Forefoot Pain | Capsulitis
Experience Podiatrists in Woodbury Heights, Haddon Heights, Voorhees, & Pine Hill, NJ
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Your forefoot is the front part of your foot. Composed of ligaments, tendons, muscles, nerves, blood vessels, and bones, it's essential for normal walking, running, and jumping.
The metatarsal bones (also known as the metatarsus) are located between the phalanges,
(toes) and the tarsal bones (the mid-foot and hind-foot). Between the tarsals and the metatarsal are the tarsometatarsal joints.
Several conditions mentioned below can impact the structures of the anterior part of the foot
Metatarsalgia
It is an umbrella term referring to pain in the ball of the foot. It is typically triggered when the metatarsal heads become tender and prominent. Pain is usually centered on one of the metatarsal bones. It can be caused by:
Calluses. Additional weight or pressure from a callus can cause significant pain in the metatarsal bone.
Bunions. These are bony deformities at the base of the big toe, causing pain and discomfort when the first metatarsal bone struggles with extra weight.
Hammertoes. Caused by an imbalance of the tendons, hammertoes push the metatarsal bone into the ground. The increased pressure can cause pain.
Other causes. Intense athletic training, obesity, high-heeled shoes, stress fractures, inflammatory arthritis, and overpronation.
Metatarsalgia treatments typically involve orthotics and other practice measures. The underlying condition should also be resolved, such as corn removal surgery or bunionectomy. Afterward, the pain will likely also subside.
Sesamoiditis
It is an inflammation of the sesamoid bones and tendons in the ball of the foot caused by repetitive strain. The sesamoid bones are two pea-sized bones under the big toe joint.
They provide leverage when weight is loaded onto the ball of the foot — essential for running, dancing, jumping, and walking in high heels.
When the sesamoid tendons are overused, it results in forefoot pain. Common symptoms include:
Pain under the big toe
Inability to bend the big toe
Swelling
Redness
Bruising
In addition to sesamoiditis, a stress fracture can also occur. If a fracture is suspected, your podiatrist will order an x-ray or CT scan for confirmation. Treatment involves RICE (rest, ice, elevation, and compression) alongside NSAIDs for pain and inflammation relief.
Your podiatrist may also refer you for physical therapy to improve recovery and restore your range of motion.
Toe Pain
It is a common presentation of metatarsal pain with several potential causes, including:
Osteoarthritis
Gout
Hammer, claw, or mallet toe
Pseudogout
Corns and calluses
Ingrown toenails
Morton's neuroma
It occurs when the tissue thickens around one of the nerves leading to your toes — especially between your third and fourth toe. It can cause burning pain in the ball of your foot alongside stinging or numbness.
Please refer to our Nerve Pain Management page for further information about identifying and treating neuromas.
Capsulitis
It is an inflammatory condition affecting the outer lining of the joint, known as the joint capsule.
The joint capsule is a type of ligament surrounding all joints. In the foot, the metatarsophalangeal (MTP) joints in the ball of the foot are most likely to be affected — in particular, the second toe MTP joint.
When the capsule becomes inflamed, patients may complain of:
Pain in the ball of the foot
Swelling of the foot
Shooting sensation in the bottom of the foot
A feeling of a stone or marble in the shoe
Foot capsulitis is also referred to as "predislocation syndrome," as, if left untreated, the condition will worsen, affecting joint stability. The unstable second toe can drift over, eventually laying on top of the big toe.
In such circumstances, additional pain and swelling are common — as well as an increased risk of bursitis and calluses.
Treatment of this foot condition involves offloading the pressure from the front part of the foot. Metatarsal pads and forefoot gel cushions are frequently used to redistribute some of the weight.
Custom shoes or inserts are another option to lessen the pressure on the ball of the foot.
In addition, NSAIDs, like ibuprofen, are administered to soothe inflammation and relieve forefoot pain. Corticosteroid injections may also help reduce pain in the short term.
Your podiatrist at Prime Foot Ankle Specialists will likely employ taping or splinting techniques to secure the toe into its proper position, preventing further drifting.
However, should the second toe continue to drift, surgical intervention becomes necessary to revert it to its normal alignment.