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Forefoot Pain

Forefoot Pain


Can be pain in the toes, the toe joints or as a result of the nail units impinging on the sulcus of the toes. This are of pain can also be pain in the ball of the foot and is then called metatarsalgia. The pain can be aching, stabbing, electric ‘like’, radiating, a dull pain or bruise ‘like’ pain.


Foot Wear

Forefoot pain is often caused by a poor choice shoe. Shoes that are:

  • Wide at the toe box
  • Deep enough to allow your toes to move around
  • Have an adjustable strap or lace across the mid-foot to stop the foot sliding forward
  • Have a firm and cushioning sole


High-heeled shoes are probably the worst type of shoes to wear if you have forefoot pain as they transfer all your body weight towards the forefoot. If you have to wear a high heeled shoe, wear one with an adjustable strap across the mid-foot. Gel pads for the forefoot can also help to alleviate pain in the ball of the foot.


Square forefoot shoes from the Mary Rose

Even the Tudors knew to wear sensible shoes as we can see here, an example from the recovered Mary Rose Warship. The front of the shoes are square, to accommodate the shape of the foot. Getting shoes quite as roomy as these can be difficult, but there are brands on the market that accommodate the foot to a large extent. We can discuss this when you arrive in clinic.




Can be either a soft tissue pain or a bony or osseous pain.


  • An irritated nerve, otherwise called a Morton’s neuroma
  • A torn or damaged plantar plate
  • Flexor or extensor tendinopathy
  • Distal plantar fasciitis
  • Intermetatarsal bursitis
  • Vascular malformation
  • Stress fracture
  • Plantar metatarsal pad bruising
  • Foreign body
  • Osteoarthritis of the metatarsal joints
  • Systemic inflammatory arthritis




  • Poor foot wear as mentioned earlier
  • The type of foot you have; foot posture – high or low arches
  • Standing for prolonged periods
  • Overtraining or training on hard surfaces alone
  • Moving from a ‘normal’ running strike pattern to a forefoot striking pattern
  • An accident or injury during sports
  • Jumping or cutting movement in sports
  • Getting older as the plantar fat pad reduces with age and provides less cushioning
  • Painful verrucae or corns


Gait Assessment for Forefoot Pain




At Lewisham Foot Health we treat forefoot pain by assessing the cause first. This may include a biomechanical assessment with gait analysis, and an orthopaedic assessment with ultrasound scanning to check for soft and bony tissue disease.


  • Foot wear modification
  • Chiropody
  • Activity modification
  • Orthotics or insoles
  • Foot and ankle mobilisations
  • Exercise prescription and home exercises
  • Shockwave treatment
  • Steroid injections


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