11 most common cause(s)
You probably don’t pay attention to your feet as you walk around throughout the day, but you definitely notice every step when you have pain. Foot pain is a very common problem. A survey from the American Podiatric Medical Association showed that 77% of American adults have experienced foot pain.
The foot is a complex structure, made up of 26 bones held together by joints, ligaments, and muscles. What that means is that there are many things that can go wrong. Some are minor, such as ingrown toenails or warts. Others are caused by wear-and-tear that occurs with aging or playing sports.
Foot pain may also be caused by trauma (like a fracture or tendon injury), damage to the nerves in your foot, or joint conditions like arthritis and gout.
Treatment often includes rest, over-the-counter pain medication, and wearing a brace or cast. Surgery is sometimes necessary to relieve the pain.
Causes
1. Ankle or foot sprain
Symptoms
- Pain in the ankle or the arch of the foot
- Pain with weight-bearing activities or being unable to bear weight
- Swelling
- Bruising
An ankle or foot sprain occurs when you overstretch or tear your ligaments, which are the strong, fibrous bands of tissue that hold the bones together at your joints. Foot sprains are common on the outside of the ankle and in the arch of the foot. A sprain usually happens while you’re playing a sport or doing an activity that involves a lot of pivoting or twisting, like football or dancing.
Sprains can take weeks or months to recover. Treatment usually includes rest, immobilizing your ankle or foot, over-the-counter or prescription pain medication, and possibly surgery if the ligament tear is severe.
Pro Tip
Your feet are so important for living a normal, healthy life! If you have foot pain that doesn’t improve within about a week, make sure you get checked out by a doctor! —Dr. Anne Jacobsen
2. Plantar fasciitis
Symptoms
- Sharp pain on the bottom of your foot near the heel that improves with walking
- Pain when stepping down first thing in the morning
- Pain after sitting for a long time
Plantar fasciitis is a common cause of heel pain. It happens when the plantar fascia, a thick band of tissue on the bottom of your foot, becomes inflamed. Plantar fasciitis can be caused by repetitive exercise like running or simply by standing for long periods of time. Symptoms can become chronic, and walking differently to compensate for the pain can lead to pain in other parts of the body, like the knees, hips, or back.
You can treat plantar fasciitis at home, though it can take months for symptoms to go away. Treatment includes ice, anti-inflammatories such as ibuprofen, stretching, and avoiding repetitive pounding activities like running or jumping. Surgery is rarely needed but may be necessary if you don’t respond to other treatments.
3. Morton’s neuroma
Symptoms
- Burning pain in the ball of the foot
- Pain that worsens when you wear shoes
- Numbness in your toes
Morton’s neuroma is a thickening of the fibrous tissue around a nerve in the ball of your foot. It most commonly develops between the third and fourth toes and can be caused by trauma, irritation, or pressure on this part of the foot. Morton’s neuroma is more common in women over 45 and can develop from wearing high-heeled shoes.
Treatment includes wearing better-fitting shoes, with a lower heel, that don’t compress the nerve. Wearing orthotics (shoe pads) can also take pressure off the nerve. Pain can be treated with over-the-counter pain medication or corticosteroid injections.
4. Ankle osteoarthritis
Symptoms
- Pain and stiffness in one ankle
- Swollen joint
- Difficulty walking
Arthritis means inflammation of the joints. It happens when the protective cartilage in the joint breaks down. Without enough cartilage, the bones begin to rub against each other, making the joint stiff and painful.
Because the feet and ankles have many small joints that carry the weight of your body, they’re often the first place where arthritis appears. Arthritis can also happen after an injury. Obesity is a risk factor because it adds stress to your ankle.
Ankle arthritis can’t be cured or reversed. Treatment includes physical therapy, over-the-counter pain medications, and glucocorticoid injections. If those don’t help with the pain, you may need surgery to repair the damaged joint.
5. Posterior tibial tendinopathy
Symptoms
- Pain and swelling of inner ankle and foot
- Pain that worsens with activity
- An outward turn of the foot while walking
- Loss of height in the arch of your foot
This condition affects the posterior tibial tendon, which attaches the calf muscle to the bones on the inside of your foot. It also provides stability and arch support. Posterior tibial tendinopathy (PTT) occurs when the tendon becomes inflamed or tears, usually from overuse or an injury caused by high-impact activities. Obesity is a risk factor because it puts extra strain on your tendons.
Treatment for PTT typically includes rest, over-the-counter pain relievers, orthotics, braces, and sometimes steroid injections into the damaged tendon. In severe cases, surgery may be necessary to repair the injured tendon, or replace it with a tendon from another part of your body.
6. Broken ankle
Symptoms
- Ankle pain after an injury
- Bruising
- Swelling
- Difficulty walking or inability to bear weight
Your ankle joint is where your foot meets the two long bones in your lower leg. A broken ankle occurs when one or both of these long bones breaks near your foot. Breaks usually happen from falls, missteps, or a serious trauma like a car accident.
Treatment for a broken ankle depends on which bone has been broken and the severity of the injury. You may have to wear a cast or boot to keep the broken bone from moving so it can heal properly. Your doctor may recommend surgery to insert pins, plates, or screws to hold the bones in place while you heal.
7. Flat feet
Symptoms
- Achy pain in the heel or arch of the foot
- Foot flattening with weight-bearing activities
- Tired feet after standing or exercising
Flat feet (pes planus) occurs when the arch of your foot is lowered. The entire sole of the foot touches the ground when standing. For some people, flat feet are genetic (their arch doesn’t develop as fully during childhood). But you can also develop flat feet in adulthood. Risk factors for flat feet include obesity, injury to your foot or ankle, rheumatoid arthritis, and diabetes.
Treatment usually starts with wearing orthotics inside your shoes for arch support. These can be purchased over-the-counter or you can get customized ones made by a podiatrist. You can also do stretches, and some people might need physical therapy.
Dr. Rx
You can prevent some (but not all) of these foot problems by wearing supportive shoes. If your shoes fit well and provide good support, you won’t experience pinching or rubbing, which can be the cause of some of these foot problems. —Dr. Jacobsen
8. Jones fracture (broken foot)
Symptoms
- Pain on the outside of the foot following an injury
- Bruising
- Swelling
- Difficulty walking
A Jones fracture is when the bone on the outside of the foot (the fifth metatarsal) is fractured. A Jones fracture can occur suddenly from a twisting energy or it may develop over time from overuse.
Treatment includes wearing a cast or boot that immobilizes your foot while the bone heals. Your doctor may also recommend surgery to insert a screw in your metatarsal bone to keep it in place.
9. Stress fracture (march fracture)
Symptoms
- Gradually worsening foot pain that’s more intense with activity
- Foot pain that may improve with rest
- Swelling
A stress fracture, or “march fracture,” is a tiny hairline break in the bones of the foot, most commonly the metatarsal bones. It’s caused by prolonged stress on the bone, usually from high-impact activities like running and jumping. Stress fractures are very common among athletes and can also occur in soldiers who spend hours marching, which is where it got its name.
Treatment includes rest, though you may still be able to do low-impact activities while the fracture heals. You may need to wear a boot or brace or use crutches to take pressure off your foot. Surgery may be needed to heal some types of stress fractures but is usually not necessary.
10. Peripheral neuropathy
Symptoms
- Burning pain in both feet that worsens gradually
- Numbness and tingling in both feet
Peripheral neuropathy is caused by damage to the peripheral nervous system, which sends signals between the central nervous system (the brain and spinal cord) and the rest of your body. It commonly occurs in the feet and may be caused by conditions such as diabetes or trauma. It is also linked to certain medications, including treatments for high cholesterol and heart conditions, chemotherapy drugs, and certain antibiotics.
Depending on the cause, peripheral neuropathy can be reversible. It’s treated by controlling any underlying condition (like diabetes) and avoiding medications that cause it. You may be given pain medication and sometimes anti-seizure or antidepressant medications. Physical therapy may help and sometimes surgery is needed.
11. Gout
Symptoms
- Pain in a joint, commonly the big toe joint
- Redness and swelling over the joint
Gout is a very painful form of arthritis that commonly affects the big toe. It’s caused by high levels of uric acid in your blood. This leads to the formation of tiny, sharp crystals that collect in your joints and cause pain and inflammation.
High uric acid levels can be caused by factors such as a diet rich in red meat and shellfish, drinking alcohol or beverages sweetened with fructose, being overweight, taking certain medications for high blood pressure, and medical conditions like diabetes and heart and kidney diseases.
Gout symptoms usually come and go. Treatment includes dietary changes, anti-inflammatory drugs, and medications that reduce uric acid production or improve your kidneys’ ability to remove it from your body.
Other possible causes
A number of conditions may also cause foot pain, including:
- Blisters
- Bruises
- Warts
- Ingrown toenails
- Corns and calluses
- Chronic conditions like peripheral artery disease or spinal stenosis
When to call the doctor
Most foot pain can be treated at home. But if the pain doesn’t get better after about 7 days of treatment, call your doctor or podiatrist.
Should I go to the ER for foot pain?
Go to the ER if you have foot pain and:
- A cold or pale foot
- Dark-colored toes or feet
- Sudden numbness or weakness
- Severe pain
- A serious foot injury
Treatments
Pro Tip
Patients often expect to have an X-ray when they have foot pain. But it’s not always necessary. The bones are only one of the many structures in your foot. If you didn’t have an obvious traumatic injury, it’s a lot less likely that the bones are causing the problem, and the soft tissue structures won’t show up on the X-ray. An X-ray doesn’t always have all the answers. —Dr. Jacobsen
At-home care
- Wear properly fitting shoes. They should be flat, comfortable, and have enough room for the widest part of your foot and your longest toe.
- Wash your feet with warm (not hot) water and a mild soap regularly. Be sure to dry thoroughly, especially between the toes.
- Trim your toenails straight across. Clipping the corners can lead to ingrown nails.
- Rest after physical activity.
- Use shoe inserts or orthotics to reduce the stress on painful areas of your feet.
- Ice your feet to reduce pain and swelling.
- Take over-the-counter pain relievers (NSAIDs) such as ibuprofen (Advil, Motrin) or acetaminophen (Tylenol) to treat foot pain.
Other treatment options
- Immobilize your foot with a splint, cast, or boot to promote healing of the injured area and reduce foot pain while the body heals.
- Take anti-inflammatory drugs to treat conditions such as gout.
- See a podiatrist to get a custom-made orthotic for your shoes.
- See a specialist like a rheumatologist or a vascular specialist if an underlying medical condition is causing your foot pain.
- Discuss surgery with your doctor if symptoms don’t improve with other treatments.
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