Foot pain is common and has a wide range of causes, including uncomfortable shoes, prolonged standing, athletic injuries, and chronic conditions such as arthritis.
The location of pain in the foot can sometimes indicate the underlying cause. However, it is not always possible to diagnose the cause of foot pain based on location.
Many conditions, such as arthritis, can affect multiple parts of the foot. Injuries, such as a broken bone, sprain, or strain, may also cause general pain or pain that migrates.
This article explores the likely causes of foot pain based on its location in the foot and explains when to consult a doctor.
Generalized pain in a single toe may be due to hammer toe. Hammer toe is a structural abnormality that affects the second, third, or fourth toe.
The affected toe bends downward and appears misshapen. It may appear swollen or discolored, and a person might not be able to straighten it. Hammer toe can also sometimes affect multiple toes.
A hammer toe occurs when there is an imbalance in the muscles, which often results from frequently wearing shoes that do not fit correctly or high heels.
Muscle-strengthening exercises and changing to more comfortable shoes may help. However, if the hammer toe does not resolve on its own, a person might need surgery.
Other causes of general toe pain could include:
- fractures
- soft tissue injury
- nerve damage
Many of the same conditions that affect the toes generally, such as broken bones, strains, sprains, and arthritis, can cause big toe pain.
However, if the pain is only in the big toe, and the top of the toe hurts most, the problem may be an ingrown toenail.
Ingrown toenail
An ingrown toenail occurs when the side edge of the toenail grows into the skin. This can be painful and may cause an infection or swelling. In some cases, it may hurt to walk on the affected foot.
When checking for an ingrown toenail, a person needs to check for swelling on one side of the toe and pain when pushing on the toenail.
It is important not to dig into the nail bed with scissors to cut out an ingrown nail. Instead, a person needs to visit a doctor who can remove an ingrown portion of the nail or offer antibiotics to treat an infection.
People can prevent future ingrown nails by avoiding cutting the toenails very short or at an angle.
Gout
Gout is a type of inflammatory arthritis that
- pain
- swelling
- hot or tender skin
The condition occurs when urate levels become too high, which can happen for a range of reasons. Crystal deposits form in the joints, causing painful flare-ups that last 1 or 2 weeks.
However, gout is one of the most manageable forms of arthritis, with early diagnosis and treatment. Options include medications to reduce pain and inflammation, drugs that reduce urate levels, and diet or lifestyle changes.
Muscle strains and sprains, minor overuse injuries, and tense muscles can all cause pain on the ball of the foot.
Several chronic conditions can also cause pain at the front of the foot, such as:
Bunions
A bunion occurs when excess bone grows on the side of the foot, below the base of the big toe. The big toe may then lean toward the other toes.
Bunions can cause pain and discomfort, particularly when walking or wearing shoes. They are more common in females and people with a family history of the condition. They may be a result of tiny injuries, such as from wearing heeled shoes, which put pressure on the balls of the feet.
Treatment may involve wearing wider shoes, or in some cases, surgery.
Morton’s neuroma
Morton’s neuroma refers to nerve pain from a benign tumor. A person may feel burning pain in the ball of the foot or in the toes.
Sometimes, the toes may feel numb or tingly. Morton’s neuroma is not cancer, and a person will not feel a bump or other signs of a tumor.
Changes in footwear, cortisone injections, physical therapy, and pain medication offer relief to most people. If these do not work, a doctor may recommend surgery to repair the nerve.
Freiberg’s disease
A rare condition called Freiberg’s disease, which usually appears in the teenage years, involves a reduced blood supply to the foot around the second or third metatarsal bones near the toes. Symptoms include swelling, pain, and stiffness at the front of the toes. It usually only affects one foot.
Medication and physical therapy can reduce pain and improve mobility. If these are ineffective, a doctor may recommend surgery.
Many conditions, including injuries to the ankle or surrounding joints, can cause pain that radiates to the heel.
Achilles tendinitis
Achilles tendinitis occurs when the tendon that extends down the back of the leg develops inflammation. This inflammation can be due to tight calf muscles, a calf injury, an increase in activity, or bone spurs.
Most people notice pain that is more severe in the morning and swelling that worsens with activity.
Various treatments can help with the pain, including physical therapy, cortisone injections, rest and ice, exercise, and pain medication.
In rare instances, a person may need surgery. In most cases, symptoms get better within 3 to 6 months of starting treatment.
Plantar fasciitis
Plantar fasciitis is inflammation of the plantar fascia, which is a thick band of tissue that extends from the heel to the toes. The pain is sharp and stabbing, often feeling worse in the morning or when beginning exercise.
Plantar fasciitis is more common in people who do intense or repetitive types of exercise, such as running. Other risk factors include:
- new or increased exercise
- prolonged standing, particularly on hard surfaces
- having flat feet or high arches
- tight calf muscles
- age, as most cases occur between 40 and 60 years old
- obesity
Most people recover within a few months by resting, icing, and stretching the affected foot, and 90% recover within 10 months.
A doctor may recommend physical therapy or cortisone injections if symptoms are persistent. Rarely, a person may need surgery to repair the plantar fascia.
Injuries to the muscles and tendons of the foot, unsupportive shoes, and overuse may cause pain in the arch of the foot.
For some people, fallen arches cause foot arch pain. People usually have fallen arches, or flat feet, when the tendons that support the arch of the foot weaken.
Doctors call this posterior tibial tendon dysfunction. Physical therapy, medication, injections, and, in some cases, shoe inserts may help.
Conditions that affect the heel, such as plantar fasciitis and tendinitis, may also cause foot arch pain.
Generalized foot pain or swelling could be due to many injuries or conditions, including:
- edema, which could occur due to heat, standing for a long time, or pregnancy
- circulation problems
- gout
- diabetic neuropathy
This list is not comprehensive.
Unless the pain is intense or a person has a high risk of conditions such as heart failure, foot pain, and swelling, it is not usually an emergency.
However, a person needs to contact a doctor right away if:
- one foot swells, and there is pain or swelling in the calf
- the feet swell suddenly and dramatically
- the feet or toes change color
- they feel short of breath
It is best to speak with a doctor about foot pain if:
- it does not get better with home treatment
- it worsens following surgery
- there is a family history of arthritis
Foot pain can make walking, sleeping, and daily tasks very painful. In severe cases, these activities may even be impossible.
Various treatment and management options are available, even for serious and chronic cases.
A person with persistent foot pain should not attempt self-diagnosis. Instead, they need to consult a doctor for a proper diagnosis and, if necessary, treatment.
