What is foot pain?
Pain in the foot can arise from several different causes. Foot pain causes include conditions affecting any of the structures in the foot, including the skin, nerves, muscles, joints, tendons, bones, ligaments, blood vessels, and connective tissue. Trauma or injury is a common cause of foot pain. Even everyday situations, such as overuse or poorly fitting shoes can lead to temporary, acute pain in the feet.
Foot pain can be described as sharp, stabbing, dull or throbbing. It can also feel like a tingling or burning sensation (paresthesia), which is common in conditions like diabetes that can damage the peripheral nerves (peripheral neuropathy). Foot pain may be mild to severe in intensity and occur only at certain times of day or when you perform certain activities. Moving your foot or ankle may either worsen or relieve the pain. With severe pain related to traumatic injuries, it may be impossible to move the affected foot at all.
In some cases, foot pain is localized in one foot (unilateral). It may occur only in one area, such as foot pain in the arch. It can also occur on the top of the foot (dorsum), the bottom of the foot (plantar surface), the heel, the ankle, or the toes. Plantar fasciitis is an example of a condition in which pain is felt primarily at the bottom of the heel.
Foot pain may be recent in origin (acute) or develop over time (chronic). In some situations, foot pain can occur because of chronic medical conditions you may have that affect your entire body, such as arthritis, vascular disease, or diabetes.
Although life-threatening complications of foot pain are rare, seek immediate medical care (call 911) for injuries that involve profuse bleeding or tissue damage. In rare cases, infections of the bone (osteomyelitis) or skin and soft tissues (cellulitis) of the foot can spread throughout the body, resulting in shock and organ failure. Another rare but potentially life-threatening cause of foot pain is cancer of the bones or soft tissues in the foot.
If your foot injury or condition is persistent, recurrent, or causes you concern, seek prompt medical care.
What other symptoms might occur with foot pain?
Foot pain may be accompanied by other symptoms, depending on its cause and any underlying diseases or conditions. Some conditions that frequently affect the feet, such as peripheral vascular disease or diabetic neuropathy, can cause symptoms in other body systems.
Foot symptoms that may occur along with foot pain
Pain in the feet may accompany other symptoms affecting any of the structures of the foot including:
Bleeding or bruising
Burning or tingling sensation (paresthesia)
Difficulty moving the foot, ankle or toes
- Swelling (edema) of the foot or joints
Other symptoms that may occur along with foot pain
Foot pain may accompany symptoms related to other body systems including:
Serious symptoms that might indicate a life-threatening condition
In some cases, foot pain may occur with other symptoms that might indicate a serious or life-threatening condition that should be immediately evaluated in an emergency setting. Seek immediate medical care (call 911) if you, or someone you are with, have any of the following symptoms:
What causes foot pain?
Injury or damage to any of the structures in the foot can cause foot pain. Diseases that affect the entire body, such as diabetes, arthritis, or vascular disease, are more complex processes that can lead to foot pain.
Causes of foot pain by location
If foot pain is localized, the location offers some clues as to the possible cause:
Arch of foot: flat feet (fallen arches from aging or overweight), overpronation, plantar fasciitis
Bottom of heel: plantar fasciitis and bone spurs are common causes; as well as, plantar warts
Side of the foot: broken foot bone or foot sprain
- Top of foot: arthritis, stress fracture, cyst
Traumatic causes of foot pain
A number of common injuries can cause foot pain including:
Injuries related to overuse
Sprains and strains
- Stress fractures
Inflammatory causes of foot pain
Inflammation can cause foot pain that is restricted to one foot or even a specific location on one foot. Examples include:
Bursitis (inflammation of a bursa sac that cushions a joint)
Gout (type of arthritis caused by a buildup of uric acid in the joints)
Peripheral neuropathy (disorder of the peripheral nerves that lie outside your brain and spinal cord)
Plantar fasciitis (inflammation of the thick, fibrous tissue on the bottom of the foot)
Tendinitis (inflammation of a tendon)
Rheumatoid arthritis (chronic autoimmune disease characterized by joint inflammation)
- Vasculitis (inflammation of the blood vessels)
Infectious causes of foot pain
Infectious processes can also cause foot pain including:
Cellulitis (skin and soft tissue infection)
Osteomyelitis (bone infection)
- Plantar warts (caused by papillomavirus infection)
Other causes of foot pain
Foot pain can also be caused by problems that affect multiple body systems including:
Benign or malignant tumors
Buerger’s disease (acute inflammation and clotting of arteries and veins)
Diabetes (chronic disease that affects your body’s ability to use sugar for energy)
Loose fragments of bone or cartilage within joint spaces
Peripheral artery disease (PAD, also called peripheral vascular disease, or PVD, which is a narrowing of arteries due to a buildup of fat and cholesterol on the artery walls, which limits blood flow to the extremities)
- Raynaud’s phenomenon (spasms of small blood vessels of the fingers and toes, reducing blood circulation; has no known cause)
Serious or life-threatening causes of foot pain
Although life-threatening causes of foot pain are rare, all serious injuries, including foot injuries, should be immediately evaluated in an emergency setting.
When should you see a doctor for foot pain?
Minor foot pain usually resolves with self-care treatment at home. However, sometimes it is best to see a doctor to determine if an injury or other condition is present.
Make an appointment to see your doctor if mild foot pain persists for more than a couple of weeks despite home treatment. You should also see your doctor for foot pain with burning, tingling or numbness.
See a doctor promptly when:
Foot pain is severe or starts suddenly.
Foot pain occurs with swelling that does not improve within a few days.
You have an open sore or wound on the foot that is not healing.
- You have diabetes or another condition that affects feeling or blood flow in your feet.
Call 911 or go to your nearest emergency room for foot pain when:
You can see a deformity in the foot or a bone protruding through the skin.
You cannot bear weight on the foot, walk on the foot, or move the foot.
You cannot feel your toes or foot.
You have a fever or redness, swelling or warmth in the area.
- You have sustained an injury or trauma to the foot.
How do doctors diagnose the cause of foot pain?
During a foot pain diagnosis, your doctor will take a medical history, perform a physical exam, and perhaps order tests.
Questions for diagnosing the cause of foot pain
Your doctor may ask you several questions related to your foot pain including:
How long has your foot pain been present?
Where exactly do you feel the pain?
Is your pain constant or does it come and go?
What other symptoms are you experiencing, such as numbness or tingling?
When do your symptoms occur?
Are your symptoms worsened or relieved by movement or specific activities?
Have you had a recent injury?
- What medical conditions do you have?
Physical exam and tests for diagnosing the cause of foot pain
The exam will involve checking your foot and comparing it to the other one. Your doctor will look for problems, such as a high arch, limited motion in your ankle, swelling, areas of pain or tenderness, and pain that worsens with certain movements. Your doctor may also check the sensation in your foot.
Your doctor may need to order testing to diagnose the cause of your foot pain. Tests mainly involves imaging exams including:
Foot X-rays to look for problems with the bones and joints, such as fractures, spurs, and other abnormalities
- MRI (magnetic resonance imaging) to examine the soft tissues in the foot, such as ligaments and tendons. MRIs may also find tiny fractures before they show up on an X-ray.
It is not always possible to diagnose an underlying cause or condition. If the problem persists and your provider is unable to determine a cause, seeking a second opinion may give you more information and answers.
How do you treat foot pain?
Since foot pain is a symptom, the treatment depends on the underlying cause and the severity of the pain. The treatment goals include relieving the pain and correcting any underlying physical problem. Most often, doctors start with conservative treatments including:
- Immobilization with a medical walking shoe or boot or a cast
- Crutches to keep weight off the foot if necessary
- Medications to relieve pain and swelling, including NSAIDs (nonsteroidal anti-inflammatory drugs), such as ibuprofen (Advil, Motrin) and naproxen (Aleve), and corticosteroid joint injections
- Night splints
- Orthotics, pads or shoe inserts to improve foot alignment and comfort
- Rest, ice and elevation to relieve pain and reduce swelling due to minor injuries
Physical therapy can be useful for treating foot pain. It is especially helpful for overuse injuries and soft tissue problems, such as plantar fasciitis and Achilles tendon injuries. It also helps relieve overly tight muscles in the feet. Physical therapists will teach you specific exercises for your type of foot pain.
For some types of foot pain, doctors may ultimately recommend surgery.
What are some home remedies for foot pain?
Home remedies are often effective for minor foot pain relief. This includes:
Rest: Avoid activities that trigger or worsen your foot pain. Allow time for your foot to heal before returning to these activities. See your doctor if pain recurs when you resume an activity.
Ice: Apply an ice pack to your foot for 20 minutes at a time to reduce pain and swelling. Repeat the cold application several times a day.
Elevation: Prop your foot up as much as possible to reduce swelling.
Heat: Some people find heat to be more soothing for foot pain. However, heat is not helpful for swelling. To use heat, soak your foot in a warm bath or apply a warm compress.
- Over-the-counter pain relievers: Take NSAIDs to relieve pain and swelling from minor injuries. If you cannot take NSAIDs, acetaminophen (Tylenol) may help with pain. It will not help inflammation.
Footwear is important when you have foot pain, as are proper exercise techniques. Additional foot pain relief strategies include:
Maintain a healthy body weight.
Replace running shoes and athletic shoes often and on a regular basis.
Stretch regularly, especially after exercise, focusing on your plantar fascia, Achilles tendon, and calf muscles.
Warm up and cool down before and after exercise. Cross-train with a variety of exercises to avoid overuse injuries.
Wear properly fitting shoes with arch support, cushioning, thick soles, and a wide toe box. Avoid shoes with high heels and narrow, pointy toe boxes.
- Wear sneakers when walking.
What are the potential complications of foot pain?
Managing the underlying causes of foot pain can, in many cases, prevent the development of serious complications, such as joint deformity, widespread infection, gangrene, or even amputation. Left untreated, long-term complications, such as infection throughout the body or gangrene of the feet, can be life-threatening.
Possible complications of untreated foot pain, depending on the cause, include: