Foot Pad Pain

The foot pad, also known as the ‘ball of the foot’, describes the padded area on the underside of the forefoot close to the toes. Sometimes it is also referred to as the plantar fat pad. This is the layer of subcutaneous fat that runs along the ball of the foot, under the metatarsal heads to provide adequate cushioning and protection to these bones. Foot pad pain is very common, has multiple causative factors and affects millions of people worldwide.

It can cause significant pain and discomfort and is often difficult to treat effectively. Any pain experienced in this area is often collectively termed ‘metatarsalgia’ by many physicians which is a loose term meaning pain in the metatarsal area and is non specific. In this article we will explore the specific causes of foot pad pain or ‘metatarsalgia’ to help you understand more about this condition and what you can do to make your feet more comfortable.


Foot Pad Pain

The following conditions are frequently associated with pain in the pad of the foot or ‘metarsalgia’:

Plantar Fat Pad Atrophy – over time the fatty tissue in the pad of the foot can become worn down and thin. This is usually due to natural deterioration associated with the aging process and can result in the already prominent metatarsal heads becoming exposed. This can become extremely painful and often patients will describe feelings of walking on the bones or ‘walking on pebbles’. The plantar fat pad cannot be restored and you may further cushioning and protection to relieve pain and make your feet more comfortable. There are a number of different solutions available and I recommended the following:









Arthritic Conditions – many arthritic conditions such as gout, osteoarthritis and rheumatoid arthritis can cause deterioration in the joints of the toes and forefoot and this can manifest as foot pad pain. Rheumatoid arthritis can also directly cause fat pad atrophy, exposing the metatarsal heads causing further discomfort.

Toe Deformities – conditions such as claw toes and hammer toes that are very common in today’s society cause the toes to be pulled back, pushing the metatarsal heads down in to the foot pad resulting in greater pressure in this area during walking or running.

Corns/Callus – any increase in pressure or friction to the skin in the area of the plantar fat pad can result in the skin becoming thickened and tougher in these area. This is known as callus (or callous) formation and may be associated with some of the conditions mentioned here. The skin thickens in attempt to protect itself against these repeated stresses but as a result there is both inflammation and pressure on the nerve endings, contributing to foot pad pain. Over time, corns can develop at the area of greatest pressure and these are hard, thick masses of skin and can be very painful when they are present on the pad of the foot.

Sesamoiditis – the sesamoid bones sit under the first metatarsal and function to act as a channel for a tendon to run through. Sometimes, through an impact or repetitive stress injury, these bones can become damaged or displaces which can become painful. This pain can radiate through the entire toe and pain may even be felt on the top of the foot or inside of the foot.

Morton’s Neuroma – this is an entrapment of the nerve, usually between the 3rd and 4th metatarsal heads. Although this pain tends to be felt between the toes rather than on the pad of the foot, pain can radiate through the whole forefoot area. Further information on this condition can be found here.

These conditions, like many others, can be exacerbated (made worse) by wearing footwear that is ill-fitting or not fit for purpose. In particular, high-heeled shoes at the main offenders as they elevate the heel, forcing the entire load of the body to be borne on the forefoot which will undoubtedly worsen the pain. Shoes that are too tight in the forefoot area, don’t provide enough padding under the pad of the foot or have poor arch support can all also contribute to foot pad pain. This should not be overlooked as treatment efforts can be in vain without addressing this important issue of footwear.

Unfortunately, some people with this condition often have jobs that require them to spend a lot of time on their feet. This only serves to aggravate the symptoms even more. It is especially important these people to take extra measures to ensures they have the correct footwear that will cushion and protect the forefoot and fat pad. Alternatively you may considering using a ball of foot cushion or silipos metatarsal cushion to provide additional cushioning and protection to the pad of the foot.

Additionally, individuals who are overweight by even just a few pounds have increased odds of developing foot pad pain as the entire body weight is borne on the forefoot at certain points during the natural walking cycle. Often losing weight has a tremendous impact on the pain levels associated with this condition. Although some of the treatments that are accessible without a physician’s prescription are often an effective approach to treating this painful condition, if this condition becomes unbearable it is wise to seek treatment.