Pain in outside ball of foot when walking

Metatarsalgia is the name for pain in the ball of the foot.

It affects the metatarsals, the bones connecting the ankle bones to the toes. They're a common source of pain because they support your weight when you're standing, walking and running.

Metatarsalgia can have a number of different causes, including wearing unsupportive footwear, conditions such as arthritis, and doing high-impact sports.

It can be very uncomfortable and interfere with your normal activities, but will often improve with some simple self-help measures.

This page covers:

Symptoms of metatarsalgia

What causes metatarsalgia?

Treating and preventing metatarsalgia

When to get medical advice

Symptoms of metatarsalgia

Metatarsalgia tends to develop gradually over time.

It may be felt in a small area of the foot, or across the whole width of it. One or both feet may be affected.

The pain of metatarsalgia is sometimes described as:

• a burning or aching sensation
• a shooting pain
• tingling or numbness in the toes
• a feeling like there's a small stone stuck under the foot

Metatarsalgia tends to be worse when you're standing, walking or running.

What causes metatarsalgia?

Metatarsalgia is usually the result of increased pressure on the ball of the foot.

Some common causes of metatarsalgia include:

• badly fitting footwear – high-heeled or restrictive shoes can force the ball of the foot into a small amount of space, which puts more pressure on that area
• high-impact sports – sports like running or tennis put extra pressure on the feet
• being overweight or obese – this can also increase the pressure on the feet
• an unusual bone structure in the feet – having narrow, high-arched or flat feet can increase the chances of metatarsalgia
• joint and foot conditions – including arthritis, gout, bunions, bursitis, Morton's neuroma, hammer toes, and stress fractures

Metatarsalgia is also more common in older people and people with diabetes.

Treating and preventing metatarsalgia

The following measures will often help improve metatarsalgia and stop it coming back:

• rest your feet – put your feet up regularly and avoid activities that make the pain worse; try low-impact activities such as cycling or swimming instead of sports that involve a lot of running or jumping
• use an ice pack – apply an ice pack to the affected area for about 20 minutes several times a day (a bag of frozen peas will also work); make sure you wrap it in a towel so it doesn't damage your skin
• change your footwear – try flat shoes that have plenty of room for your feet and have a well-cushioned sole; replace any worn out shoes as they could make things worse (read more about choosing sports shoes and trainers)
• use shock-absorbing pads or insoles – these can fit inside your shoes to help cushion your feet; they're available from pharmacies and sports shops, or can be bought online
• maintain a healthy weight – adopting a healthy, balanced diet and doing regular low-impact exercises can help you lose weight if you're overweight
• take paracetamol or ibuprofen to help relieve pain and swelling if necessary

Try these measures for a few weeks to see if your symptoms improve.

When to get medical advice

You can usually treat metatarsalgia at home without seeing your GP.

However, you should get medical advice if:

• the pain doesn't improve despite trying self-help measures
• the pain significantly interferes with your normal activities
• you develop sudden and very severe foot pain or a change in the shape of your foot – this could be a sign of a more serious problem that requires immediate treatment

Your GP can arrange a number of tests to check for any underlying problems, such as X-rays, scans or blood tests.

They can also refer you to a health professional that specialises in foot care, such as a podiatrist, (also known as a chiropodist), physiotherapist, or foot and ankle surgeon.

These specialists may recommend additional treatments, such as custom-made insoles (orthotics), foot and ankle exercises, steroid injections or, in rare cases, surgery.

1. Home
2. Diagnosis Guide
3. Side Foot Pain

Written By: Chloe Wilson BSc(Hons) Physiotherapy
Reviewed By: FPE Medical Review Board

Pain on the outside of the foot is a common problem. 

The pain may be on the inner side of the foot (medial foot pain) or on the outer side (lateral foot pain). 

Symptoms may have come on gradually over time, or developed suddenly with an injury. 

Thinking about the location and onset of side foot pain can give us a good indication of what the problem is.

So let's have a look at the most common causes of pain on the side of the foot.

Ankle Sprain

Ligament tears account for 85% of all ankle injuries and are the most common cause of pain on the outside of the foot. 

Cause: Rolling over on ankle

Symptoms: Side foot pain, swelling, bruising, instability

Full Article: Ligament Sprains

Cuboid Syndrome

Cuboid bone shifts out of position, subluxes. Often goes undiagnosed causing ongoing pain.

Cause: Inversion injury (ankle sprain) or repetitive strain

Symptoms: Pain on outside of foot, worse in the morning or when when walking/running esp. on uneven ground

Full Article: Cuboid Syndrome

Peroneal Tendonitis

Repetitive tension through the peroneal tendons causes inflammation & degeneration.

Cause: Frequent overuse e.g. long distance running, abnormal foot position, muscle imbalance, ankle injury

Symptoms: Gradual onset lateral foot pain, worse with activity, hurts to twist foot

Full Article: Peroneal Tendonitis

Stress Fractures

Small break in one of the foot bones that if left untreated can cause long-term problems.

Cause: Repetitive overloading in sports, running and jumping, sudden increase in activity

Symptoms: Progressive pain, worse with activity, localised swelling, tenderness

Full Article: Foot Stress Fractures

Foot Bunions

Bunions are a common cause of deformity and pain at the big toe, aka hallux valgus, or little toe, aka bunionette

Cause: Genetics, tight-fitting shoes with pointed toes or high heels, flat feet, arthritis

Symptoms: Big toe rotates inwards, increasing pain and deformity, toes may end up crossing-over each other, redness

Full Article: Bunions & Bunionettes

Foot Corns & Calluses

Corns & calluses are thick, hard, raised areas of skin that frequently develop on the side of the feet and toes

Cause: Excessive friction on the skin from tight shoes, foot deformities, aging

Symptoms: Callus - thick, hardened skin, usually painless. Corns - small, circular areas raised skin, yellow/white, painful

Full Article: Corns & Calluses

Posterior Tibial Tendonitis

Irritation and inflammation of posterior tibial tendon which supports the inner foot arch

Cause: Repetitive overuse e.g. running, jumping or injury

Symptoms: Pain on the inner side of the ankle and foot, worse with activity, flat feet

Full Article: Posterior Tibial Tendonitis

At The Doctors

Any new incidence of pain on the outside of the foot that doesn't settle down within a few days should be assessed by your doctor. At your appointment the doctor will:

• Take A History: Asking lots of questions to find out e.g. when & how the pain on outside of foot started, how it's behaved since, any other symptoms, anything that makes it better or worse and pain severity
• Examine Your Foot: Looking at the appearance, movement, strength, functional activities involving the foot e.g. walking, special tests e.g. to look at integrity of the ligaments
• Order Further Investigations: If they feel there may be bone damage you will be sent for an xray. Soft tissue injuries may require ultrasound, CT or MRI imaging. You may also be sent for a blood test
• Treatment: Once the doctor has identified what is causing your pain on the outside of your foot, they will advise you on appropriate treatment e.g. exercises, physiotherapy, orthotics or rest.

If you have injured your foot, have severe foot pain, are unable to walk, have lost sensation in your foot, or your foot has changed colour, see your doctor immediately.

Treating Pain On Outside Of Foot

The best treatment for pain on the outside of the foot will depend on what is causing it and what stage you are at in the healing process.

• Rest Ice Compression Elevation: Generally, the best place to start is with RICE - a combination of resting from aggravating activities, regularly applying ice, wearing a compression bandage to reduce swelling and support the foot and elevating the leg to help reduce swelling.

  When used properly, RICE helps to reduce further damage, speed up healing and reduce pain and inflammation. LEARN MORE >

• Physical Therapy: As well as advising you on rehab, your physical therapist may also carry out other treatments such as ultrasound or acupuncture for pain on outside of foot. They can also advise on orthotics and whether special shoe insoles will help
  
  
• Exercises: After a few days, any swelling should have started to go down and in most cases you can start some gentle foot and ankle exercises. This helps you to regain the full range of movement and strength, aids healing by bringing fresh nutrients to the injured area and puts the right stresses and strains through the soft tissues so that they heal fully in the correct position. 

  People are often unsure what exercises will help and worry about overdoing things so it is really important to get the right advice. LEARN MORE >

• Crutches: with severe pain on outside of foot, it may help to use crutches for a few days to take the weight off the foot
• Surgery: In some cases, foot and ankle surgery may be advised for your lateral foot pain if other treatment methods have failed

You can find out more about specific treatment techniques for each of the different causes of pain on outside of foot by reading the full articles about your specific foot problem.

What's Causing My Side Foot Pain?

So as you can see there are lots of possible causes of lateral foot pain each of which present slightly differently: 

• Pain on Outside of Foot: ligament tear (sprain), stress fracture, peroneal tendonitis, cuboid syndrome
• Pain on Inner Side of Foot: bunion, posterior tibial tendonitis
• Hard, Thickened Skin: corns and calluses
• Twisted Foot Inwards: ligament sprain, cuboid syndrome
• Pain Developed Gradually: tendonitis, stress fracture
• Ongoing Pain after Ankle Sprain: cuboid syndrome
  
  
• Pain Worse With Activity: stress fracture, tendonitis, cuboid syndrome
• Pins & Needles or Numbness: nerve problem
• Swelling or Bruising: ligament sprain, stress fracture
• Pain Worse When You First Get Up: cuboid syndrome
• Abnormal Toe Position or Hard Lump: bunions
• Difficulty Standing On Tiptoes: posterior tibial tendonitis, cuboid syndrome

If you have noticed a lump on the side of your foot which may or may not be painful, check out the Lump On Side Of Foot article.

What Next?

If you are having trouble working out what is causing the pain on the outside of your foot, or your foot pain is more widespread, visit the foot pain diagnosis section for help working out what is going wrong.

If you want to find out more about treatment options, including the best exercises to regain strength and function, visit the foot pain treatment section. Don't let your pain on outside of foot get you down, take back control today.

Related Articles

Page Last Updated: 10/11/22
Next Review Due: 10/11/24

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