Few aches are as annoying and inconvenient as foot pain. After all, feet are the vehicles that move most people through their days, so it’s extremely noticable when they’re not performing at their best. According to the American Podiatric Medical Association (APMA), a whopping 77% of U.S. adults have experienced foot problems, which means that for a vast majority of us, doing things as seemingly basic as going for a walk may be a an unexpectedly big undertaking.
Meet the Experts: Rick Olderman, M.S.P.T., an orthopedic physical therapist in Denver, and author of Fixing You: Foot & Ankle Pain, Jeffrey A. Oster, D.P.M., a podiatrist in Newark, Ohio, Rachel Scott, a medical massage therapist in Lynnwood, Washington, Suzanne C. Fuchs, D.P.M., a holistic podiatrist and fitness specialist in New Hyde Park, New York, and others.
“The foot has almost as many bones as the hand and wrist, so it’s a complicated piece of real estate,” says Rick Olderman, M.S.P.T., an orthopedic physical therapist in Denver, and author of Fixing You: Foot & Ankle Pain. “Yet we don’t pay much heed to our feet until there are problems.”
The silver lining here is: If you have foot pain, you don’t have to suffer silently. “The first step in fixing chronic foot pain is to understand why you’re having it,” says Olderman. For answers, we break down the most common causes of foot troubles, below.
Foot pain causes
Here, the most common issues that may keep you from pounding the pavement, and what to do for happy feet once again.
1. Plantar fasciitis
“This is by far the most common problem I see in my middle-aged patients,” says Jeffrey A. Oster, D.P.M., a podiatrist in Newark, Ohio. Plantar fasciitis is an overuse syndrome that causes painful inflammation of the band of fibrous tissue that runs along the bottom of your foot (called the plantar fascia).
“You don’t find plantar fasciitis in children—they heal too quickly. And you don’t find it in older folks because they’re not out there doing activities that would contribute to it,” says Dr. Oster. But if you’re somewhere in the 40- to 65-year-old range, you may be more likely to experience heel pain, especially if you’re carrying extra pounds.
“The force on your feet is about 120% of your weight,” Dr. Oster says. “Over time, that causes the tissue in the foot to become less elastic,” he adds, leading to pain.
Foot fix: Massage and stretch your feet and calves.
Not only can a good massage help relieve inflammation by prompting a fresh supply of oxygenated blood to rush to the area, but it, in combination with stretching, may also lengthen the plantar flexor muscles, helping them move more freely and with less pain, says Rachel Scott, a medical massage therapist in Lynnwood, Washington.
“People tend to focus solely on the bottom of the foot and forget that the plantar fascia is part of a system that starts with the calf muscles and continues through the Achilles tendon,” says Scott.
And while buying shoes for plantar fasciitis or trying new insoles won’t cure your condition, it can certainly help make things more comfortable. Try these podiatrist-approved options—all of which have ample arch support, a firm but flexible midsole, and forefront cushioning:
2. Bunions
With bunions, a firm, painful bump develops at the base of the big toe, sometimes causing that toe to veer diagonally toward the second toe. Bunions can get worse if you consistently wear too-tight shoes, says Suzanne C. Fuchs, D.P.M., a holistic podiatrist and fitness specialist in New Hyde Park, New York. “These joints commonly become painful when shoes rub against them and cause inflammation, swelling, and redness,” she says.
Foot fix: Choose the right shoes.
To help prevent bunions in the first place, make sure you’re wearing shoes with a wider toe box, says Dr. Fuchs. There should be about a half-inch of space between the tip of your longest toe and the end of the shoe. “Your shoes shouldn’t cause too much pressure on your feet and toes or cause them to crunch up,” she says.
You might also add specific padding to help alleviate calluses (caused when these enlarged toe joints rub against your shoes) or talk to your doctor about adding orthotics to your shoes, says Dr. Fuchs. These prescribed inserts “can improve the biomechanics of the foot, helping to balance the muscles and tendons and stop bunions and hammertoes from worsening,” she explains.
3. Hammertoes
A hammertoe is a foot deformity in which there’s an abnormal bend in the middle joint of your toe. Hammertoes happen when there’s an imbalance in the muscles of your foot.
“You have muscles at the top and bottom of your feet. If one of those muscle groups is stronger than the other, it may result in a hammertoe,” explains Jacqueline Sutera, D.P.M., a podiatric surgeon at City Podiatry in New York City. The toe becomes crooked because one of the toe muscles becomes weak, which puts pressure on the tendons and joints in one or more toes. This causes the toe to stick up at the joint.
Dr. Sutera says that wearing poorly designed shoes that don’t fit your feet, incurring an injury such as stubbing your toe, and having a family history of hammertoe are common causes. People with hammertoe are also prone to developing corns and calluses, she adds.
Foot fix: Use non-medicated corn pads.
“I recommend my patients to use non-medicated corn pads because they provide support and cushion while helping to relieve pain and prevent friction,” Dr. Sutera says.
Medicated corn pads should be avoided in this case “because the acid in the medication can eat away at your skin and cause bacteria to form, which leads to an infection,” she says.
Dr. Sutera also recommends using shoes that are appropriately sized and are designed for the activity you’re doing. “Wear commuter shoes on your way to work, but don’t wear your high heels all day,” she says. If the issue worsens and you’re experiencing a lot of discomfort, Dr. Sutera says to consider surgery: “It takes 15 minutes, you’re under local anesthesia, and it’s covered by insurance.”
4. Flatfeet
Flatfeet occurs when the foot completely lacks an arch, meaning your entire foot touches the floor when standing. This is more common than you may think: About 18 million Americans deal with the uncomfortable condition.
Many people are born with flatfeet, but you can also develop it later in life due to direct trauma to the posterior tibial tendon, which is the tendon that attaches your calf muscles to the bones on the inside of your feet. “If you do high-intensity sports or exercise, the posterior tibial tendon can be overused and inflamed. You can develop flatfeet because of this,” Dr. Sutera says. She also says people with flatfeet are prone to developing plantar fasciitis and bunions.
Foot fix: Wear orthotics.
“The best thing to do is to wear appropriate shoes and orthotics, which forces your foot to walk with an arch,” Dr. Sutera says. “Orthotics will also help absorb shock from walking or running and help prevent pain in the ankles, knees, and back, which are affected with flatfeet.”
5. Calluses
While most of us think of these areas of thick skin as simply unsightly, calluses are pressure spots that can be painful when you walk, says Dr. Oster. Interestingly, they’re actually the body’s way of preventing painful blisters from developing. Without a callus, the pressure and friction would irritate your skin to the point of creating those painful, fluid-filled bubbles you know as blisters.
However, that doesn’t help if your calluses—oftentimes on the ball of the foot, the heel, or the top of bunions or hammertoes—keep you from walking or running around comfortably.
Foot fix: Soak, then soften.
To treat calluses at home, soak your feet in warm water and then apply a moisturizing lotion that’s loaded with glycolic acid, lactic acid, or urea (like Eucerin Advanced Repair Foot Cream). These ingredients can help soften the skin and minimize the callus. If your callus is especially large or painful, schedule an appointment with a podiatrist or dermatologist who can remove it with a surgical blade or administer a shot of cortisone if your pain is particularly bad.
6. Turf toe
Turf toe is a sprain of the main joint of the big toe, according to the American Academy of Orthopaedic Surgeons (AAOS). This can happen when the toe is forcibly bent up, like when you’re pushing off into a sprint and the toe gets stuck on the ground, says Miguel Cunha, D.P.M., a podiatrist and founder of Gotham Footcare.
“It can happen to any toe, but 90% of the time it’s the big one,” explains Melissa Lockwood, D.P.M., a podiatrist at Heartland Foot and Ankle Associates in Bloomington, Illinois, and a diplomate of the American Board of Podiatric Medicine. “It usually happens when you are trying to push off the big toe and another force—a person running into you, a car accident, riding a horse—pushes you down. It causes the ligaments around the joint to stretch and sometimes break. It is very painful.”
The injury actually got the name “turf toe” because it became more common in football players after artificial turf became popular on playing fields, the AAOS says. (Artificial turf is a harder surface than grass and it doesn’t have much give.) Turf toe can cause pain, swelling, and stiffness at the base of the big toe. “This develops slowly and progresses over time,” Dr. Cunha says.
Foot fix: Rest, ice, compress, and elevate your toe.
It’s an acronym known as RICE. “You want to make sure that your injury gets the rest it deserves, which also can protect it from further injury,” Dr. Cunha says. Icing it and compressing the injury (any wrap will do) can help tamp down on swelling and ease your pain, he says.
Finally, you want to elevate your foot (say, on top of a pillow) to ease the pressure. “Because your feet take on pressure that you don’t even realize, you want to pay close attention to making sure that you’re not further injuring yourself,” Dr. Cunha says.
7. Achilles tendonitis
Your Achilles tendon, which attaches to your heel bone at the back of your foot, can become irritated and inflamed when it’s overused, says Dr. Fuchs. The result is tendonitis, and runners are particularly susceptible, she says, as are those who regularly wear high heels. Other potential, though not as common, causes include inflammatory illnesses such as rheumatoid arthritis or gout.
Foot fix: Rest, ice, repeat.
The sooner you nip this problem in the bud, the better, Dr. Fuchs says, which is why she recommends avoiding any activity that aggravates your pain for a week to a month. When you feel even a little twinge, ice the area ASAP. Your doctor may also suggest you take a non-steroidal anti-inflammatory (like Motrin or Advil) to ease your discomfort and inflammation.
8. Metatarsalgia
“This is a common foot disorder that can affect the bones and joints at the ball of the foot,” Dr. Cunha says.
Most metatarsal issues happen when something changes in the way your foot normally works, impacting how your weight is distributed, Dr. Cunha says. This can put extra pressure on the ball of our foot, leading to inflammation and pain.
Sometimes one thing can cause metatarsalgia, but usually several factors play a role, like doing intense training. “Runners are at risk of metatarsalgia, primarily because the front of your foot absorbs significant force when you run,” Dr. Cunha says. “This condition commonly occurs when performing high impact activities, especially if your shoes are ill-fitting or are worn out.”
Foot fix: Get new shoes, consider orthotics, and rest up.
Your doctor will likely want to do an X-ray first to make sure your bones and joints look okay, and that you’re not actually dealing with a stress fracture, Dr. Cunha says.
If your shoes are worn out, it’s best to get a new pair. “Footwear designed with a high, wide toe box and a rocker sole is ideal for treating metatarsalgia,” Dr. Cunha says. “The high, wide toe box allows the foot to spread out while the rocker sole reduces stress on the ball of the foot.” Orthotics that are designed to reduce pain on the ball of your foot can also help, he says.
Other than that, resting, icing, and using oral and topical anti-inflammatories can help, Dr. Cunha says. If you do all of this and you’re still in pain, your doctor might recommend surgery. (It’s rare that it’s needed, though, Dr. Cunha says.)
9. Tarsal tunnel syndrome
Tarsal tunnel syndrome is actually similar to carpal tunnel syndrome—just in your feet. “Similar to carpel tunnel, it is caused by mechanics ‘pinching’ the nerve,” says Dr. Lockwood.
This can result in pain, numbness, and tingling, often due to a previous ankle injury or having flatfeet. “People with flatfeet are more susceptible to tarsal tunnel syndrome because the outward tilting of the heel that occurs with fallen arches produces strain and tension on the nerve,” Dr. Cunha says.
Foot fix: Rest, ice, and take anti-inflammatories.
RICE is a good solution, Dr. Cunha says, adding that “you can take anti-inflammatory medications to reduce inflammation.” Physical therapy may also help reduce your pain, and it also doesn’t hurt to get orthotics that can help support your foot’s arch and take the stress off of your tibial nerve (a major nerve of your lower body), Dr. Cunha says.
10. Morton’s neuroma
This condition causes pain in the ball of your foot that commonly radiates toward your third and fourth toes, says Dr. Fuchs. “It can feel as if you’re standing on a pebble that’s stuck in your shoe,” she says.
Dr. Sutera says Morton’s neuroma is often the result of wearing high heels or pointy, narrow shoes. “Your metatarsals, which are the bones in your feet, are compressed when you’re wearing tight shoes. They put pressure on the nerves around them, causing a sharp, stabbing pain,” she explains.
High-impact sports like tennis and running can also cause Morton’s neuroma. The repetitive pounding on hard surfaces can cause trauma to the nerves that lead to your toes. People who have bunions, hammertoes, high arches, or flatfeet are also at higher risk for Morton’s neuroma.
Foot fix: Try new shoes, custom orthotics, and possibly cortisone injections.
One thing you can do for quick relief is to massage the space between the metatarsals, Dr. Sutera says. “Take your thumbs and use them to massage the top of your foot and use your other fingers to put pressure at the bottom. Massage spaces in between your toes where the nerves live,” she says.
Make an appointment with your doc to do an X-ray to rule out other problems, and follow up with an ultrasound or MRI, which are better diagnostic tools for revealing soft tissue abnormalities. Then, you may be in for a shoe shopping spree, as ill-fitting shoes contribute to your problem and make the pain worse, says Dr. Fuchs.
“You might be able to try arch supports, foot pads, or custom orthotics, which will help contour and cushion your foot while you walk,” she says. Dr. Sutera also recommends wearing a variety of shoes and tossing out those with uneven or damaged soles. If these more conservative tactics don’t work, cortisone injections or even surgery to relieve the compression on the nerve could be options.
11. Arthritis
Arthritis happens when the cartilage in your joints begins to wear down and cause inflammation. When it comes to feet, it usually impacts the big toe joint, but it can also crop up in other joints, Dr. Cunha says.
Arthritis can usually be traced back to former injuries and traumas like broken bones and sprains, but one of the biggest factors is age, since your cartilage wears down over time, he explains.
Symptoms usually include tenderness and pain, stiff and swollen joints, and trouble walking or bearing weight.
Foot fix: Take anti-inflammatories, use orthotics, and undergo physical therapy.
There are a bunch of different treatment options when it comes to arthritis, and Dr. Cunha says a lot depends on where the arthritis is and how severe it is. Here are just a few to consider:
- Oral and topical anti-inflammatory or pain-relieving medications
- Steroid injections
- Custom molded orthotics
- A type of brace called an ankle-foot orthosis
- Physical therapy
- Maintaining a healthy weight
If you have arthritis and it doesn’t get better with more conservative treatments, Dr. Cunha says your doctor might recommend surgery.
12. Bursitis
When joints within the foot undergo repetitive motion or direct pressure, painful, fluid-filled sacs called bursae can develop, according to the APMA. They’re often caused by the frequent wearing of tight shoes, high heels, or long hours of standing. They can also cause general stiffness, swelling, and redness at the affected areas.
Foot fix: Adjust exercise practices, footwear, and reduce swelling with ice and anti-inflammatories.
The APMA stresses that foot pain is never normal, and therefore, if you think you have bursitis, you should see a podiatrist right away. Treatment plans may include wearing more supportive footwear, prioritizing foot stretches before exercise, and taking over-the-counter anti-inflammatories.
13. Stress fracture
It may seem obvious, but you’d be surprised by how easy it is to endure chronic pain that is actually a bunch of tiny stress fractures caused by overuse of the feet, usually in athletes. Research shows that stress fractures most commonly affect the feet, and often go undiagnosed or missed because pain discontinues with activity. The delay of treatment can make the prognosis much worse, so it’s crucial that the proper diagnostic steps are taken as soon as possible.
Foot fix: See a podiatrist ASAP.
After proper X-rays and imaging confirm the stress fractures, a podiatrist can provide a proper treatment plan that will likely include rest and keeping pressure off of the injury.
❗When should I see a doctor for foot pain?
Overall, if you have foot pain that persists and it’s bothering you, Dr. Cunha says you should at least talk to your doctor. That’s especially true if it’s impacting your quality of life, and doesn’t seem to be getting better. “We have lots of conservative, non-surgical ways to treat all of these problems,” Dr. Lockwood adds.