Types of Foot Pain
by Ricker Polsdorfer, MD
Because of the complex nature of the foot, it is subject to a wide variety of conditions.
Conditions That Occur Anywhere on the Foot
Tendinopathy is an injury to a tendon. A tendon connects muscle to bone and helps move joints. Tendinopathy includes:
Tendinopathy is generally the result of overuse or repetitive motion. The strain on the tendon causes tiny tears in the tissue that accumulate over time.
A sprain is a stretch or tear of a ligament. Ligaments bind bones to one another. Sprains can be caused by overstretching a ligament during activity, or it can occur during a traumatic injury, such as a fall. They vary in severity, up to and including a complete tear.
Fractures are broken bones. They can occur during athletic activity, be the result of a fall, or a traumatic accident. Fractures also occur as a result of conditions that weaken bones, such as osteoporosis. The severity of the fracture depends on the type and location of the break.
Infections that occur on the skin or in soft tissue can spread to the bones if left untreated. Infections that affect the foot can be bacterial, fungal, viral, or parasitic. Organisms can enter the body from a break in the skin as a result of a scratch, cut, or ulcer. People with diabetes have to be especially careful of any wound or injury to their feet. Signs of infection include warmth, redness, drainage, and discomfort.
Foot pain may be a sign of a more serious health condition that is affecting the entire body. Some examples include:
Corns and Calluses
Corns and calluses are thickened layers of skin. They are caused by irritation. The corn is usually cone-shaped and has a knobby core that points in. This core can put pressure on the thin skin under it and cause sharp pain. Corns can develop on top of or between your toes. Soft corns develop between your toes. They are kept flexible by the moisture from sweat. Calluses develop on the bottom of your foot. Corns and calluses develop as a result of friction from the toes rubbing together or against the shoe. Calluses can also develop anywhere on the foot.
Corns are a result of:
Calluses are a result of:
Note: If you have diabetes, having calluses is a strong sign of future ulceration, especially if you have a history of foot ulcers. Contact your doctor.
Bursitis of the Toe
Bursitis is an inflammation of the fluid-filled sacs that protect your toe joints, particularly the big toe. It often occurs as a result of irritation from rubbing.
Ingrown toenails can occur on any toe. They are most common on the big toe. They can develop due to tight-fitting or narrow shoes. These put too much pressure on the outside of your big toe. This forces the nail to grow into the flesh of your toe. Incorrect toenail trimming can also add to the risk of developing an ingrown toenail. Other conditions that can lead to ingrown toenails include:
A bunion is a painful swelling. It is the result of the movement of the base of the big toe away from the smaller toes. At the same time, the end of the big toe moves toward the smaller toes. This may cause the head of the metatarsal bone to stick out and rub against the side of your shoe. The tissue under it becomes inflamed. A painful swelling forms. Bone growth may occur at the site of irritation.
Bunions can be caused by a number of conditions:
A hammertoe is a permanent deformity of your toe joint. With hammertoe, your toe bends up slightly and then curls downward, resting on its tip. When forced into this position long enough, the tendons of your toe contract and it stiffens into a hammer, or claw-like, shape.
A hammertoe is most common in the second toe. However, it may develop in any or all of your 3 middle toes if they are pushed forward in a shoe and do not have enough room to lie flat.
Hammertoes are often caused by wearing shoes that are too short.
Forefoot Pain TOP
Neuromas occur when a nerve, or the tissue surrounding the nerve, becomes enlarged and inflamed. One symptom is a burning or tingling sensation. Another symptom is cramping in the front of your foot. This condition can be caused by:
Morton neuroma is the most common neuroma of the foot. It develops when the metatarsal bones in the middle toes pinch the nerve that runs between them.
A stress fracture in your foot usually occurs in one of the five metatarsal bones. It is most common in the second or third. These fractures are caused by overuse during strenuous exercise, particularly running and other high-impact aerobic sports.
Sesamoiditis is a condition involving the sesamoid bones. These are small bones under the head of the first metatarsal bone (at the base of the big toe). The sesamoid bones carry a great amount of weight. The bones and tissues around them can become inflamed and irritated. Sesamoiditis injuries are common among people who do high-impact activities. These include ballet dancing, running, and aerobic exercise.
When a cause cannot be determined, any pain in the ball of the foot is generally referred to as metatarsalgia. It is most likely caused by poor footwear or by high-impact activities. People with a high arched foot are more likely to develop metatarsalgia.
Midfoot Pain TOP
Tarsal Tunnel Syndrome
Tarsal tunnel syndrome results from compression of a nerve that runs through a narrow passage. It goes behind your inner anklebone down to your heel. It may be caused by injury to your ankle, such as a sprain or fracture. It may also be caused by a growth that presses against the nerve.
Pronation is the normal motion that allows your foot to adapt to uneven walking surfaces and to absorb shock. When you have too much pronation, the outside your foot turns upward. This flattens your arch. It also stretches and pulls the fascia. It can cause foot pain. It can also affect the way you walk. This can lead to problems in the hip, knee, and lower back.
Heel Pain TOP
The heel is the largest bone in the foot. Heel pain is the most common foot problem. It can occur in the front, back, or bottom of the heel.
Plantar fasciitis occurs from small tears and inflammation in the plantar fascia. The plantar fascia is a ligament-like structure that stretches from the heel to the ball of your foot. It supports the arch of your foot and helps to serve as a shock absorber.
Plantar fasciitis is usually a result of overuse during high-impact exercise and sports, especially running. Because the condition often occurs in only one foot, factors other than overuse may be responsible in some cases. Other factors that may increase the risk of this injury include obesity, tight calf muscles, poorly fitting shoes, or an uneven stride.
Pain is often mainly around the undersurface of the heel. It often spreads to your arch. The condition can be temporary. It may become chronic if you ignore it. Resting usually provides relief. The pain may return.
Heel spurs are bony growths that stick out from the bottom of the heel bone. They are parallel to the ground. The spur occurs where the plantar fascia attaches. The pain in that area is due to irritation of the attachment. There is a nerve that runs close to this area and may contribute to the pain which occurs. There are many people with heel spurs who have no symptoms at all.
Haglund deformity is a bony growth on the back of the heel bone. It irritates the bursa and the skin behind the heel bone. It is commonly called a "pump bump." It develops when the back of your shoe repeatedly rubs against the back of the heel. This irritates the bursa and skin that is over the bone.
Achilles tendinopathy is degeneration of the tendon that connects your calf muscles to your heel bone. There are two common types of tendinopathy: tendinosis and tendonitis. Tendonitis is an inflammation of the tendon. Although the term tendonitis is used more often, tendonopathies are more likely to be a tendinosis, with no inflammation. The tendon suffers excessive stress and internal injury. A small area undergoes degeneration. Small internal tears may develop. Achilles tendinosis occurs mostly in people who do high-impact exercise, particularly running, racquetball, and tennis. People with calf muscle tightness are at more risk.
A stress fracture can occur in the heel. It is caused by overuse during strenuous exercise, particularly running and high-impact aerobics. Stress fractures are common in military training.
Arch and Bottom-of-the-Foot Pain TOP
Flat feet is a defect of your feet that eliminates the arch. The condition is most often inherited. However, arches can also “fall” in adulthood. This condition is sometimes referred to as posterior tibial tendon dysfunction (PTTD). This occurs most often in women over 50, but it can occur in anyone. Overall, normally occurring flat feet in adults do not cause many functional problems.
Abnormally High Arches
An overly high arch can cause problems. This is also known as cavus foot. The cavus foot is much less common than the flat foot.
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Gout. EBSCO DynaMed Plus website. Available at: http://www.dynamed.com/topics/dmp~AN~T115215/Gout . Updated March 27, 2017. Accessed February 7, 2018.
Hallux valgus and bunion. EBSCO DynaMed Plus website. Available at: http://www.dynamed... . Updated November 22, 2017. Accessed February 7, 2018.
Hammer toe. EBSCO DynaMed Plus website. Available at: http://www.dynamed.com/topics/dmp~AN~T114646/Hammer-toe . Updated March 30, 2015. Accessed February 7, 2018.
Joint pain in the foot. Foot Health Facts—American College of Foot and Ankle Surgeons website. Available at:
...(Click grey area to select URL)
Accessed February 7, 2018.
Heel pain. Ortho Info—American Academy of Orthopaedic Surgeons website. Available at: https://orthoinfo.aaos.org/en/diseases--conditions/heel-pain/. Updated October 2017. Accessed February 7, 2018.
Pes planus. EBSCO DynaMed Plus website. Available at: http://www.dynamed.com/topics/dmp~AN~T114291/Pes-planus . Updated September 26, 2017. Accessed February 7, 2018.
Stress fractures. Ortho Info—American Academy of Orthopaedic Surgeons website. Available at: https://orthoinfo.aaos.org/en/diseases--conditions/stress-fractures/. Updated October 2007. Accessed February 7, 2018.
Last reviewed March 2018 by EBSCO Medical Review Board Warren A. Bodine, DO, CAQSM
Last Updated: 3/15/2015
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