Ball screws, as critical components in high-precision transmission systems, are prone to performance degradation due to minor faults. To address the high deployment cost of traditional vibration sensors and the insufficient positioning accuracy of existing algorithms, this paper proposes a ball screw fault detection and localization method based on motor control signals. By analyzing the servo motor's q-axis current and built-in encoder angular position signals, the proposed method employs Time Synchronous Averaging (TSA) to extract periodic components from angle-resampled current signals. The deterministic signal is derived, and the residual signal is computed to construct a comprehensive Health Indicator (HI) combining average kurtosis and centroid frequency. Through lead segmentation analysis, fault localization is achieved without external sensors, making it suitable for compact industrial equipment. Experimental results demonstrate that the method successfully locates wear faults near the 80th lead on a ball screw testbed. Compared to vibration-based monitoring, this approach leverages control bus signals, offering a cost-effective solution for ball screw health monitoring by eliminating the need for external sensors. Future work will explore fault compensation strategies via control-diagnosis synergy to maintain operational precision.