By the time the average person reaches the age of 50, they have logged an estimated 50,000 miles on their feet. Considering that fact, it’s no surprise most people will experience foot pain at some point. If you have pain in any part of the foot, a proper diagnosis is essential. Foot problems that go untreated can lead to more severe pain and issues with movement and function.
Learn more about the different types and common causes of foot pain so you can take the first “step” toward treatment and relief.
A basic knowledge of the anatomy of the foot is helpful to identify the source of your foot pain. One of the more complex parts of the body, the foot is comprised of 26 bones that are connected by joints, muscles, tendons, and ligaments.
The foot is divided into three sections:
• Forefoot: consists of the five toes (phalanges) and five long bones that connect the ankle to the toes (metatarsals)
• Midfoot: consists of several bones that form the arch, including the cuneiform, cuboid, and navicular bones
• Hindfoot: consists of the heel bone (calcaneus) and the talus bone that join to form the ankle
Muscles, tendons, and ligaments are located along the surface of the foot and work in concert to produce the movements that allow for motion and balance. Certain nerves in the foot control movement, while others provide sensation.
Pain can affect the entire foot or just a single area like the toes, ball, arch, or heel. It is possible for pain to radiate along the nerves between the back and foot as well. Foot pain may be related to traumatic injury, overuse, or disease and feel like burning, aching, or stabbing and be constant or occur during certain movements. Pain is often accompanied by other symptoms like numbness or tingling.
Pain in the heel of the foot has several possible causes. Heel spurs and plantar fasciitis are two of the most common.
A heel spur is a bony, calcium deposit that forms over time on the underside of the heel bone, often caused by wear and tear on the muscles and ligaments of the foot. Athletes who jump or run for long periods of time are at risk of developing heel spurs, as are people who wear ill-fitting shoes, people experiencing obesity, and those with gait differences that put excess pressure on the heel bone.
Not all heel spurs cause foot pain. People with heel spur pain describe it as a sharp stabbing on the bottom of the foot that is worse first thing in the morning and after sitting for extended periods of time.
Heels spurs are often associated with plantar fasciitis, another condition that causes pain in the heel and sometimes the arch of the foot. Plantar fasciitis is a degenerative irritation of the plantar fascia, the thick band of tissue connecting the heel bone to the base of the toes.
An elevated BMI, poorly-fitting shoes, gait issues, and excessive low or high arches are all risk factors for plantar fasciitis as they contribute to excess strain and overuse on the fascia. Heel pain and tenderness are common plantar fasciitis symptoms and can often be managed with physical therapy and other conservative treatments.
The arches of the human foot serve an important purpose. They support the weight of the body and like a spring, they absorb the shock produced during locomotion. People have different arch types (normal, high, and low) and may have arch pain if they aren’t wearing the right shoe for their arch type.
Fallen arches or “flat feet” aren’t necessarily a medical diagnosis, however they are an anatomical condition that may contribute to nerve pain, plantar fasciitis, and other conditions. Someone with fallen arches has no arch, causing their entire foot to flatten when touching the ground. Without that “spring” to absorb the shock during motion, someone with flat feet may have pain and other symptoms (although many have no symptoms at all.)
Fallen arches are common and generally occur when the arches are not formed during child development or when the tendons of the foot are damaged through injury. Arch supports, rest, ice, and muscle strengthening and exercise through physical therapy can all be effective to manage foot pain from flat feet.
The ball of the foot is the soft padded area of the sole located between the arch and the toes. It is a common site of pain because many movements and activities place excess stress on this area.
Metatarsalgia is an overuse injury which causes pain and inflammation in the ball of the foot. Symptoms typically develop over time in people who engage in activities that put excess pressure on a certain part of the foot. Pain from metatarsalgia can feel like a burning sensation, a dull ache, or a sharp, stabbing feeling.
Risk factors for metatarsalgia include high-impact sports, weak or tight toe muscles, gait differences, and toe fractures. High heels and other shoes that don’t properly support the entire foot can also lead to pain. Rest, exercise, and other conservative therapies can reduce discomfort and inflammation due to metatarsalgia.
Morton’s neuroma is another common cause of pain in the ball of the foot. This condition most often affects the area between the third and fourth toes and is described as feeling like one is standing on a pebble in the shoe.
Other symptoms include sharp burning, stinging, and/or numbness in the ball of the foot. High heels or tight-fitting shoes may cause Morton’s neuroma and switching to lower, more comfortable footwear is often enough to relieve pain.
The sesamoid bones are two small bones located just under the big toe joint. They are connected to the tendons in this area and experience stress that occurs during activities that transfer weight to the ball of the foot. Overuse of the tendons that surround the sesamoid bones can cause pain, bruising, swelling, and difficulty standing or walking associated with sesamoiditis.
Recovery with physical therapy, rest, ice, and other nonsurgical treatments can take anywhere from days to months. In rare cases, surgery to remove the sesamoid bones may be necessary if nonoperative measures are ineffective.
Now let us touch on conditions that cause pain in other parts of the foot and some linked to generalized pain and inflammation throughout the entire foot.
Physical therapy has two main goals: to address pain and other physical symptoms, and to increase function in the muscles and joints of the affected area. Your therapist has a wealth of knowledge and tools at their disposal:
Every physical therapy care plan is unique and designed to address the patient’s unique symptoms and health goals. One patient may be rehabbing from a sports injury, while another is learning to stay active and reduce pain while managing a chronic illness, for example. Physical therapy is a noninvasive alternative to surgery and/or opioid pain medication that helps patients feel and move better.
Many people with foot pain find that temporary rest and modifying activities help relieve symptoms. Over-the-counter pain relievers, orthotic shoe inserts, and ice are also affective for temporary relief of mild pain. It is important to know when to see a healthcare professional for foot pain to prevent your condition from getting worse and affecting your ability to get around.
See your healthcare provider if you have a sudden injury, open wound, or intense pain that comes on suddenly. Anyone with a medical condition that affects blood flow should also contact their healthcare professional. Fever associated with foot pain is another symptom that should be checked out.
We don’t often think about how important our feet are until they become painful. Something as simple as an ingrown toenail can quite literally keep you off your feet. The good news is, many foot issues can be improved through noninvasive methods. Talk to your physician and schedule a physical therapy screening to manage your pain and improve your comfort and mobility. Find a physical therapy clinic near you.
