What Causes Foot Pain?

For most people, maintaining healthy feet isn’t a top concern — until they experience foot pain. Pain can occur due to a number of foot problems, from short-term injuries to chronic conditions like arthritis.

Here’s what you should know about the most common causes of foot pain, and what to do if they affect you.

Foot pain can occur due to a long list of health conditions. “The foot has so many bones and joints and tendons, the possibility of what can go wrong is almost endless,” says Alexander Peterson, MD, an orthopedic surgeon at Keck Medicine of the University of Southern California.

Here are some of the most common causes of foot pain.

Plantar Fasciitis

Achilles Tendinitis

Bunions

Metatarsalgia

Your metatarsals are the bones in the front of your feet, below your toes. When this area of your foot (sometimes called the ball of the foot) becomes inflamed, you can develop pain and irritation.

Neuromas

A neuroma develops when the tissue surrounding a nerve thickens, which can cause stinging, burning, or numbness in affected areas. A common form is called Morton’s neuroma, which affects the front, or ball, of your foot, often between your third and fourth toes, but it can occur in between any of the toes.

Bone and Ligament Injuries

Arthritis

• Osteoarthritis This form of arthritis can cause pain and stiffness in any area of your feet and ankles.

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   The big toe and midfoot are the most commonly affected areas, according to Peterson.
• Psoriatic Arthritis This condition often causes pain in the back of the heel or bottom of your feet.

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• Rheumatoid Arthritis This form of arthritis can cause pain and swelling in any area of the feet and ankles, and usually affects both feet.

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Not every form of foot pain can be prevented, but there are steps you can take to avoid conditions related to overuse or other types of injury.

“Maintaining good foot health is all about prevention, common sense, and wearing appropriate shoes for the planned activity,” says Elizabeth Bass Daughtry, DPM, a podiatrist at Foot & Ankle Specialists of the Mid-Atlantic in Dunn, North Carolina.

• Prolonged standing
• Older age
• Overuse due to activity
• Obesity
• Wearing tight, high-heeled, or unsupportive footwear

Women are at higher risk for bunions, largely due to footwear choices. “Really tight shoes, especially with an elevated heel, put a lot of pressure on the big toe joint and can lead to weakening of the ligaments on the inner aspect of that joint,” says Peterson.

Wear wide, supportive shoes. A wide toe box can help your feet move naturally and avoid excessive rubbing, while arch support can help prevent some types of straining. “Not all arch supports are created equal,” says Dr. Daughtry. “Just as some shoe brands and styles are more comfortable for you, they may not work for the next person.”

If you sometimes wear shoes that aren’t designed for activity, Daughtry recommends keeping athletic shoes on hand — such as in your car or backpack — in case you end up doing unplanned walking or standing.

Warm up and stretch before exercise or physical activity. Stretching your calves may help prevent Achilles tendonitis, while warming up in general can help prevent injury to your feet and ankles.

Replace athletic shoes regularly. It’s important to wear shoes that aren’t too worn out, and can provide the support and cushioning you need.

Maintain a healthy body weight. Overweight and obesity lead to greater stress on the joints and other structures of your feet.

“For most problems, the reason to come in would be if you’ve modified your activities to avoid the pain, but the pain sticks around and it’s affecting what you want to do,” says Peterson.

• You have foot pain following an injury
• You have sudden, severe foot pain
• Your foot pain doesn’t improve after 2 weeks
• You experience redness, swelling, or fever
• You have diabetes and foot pain
• You have an open wound on your foot
• You can’t walk or put weight on your foot
• You experience ongoing tingling, burning, or numbness

At your appointment, your doctor will ask about your symptoms and examine your foot thoroughly. If you have a problem that could require complicated treatment, your doctor may refer you to a podiatrist or other foot specialist.

In addition to going over your symptoms and medical history, and examining your foot, many podiatrists will take an X-ray of your foot in a standing position, says Daughtry.

“I spend a lot of time doing a physical exam” to locate problems, notes Peterson. “The difference between an injured structure and an uninjured structure can be just a few millimeters.”

Sometimes, Peterson says, imaging beyond typical X-rays may be needed, such as an MRI or CT scan.

• Rest Take a break from activities that make your foot pain worse.
• Ice Applying ice for 15 to 20 minutes a few times daily can help with redness and swelling.
• Heat Applying heat can help with stiffness and soreness.
• Elevation Keeping your feet raised while you sit can help reduce swelling.
• Soaking Similar to applying heat, soaking your feet in warm water can ease soreness.
• Massage For stiff or sore feet, try massaging them or rolling them on a tennis ball.

“There are topical preparations of anti-inflammatories that can be very effective in the foot and ankle because a lot of the structures that are injured are very close to the skin surface,” says Peterson.

Your doctor may prescribe or recommend certain devices for your foot pain. These include:

• Orthopedic boots or ankle braces for injuries
• Toe spacers for bunions
• Metatarsal pads to help with foot alignment
• Orthotic insoles (inserts) for greater support

Many over-the-counter orthotic insoles are adequate for most people who need extra foot support, but prescription insoles could be beneficial for severe cases, says Peterson.

• Physical Therapy You’ll learn exercises that can help with strength and flexibility in key areas.
• Shock Wave Therapy Focused sound waves are used to create low-level damage that promotes healing.
• Casts or Splints These may be needed for bone fractures when a boot isn’t enough to immobilize your foot.
• Steroid Injections Targeted injections of corticosteroids can help reduce pain and swelling.
• Surgery “For certain injuries, surgery is the best treatment,” says Peterson, such as some bone fractures and dislocations.

Even if you don’t have any foot problems right now, it may be worthwhile to think about how to prevent future sources of foot pain.

• Stretching
• Wearing comfortable, supportive shoes
• Maintaining strong, healthy bones

“If I could have every patient do one thing for prevention, improving the flexibility of your calf can have a really positive effect on a lot of different parts of the foot and ankle,” says Peterson. Doing so may help prevent Achilles tendonitis, plantar fasciitis, and metatarsalgia.

• Getting enough calcium in your diet
• Getting enough vitamin D
• Avoiding tobacco
• Drinking alcohol in moderation, if at all
• Staying physically active

• Foot pain can be caused by sudden injuries, overuse injuries, or chronic health conditions.
• Self-care measures like rest or applying ice can be beneficial for many sources of foot pain.
• See a doctor if your foot pain doesn’t improve with self-care or is sudden, severe, or accompanied by redness and swelling.
• Wearing comfortable and supportive shoes, stretching, and maintaining healthy bones can help prevent conditions that cause foot pain.