain.

Fatigue break in the midfoot

The fatigue fracture of the metatarsus can basically be attributed to two causes. First, the bones of the metatarsus may have structural damage. So you no longer have their actual bone density and thus no longer their hardness and resilience. Reasons for this can be, for example, bone diseases, but also drugs such as cortisone.

On the other hand, an overload of the metatarsal bones is also a possible cause. In most cases due to too much physical activity without the body being used to it. But also wrong running shoes can lead for example to an unfavorable power distribution while running.
The first early warning symptoms are the pain that occurs during exercise, which disappears at rest. However, the pain does not disappear at rest due to the fracture and every step costs painful overcoming. In addition, a bruise appears near the affected bone and gradually spreads.

For the treating physician, the information should give rise to an X-ray examination of the foot. Here you can see in X-ray image then a fracture gap in mostly a metatarsal bone.

Inflammation on the ball of the foot

In general, inflammation in the ball area caused by a wound that germs the ability to penetrate from the outside into the body. Accordingly, are more at risk for people who move barefoot. Barefoot runners can experience the slightest injuries to the soles of their feet that they never notice, but which give bacteria the ability to 'enter' and multiply the human body.

Typical signs of inflammation on the ball of the foot are usually pain when the ball of the foot is loaded. Due to the invading bacteria, the foot is much more sensitive here and stresses that would normally cause no pain are perceived as painful. Further evidence of inflammation is swelling and redness of the foot at the site. In addition, the ball of the foot feels much warmer at the reddened area. Last symptom of the inflammation of the football are difficulties to run in the tiptoe.

Morton Neuroma

The Morton Neuroma is basically a nervous disorder that is responsible for the sensation of feeling on the underside of the foot and the toes. These nerves run between the bones of the metatarsus and pass through a very narrow gap in the area of ​​the ends of the bones through which they pass. By overloading the foot or by a splay existing from the beginning, for example, this gap is additionally narrowed. The bones begin to squeeze the nerve a bit and slide along it.

This leads to a nerve irritation in the appropriate place and beyond that forms a shell of solid connective tissue around the nerve. This shell, however, ensures that the nerve has even less space and is therefore narrowed and squeezed even faster.

Typical signs of a Morton neuroma are a slight tingling sensation or a disturbed feeling on the underside of the foot. As they walk, the more they feel their feet rolling, they feel an uncomfortable pain. This can also be provoked by grasping the foot on the two long sides and compressing it. As a result, the metatarsals are also compressed, so that the damaged nerve is also compressed. In the majority of cases, the nerve between the third and fourth toes is affected by a Morton neuroma.

Arthrosis in the midfoot as a cause of pain

Midfoot arthrosis is one of the rarer forms of arthritis and is generally more common in women than in men. As with any other form of arthrosis, the cartilaginous articular surfaces of the bones are damaged.

Overuse of the joints - be it due to a foot deformity or too much body weight - increases the cartilaginous abrasion of the joints until it is finally worn out. Compensatory, the body at the joint edge small bone attachments (osteophytes), in order to better distribute the pressure on the joint can. However, since these are not as stable as the original bone and are partially released by the movement, a permanent latent inflammation develops in the affected joints.

As a rule, those affected complain of pain in the area of ​​the metatarsus, which is particularly pronounced during unrolling, ie when the foot is bent. This pain, however, seems to be most likely located on the back of the foot, ie the upper side of the foot. Depending on how strong the arthrosis has already progressed, one can also feel the previously described "bone attachments" when feeling the joints. But at the latest at the x-ray of the foot they are visible. Furthermore, the affected area of ​​the metatarsal heats up to the rest and the person concerned tries to take compensatory restraint with his feet in order to minimize the burden on the metatarsus.

Pain in the toe joint can have many causes. Pain in the big toe joint, however, is a typical symptom of a gout attack, which is why this aspect should be discussed in more detail. Typically, the gout pain in the cold season, as the uric acid crystallizes in the cold easier to small lumps. These in turn rub within the joint and cause pain when the foot is moved or unrolled. A typical indication is that the pain decreases when warming the foot.

Another possibility that could cause pain in the toe joint is a fracture of a toe bone. Often it affects the little toe or possibly the fourth toe. Trapped in a door or clumsily stuck to an edge, this force can cause a break.
The patient feels in the acute incident and then after severe pain and it comes to the formation of a hematoma at the affected site.

Accompanying symptoms

Based on the accompanying symptoms, the orthopedist can draw conclusions about the cause of the disease.

Pains in the ball of the foot may be drawing or stinging depending on the cause, may be accompanied by tingling and numbness (Morton Neuroma), or may be associated with painful pressure points and blisters following excessive stress (fatigue / fatigue fracture). With an inflammatory cause of the pain, the ball of the foot can be reddened and swollen (gout).
Depending on the cause of the pain in the ball of the foot occur only under load of football, immediately after the burden of football or even at rest.

Pain on the ball of the foot due to gout

The clinical picture of gout is a relapsing metabolic disease in which there is too much uric acid in the blood.

Typically, the disease deposits uric acid crystals in joints and leads to severe inflammation.
An acute attack of gout causes very severe pain and often occurs in the so-called metatarsophalangeal joint.

The pain typically occurs in such a gout attack after the consumption of alcohol and / or meat. In addition, the number of seizures increases especially at night or in the morning. The pain in the metatarsophalangeal joint can radiate throughout the foot which is usually painful and red and swollen. At the same time fever can occur. Normal walking is usually no longer possible during an acute gout attack. During such a spell, the seizure is usually treated with analgesics or cortisone.

In order to reduce the likelihood of another attack of gout, a change in diet ( purine-poor diet ) and, if appropriate, ingestion of so-called uricostatic drugs should be carried out.
If an acute attack of gout is suspected, a doctor should always be consulted for further clarification.


First, a detailed questioning of the person concerned by the doctor takes place in order to exclude already some possible triggers of pain in the ball of the foot. The better the person concerned can describe and localize his pain in the ball of the foot, the easier the diagnosis will be.

Further important questions are when exactly and in which situation the pain will occur, if the patient has other complaints in addition to the pain in the ball of the foot and if the affected person additionally suffers from other illnesses.

Afterwards an appraisal and an investigation of the football take place.
Also, an X-ray of the foot can provide clues to the cause of pain in the ball of the foot. Abrasion of the toe joints, fractures or bone tumors are often visible in the radiograph. Furthermore, computed tomography (CT), magnetic resonance imaging of the foot (MRI foot) and an examination of the affected person's blood can also contribute to the diagnosis.

Where are your complaints?

Pain on the outside of the ball of the foot

In general, pain on the ball of the foot is usually due to an overload of the corresponding site.

If pain occurs on the outside of the football, this can have different causes. Thus, an overload, which acts mainly from the outside on the foot can be influenced by a malposition of the legs. Such a malposition usually leads to a morbid unwinding while running and as a result to an overuse of only a certain part of the football.
But even without a misalignment of the legs it can come isolated to pain on the outside of the football. For example, an overload caused by extreme overweight or physical activity, even with correct roll-off behavior, can manifest itself above all on the outside.

In case of persistent pain, consult a doctor who can rule out other conditions, such as warts on the sole of the foot in this area, and possibly run a running analysis. The ball of the foot can be supported by shoe inserts in case of noticeable roll-off behavior. In some cases, additional medication or physiotherapy may be necessary.

Pain in the back ball of the foot

Strictly speaking, the ball of the foot comprises only the front part of the foot behind the toes, which is in direct contact with the ground when running. So the ball of the foot is located in the front foot area. Pain in the back ball of the foot includes complaints that occur in the middle to front foot area.

Pain, which occurs further back on the ball of the foot, like all other pains on the ball of the foot, usually occurs due to an overload.
Thus, a non-optimal rolling behavior with simultaneous high stress of football can lead to this complaint. In order to be able to better narrow down the cause of the pain on the posterior ball of the foot, the type of movement in which the discomfort occurs and the precise localization of the pain are decisive. For example, if a new shoe is used and the pain occurred shortly after the shoe was changed, it is most likely responsible for the onset of the condition.
Even warts or muscular problems resulting from splayfoot can cause pain in this area. A running analysis and physical examination with a doctor can help to find out the exact causes of the symptoms.

Pain on the middle / outer ball of the foot

Pain on the outside and middle of the foot can generally be different.

Mainly responsible for pains of the football is, regardless of the exact localization, an overload of the affected area. Especially if the symptoms occur only at certain points of the football and possibly even on both feet this speaks for a striking rolling behavior when walking and running which can be held responsible for the complaints.
Such a rolling behavior can be accurately diagnosed with a running analysis and treated by means of deposits. Other causes that cause pain only on the outside and in the middle of the football are the wearing of inappropriate shoes or performing special activities that particularly stress these areas.

Even a malposition of the hip can cause a false burden of football and cause such pain. Especially if the pain does not disappear even after a long time and no obvious cause for the symptoms can be found, it is advisable to visit a doctor who can find the individual diagnosis and initiate a suitable therapy.

Pain in the ball of the foot and big toe

When the big toe is in pain this may have different causes depending on the symptoms. Common cause of a sore big toe is an acute attack of gout which causes severe pain due to uric acid crystal deposition in the joint. In an acute attack of gout, in addition to the pain, other symptoms such as swelling of the toe and redness of the area occur.

Other causes that can lead to pain in the area of ​​the big toe are warts and colloquially referred to as corns skin lesions. In addition, there may be pain in unfavorable rolling behavior and an overload of the foot area on the big toe. When changing the shoes and the activity or sport practiced should be critically questioned whether on the one hand, the technique is carried out correctly and the footwear fits to the respective foot.

In addition to the correct size of the shoes should be paid to special features such as special shoes for lowering or spreading feet.

In the case of chronic pain in the ball and big toe, it is also necessary to think of osteoarthritis, which is called hallux rigidus.

Pain on the ball of the foot and toes

Strictly speaking, the toes do not belong to the area of ​​the sole of the foot known as the ball of the foot.

However, since these are directly adjacent to the ball of the foot and contribute to the natural rolling movement of the foot, these are often affected by pain in an overload of the foot. Pain on the toes, however, may have other causes as well as being overburdened by a conspicuous unrolling of the foot.
So, especially the choice of shoes is essential for a painless walking and running.

In addition to the correct size of the shoes, the shape of the sole is also crucial. A treadmill analysis can help to find the right model when buying a shoe. Diseases such as the colloquially referred to as a corn borer skin lesions also often occur on the toes and can cause discomfort. The same applies to warts in the area of ​​the toes and the transition between the ball of the foot and the toes. In the case of complaints that persist for a longer period of time, a doctor should be consulted so that not only the diagnosis can be started, but also treatment of the symptoms.

Pain on the ball of the foot and metatarsus

The term "football" describes anatomically the region of the sole of the foot, which has contact with the ground during the typical rolling movement in the front foot area.

The foot itself consists of a variety of different bones and muscles.
A certain area of ​​the foot, which lies behind the toes, is called the metatarsus. This area is formed by five metatarsals ( Os metatarsalia IV ). A number of different muscles run in this area of ​​the foot and allow a smooth movement of the toes. They are therefore essential for the rolling of the foot while running. Pain, which arises in the area of ​​the metatarsus, can be different causes.

Thus, a simple overuse of the muscles and tendons in the area of ​​the metatarsus can cause severe pain. This is also the most common reason for complaints in this area.

In addition, high-impact metatarsal injuries may cause fractures of the metatarsal bones. Especially in the colloquial " kinking " it can come to these breaks. A metatarsal bone fracture is usually accompanied by severe pain, swelling and bruising in the affected area. If these concomitant symptoms fail, a bone fracture is unlikely. For longer-lasting complaints, it is advisable to visit a doctor, who can find the cause of the symptoms as well as initiate a suitable therapy.


The treatment depends on the cause of the pain in the ball of the foot and includes conservative, medicinal or surgical measures.

Pain that occurs after overworking or overuse of football, often disappears by itself and can be alleviated by immobilizing the foot. Furthermore, the use of cold or heat for the treatment of pain in the ball of the foot into consideration.

If the pain in the ball of the foot causes inflammation, anti-inflammatory and pain-relieving medicines such as diclofenac can be used in the form of tablets or ointments.

If a bone tumor is responsible for footpad pain, surgical removal of the tumor is often the method of choice. Deformations of the foot can also be corrected during surgery.


The prognosis depends on the cause of the pain in the ball of the foot. Pains in the ball of the foot, which result from incorrect loading or overloading of the football, often disappear after a short time by themselves.


The best way to prevent pain in the ball of the foot, in which one avoids overuse of the football. If a heavy burden of football, for example, a hike planned, so you can avoid the emergence of pain in the ball of the foot by wearing suitable footwear.

Figure pain in the ball of the foot

Pain in the ball of the foot: Right sole (A) and right foot from above (B)

Pain in the ball of the foot
(Ball of the foot is part of the sole of the foot)

  1. Toe end member -
    Phalanx distalis
  2. Big toe joint -
    Articulatio interphalangea
  3. Toe element -
    Phalanx proximalis
  4. Toe joints -
    Articulation of metatarsophalangeae
  5. Big toe
  6. Metatarsal bones -
    Os metatarsi
  7. Small toe pads
  8. Sole of the foot -
    Planta pedis
    - Overload or overuse
    of footballing (hike,
    long standing)
    - wrong footwear
    - strong overweight
    - Disease of the toe joints
    (Inflammation, wear or breaks)
    - gout (deposition of uric acid crystals)
    or rheumatic disease
    - Bone tumor

Figure pain ankle

Figure foot pain

Foot Pain

  1. Achilles tendonitis /
    Achilles tendon rupture
  2. Bone fracture - toes,
    Metatarsal, tarsal bones
    (here outer ankle fracture)
  3. Ligament extension / ligament tear
    at the ankle
  4. Lower and upper heel spurs
  5. Hammer toes and claw toes
    ( Deformities of the toe bones)
    Digitus malleus
  6. plantar warts
    Verrucae plantares
  7. Hallux valgus -
    (Deviation of the big toe
    in the base joint)
  8. Hallux rigidus -
    (Joint wear of the
    Metatarsophalangeal joint)
  9. Inflamed nails / nail fungus
  10. Osteoarthritis / Arthritis -
    degenerative change of
    Joint / inflammation of the joints

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