Pain in the ball of the foot may be due to "pre-dislocation syndrome", inflammation of the joint under the second toe on the bottom of the foot. This pain may be confused with a neuroma, inflammation of a nerve between the toes. The injury can happen suddenly or over a long period of time. Certain activities like downward dog pose, cross country skiing, or lunges can make it worse due to bending the toes. Patients often have a bunion or arthritis of the big toe joint causing overloading of the second metatarsal phalangeal joint. The second toe is not as strong as the first toe and does not do well with the increased stress and strain. If left untreated the second toe can drift toward the big toe or become completely dislocated crossing over the big toe.
Some treatments to try before making an appointment.
take anti-inflammatories like ibuprofen for 2 weeks
ice the area
avoid activities where you bend or go up on your toes
change shoes...Hokas sneakers and Oofos sandals are a good choice
OTC inserts like Powersteps Protech with a metatarsal pad
If you have tried these home therapies and continue to have pain, we can help!
We diagnose the condition based on an exam, where the pain is located is the biggest clue. X-rays will evaluate the joint alignment and any arthritis of the big toe joint. We have a diagnostic ultrasound to help evaluate a neuroma, inflammation, or a tear of the soft tissue. If there is inflammation in the joint, we recommend class IV laser therapy and taping the toe weekly with Kinesio tape for 4- 6 weeks. We do not recommend steroid injections due to the possibility of rupturing or injuring the small muscles that stabilize the toe. It is important to identify and address the problem early to prevent dislocation of the 2nd toe. Once the pain is resolved patients transition to custom-molded orthotics to address the faulty mechanics that created the problem.
If you or someone you know has pain in their feet or ankles Dr. Michele Kurlanski is here to help. Call us today at (207) 774-0028 to schedule your next appointment at our location in Scarborough, Maine!
