14 Reasons Your Feet Hurt–and How to Ease the Pain
What causes foot pain?
Our feet are the foundation for our entire body, and they serve us well—carrying us around 110,000 miles over an average lifetime by some estimates. But with 26 bones, 33 joints, and a network of more than 100 tendons, muscles, and ligaments, a lot can go wrong with these amazingly complex structures. Whether your heels ache or you have toe troubles, here’s how to step away from foot pain.
Heel pain: Plantar fasciitis
is the most common problem affecting the foot, according to the American Academy of Orthopaedic Surgeons (AAOS), and plantar fasciitis is the most common cause of heel pain. If the first step you take when you get out of bed in the morning feels like a sharp pain under your heel, you probably have plantar fasciitis, or inflammation of the plantar fascia, a thick band of tissue that connects the heel to the front of your foot and supports your arch.
Plantar fasciitis, which usually stems from repeated stress to the foot that strains the fascia beyond its normal extension, is often worse after long periods of inactivity and temporarily diminishes as you begin to walk around. “The fascia relaxes when you’re sleeping and the swelling kicks in more,” says Jacqueline Sutera, DPM, a podiatric surgeon in New York City. “Then, when you stand, you put all your body weight on this inflamed tissue.”
“Plantar fasciitis is aggravated by tight muscles in your feet and calves,” says Dr. Sutera, so stretch your Achilles tendon and calf muscles several times throughout the day. Treatments to reduce inflammation include rest (avoid activities that make the pain worse), nonsteroidal anti-inflammatory medications (NSAIDs), ice, and massage (rub lengthwise and across your arch, ideally after taking a bath or shower).
Wearing shoes (even slippers) with good arch support is also key, since supporting the arch takes tension off the fascia. Flip-flops, ballerina flats, and going barefoot are no-no’s. Your weight and gait may play a role too: In one study, were three times more likely to be obese and nearly four times more likely to have feet that roll inward more than normal, so consider orthotics to decrease strain on the plantar fascia.
If pain lingers longer than two weeks, see your doctor, who may recommend physical therapy, cortisone injections, or a night splint.
Heel pain: Heel spur
A heel spur is growth of extra bone that protrudes from the base or the back of the heel. It often occurs alongside plantar fasciitis, has similar symptoms (sharp pain at the back of the bottom of the foot), and responds to the same treatments, but—despite common belief—the conditions are not the same. In fact, heel spurs aren’t necessarily even a problem: According to the AAOS, while one out of 10 people have them, only one out of 20 people with heel spurs experiences foot pain.
While heel spurs by themselves may not be painful, these pointy calcifications can cause irritation in the surrounding tissue, including where the plantar fascia attaches onto the heel bone, says Dr. Sutera. Common causes of heel spurs are repetitive trauma to the base of the heel, obesity, poorly fitting shoes, or genetics. Treatment is rest, managing pain with NSAIDs, ice, and stretching, and correcting biomechanical problems with shoe inserts.
Bottom of foot pain: Plantar warts
Feel like you have pebbles in your shoe? Check the soles of your feet for plantar warts. Plantar warts are caused by an infection in the skin due to one of the many forms of human papillomaviruses (HPV). But unlike other types of warts, the plantar variety doesn’t grow outward; instead, the pressure from walking and standing causes them to grow into the skin, creating pain and tenderness on the bottom of your feet. You may develop just one wart or they may occur in a cluster (called mosaic warts). Because they’re flat and tough, it’s easy to confuse plantar warts for calluses. Warts are more likely to have black seed-like dots, which are small areas of dried blood.
Plantar warts can disappear with no treatment at all, but it may take several years. They don’t pose a serious health threat, but they can cause discomfort and pain, so you may want to speed their departure. Over-the-counter peeling medications or patches contain salicylic acid to gradually dissolve the dead cells of the warts.
If your wart doesn’t improve with home treatment, your doctor can try using liquid nitrogen to freeze it off or burning, scraping, cutting, or shaving it off. Warts are contagious, so to avoid getting or spreading them, wear flip-flops in locker rooms, don’t touch someone else’s wart, and—since moisture tends to allow warts to spread—keep foot warts dry.
Bottom of foot pain: Calluses
These thick, hard patches of skin form over time as part of your body’s normal protection against prolonged rubbing or pressure—the buildup helps protect the underlying skin. (Calluses are not to be confused with blisters, which have a watery liquid inside and tend to develop more quickly.) When calluses appear on the feet, they’re typically on the underside (sole), often on the ball or heel, and they can be painful when standing or walking. Ill-fitting shoes are frequently the culprit, but gait issues can create excess pressure that causes skin to thicken too.
To treat a callus, NYC dermatologist Sejal Shah, MD, recommends using a pumice stone to gently remove the buildup of dead skin after bathing. Be careful not to take off too much skin, which can cause bleeding and infection. Then apply a moisturizer with salicylic acid, urea, or ammonium lactate twice a day to the area to gradually soften tough skin. Avoid razors and scissors (you don’t want to cut into living tissue and expose it to infection!), and don’t use a medically treated pad unless your doctor advises you to. “Try to avoid any repetitive actions that may be causing the calluses,” advises Dr. Shah, who also suggests using cushioned pads to protect calluses from further irritation: Cut a piece of moleskin into two half-moon shapes and place them around the callus. To prevent future calluses, wear properly fitting shoes and consider orthotics to correct any gait abnormality.
Toe pain: Bunions
Unlike many foot problems, which are felt but not seen, it’s easy to spot bunions, the bony protrusions that form at the base of the big toe. Bunions are caused by faulty foot mechanics that affect the way you walk: Years of abnormal motion and pressure on the big-toe joint forces the big toe to tilt in toward the second toe. As the bones are progressively thrown out of alignment, the telltale bump appears. People with certain foot types—flat feet, low arches, or feet that roll inward—are most likely to develop bunions. Since the mechanical structure of your feet is often inherited, bunions tend to run in families.
The big-toe joint carries much of your weight while walking, so untreated bunions can cause severe and constant pain. The fluid-filled sac surrounding the joint can also become inflamed, compounding the problem. Symptoms mostly occur when you wear shoes that crowd the toes (think narrow, pointy shoes or high heels), which may explain why the American Podiatric Medical Association says that women are up to nine times more likely than men to develop bunions. To reduce pain, opt for shoes with a wide toe box and heels two inches or lower. Gel pads placed over bunions can cushion the area and reduce pain. Also helpful are ice, NSAIDs, and avoiding activity that causes pain, including standing for long periods of time.
For severely inflamed bunions, your doctor can inject cortisone right into the joint to reduce swelling and discomfort. If a bunion continues to worsen, becomes very painful, or begins to affect your mobility, you may want to consider surgery to realign the joint and shave off the protruding bone. Don’t wait too long though, advises Dr. Sutera. “Results may not be as good when the problem is too severe.”
Toe pain: Corns
Corns and calluses are essentially the same thing, except corns occur on parts of your feet that don’t bear weight, such as the sides or tops of toes. “They’re usually small and circular with a well-defined center that can be hard or soft,” says Dr. Shah, who notes that mushy corns tend to develop between the toes where the skin is moist and sweaty. Unlike blisters, which form quickly, corns develop over time as a result of repeated friction and can be painful when you walk or stand. Treatment is the same as for calluses: Buff to remove the buildup of skin and moisturize regularly to soften skin. Corns can form when too-long toenails force the toes to push up against your shoe, so keep your toenails trimmed to help prevent them.
Toe pain: Gout
Gout is a form of inflammatory arthritis that triggers a sudden episode of burning pain, stiffness, and swelling in a joint—often in the joint of the big toe. The guilty party in gout is an excess of uric acid, a substance that’s naturally found in the body. While your body is usually proficient at regulating the level of uric acid in your blood, too much can lead to the creation of crystals that are deposited in joints.
A gout attack happens when something (such as an evening of drinking) causes uric acid levels to spike or jostles the needle-like crystals in your joints. The pain usually strikes at night and intensifies over the next eight to 12 hours before easing after a few days. Gout is more common in men than women, and an unlucky 60% of people who have an attack will have a second one within a year. To prevent future attacks, your doctor may prescribe medication, as well as suggest lifestyle changes, including modifying your diet to lower your body’s level of uric acid.
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Toe pain: Hammertoes
If a toe (usually the second, third, or fourth) becomes bent upward in the middle in a V shape so it looks like it could hammer a nail, you’re said to have a hammertoe. This often occurs in conjunction with other toe problems, like bunions or corns on top of the bent toe where it rubs against your shoe. Hammertoes develop over time, often from wearing high-heeled or toe-cramping shoes that push toes into a flexed position. Initially, hammertoes are flexible and can be corrected; if left untreated, toe muscles are unable to straighten and the deformity can become permanent.
Step one to reducing the pain and stopping the progression of a hammertoe is to buy shoes with soft, roomy toe boxes that can accommodate the hammertoe. Placing cushioned pads on the tops of hammertoes may prevent or limit corns. Taping the bent and painful toe to a neighboring straight one (called “buddy taping”) or using straps and splints to keep a hammertoe in its correct place are also helpful. Exercises, such as using your toes to pick things like marbles up off the floor, can stretch and strengthen muscles. If conservative measures fail to alleviate pain, you may need surgery.
Toe pain: Ingrown toenails
Any toenail can become ingrown, but this painful problem is most common on the big toe. Ingrown toenails occur when the nail grows into the surrounding skin or when the skin on one or both sides of a nail grows over the nail’s edge. The toe might throb and become red and swollen. The real agony sets in if the skin around the toenail becomes infected, which can happen if the nail pierces the skin. “It causes so much pain with every step that people are literally tortured by it,” says Dr. Sutera.
She recommends treating ingrown toenail pain by soaking feet in warm water and Epsom salts to reduce inflammation. Then, gently nudge the skin away from the nail bed with a cotton swab and smooth the corner of the nail with an unused fine emery board. Swab the area with antibiotic cream. See a physician if there’s swelling, redness, pus, or increased pain; chances are the skin has become infected.
You might get an ingrown toenail after injuring your toe, but too-tight shoes and poor nail-grooming habits are the main causes of ingrown nails. To prevent future ingrowns, cut nails straight across and then file the corners into a slightly rounded shape—avoid “points” that can jab skin.
Toe pain: Osteoarthritis
Almost everyone will eventually develop some degree of osteoarthritis (OA), which is caused by the wear and tear on the cartilage that acts as a shock absorber between bones. As the cartilage breaks down, bones rub against each other, causing pain and restricting movement. The most common site of OA in the foot is in the joint at the base of the big toe, according to the AAOS. Adding insult to injury, a bone spur can develop where the bones rub together, and this overgrowth can keep the toe from bending as much as it needs to when you walk, resulting in a stiff big toe (technically called hallux rigidus).
There are many ways to ease the pain of OA, including NSAIDs, heat and ice, exercise and physical therapy, and losing weight. If you don’t find relief from these options, your doctor may recommend more aggressive treatment.
If you develop hallux rigidus, wearing the right shoes is important. Make sure they have plenty of room for your toes, and consider shoes with —some people find they relieve pain. You may need to avoid high-impact activities like running. If these remedies aren’t enough to reduce pain, your doctor may recommend cortisone injections or surgery to shave the bone or realign the big toe.
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Ball of foot pain: Fat pad atrophy
When the natural protective cushioning in the ball of your foot becomes diminished, it can feel like you’re walking on rocks or standing right on the bones of the ball of the foot. Ouch! Sadly, this thinning of the fat there is common and permanent: “Over time, you just wear out your fat pad and you can’t regrow fat,” says Dr. Sutera.
To prevent the problem and keep it from progressing, avoid anything that puts pressure on the balls of your feet. That includes wearing high heels and going barefoot, especially on hard surfaces like cement, stone, and tile. Choose supportive footwear and padded socks that cushion your feet and replace high-impact activities like running with swimming or cycling. Cushioned pads or insoles reduce pain, and since mechanical issues like having high arches or excessive pronation can exacerbate the problem, orthotics can help support the foot, absorb shock, and evenly distribute weight.
Ball of foot pain: Metatarsalgia
Metatarsalgia is a condition where the ball of the foot, the part of the sole just behind your toes, becomes painful and inflamed. It’s so-named because the pain strikes where the metatarsals (the bones in the midfoot that give your foot its arch) attach the toes to the rest of the foot. Over time, the area becomes tender, sort of like having a toothache, and may be swollen, though pain can also be sharp or burning. “Swelling occurs after a long period of time of wearing high heels or doing any kind of activity where you’re pounding on the ball of the foot,” says Dr. Sutera. The pain generally worsens when you stand, run, flex your feet, or walk and improves when you rest.
Treatment includes avoiding activities that cause pain, ice, compression, cushioned shoes (no going barefoot or wearing high heels!), and NSAIDs. If the pain doesn’t fade within a couple of weeks, see your doctor.
Ball of foot pain: Neuromas
Sometimes referred to as a “pinched nerve,” a neuroma is inflammation and/or thickening of tissue around the nerve between the base of the toes. People often describe the pain as being similar to having a stone in their shoe, but symptoms also include a burning sensation, tingling, or numbness between the toes and in the ball of the foot. The most common type of foot neuroma is Morton’s neuroma, which occurs at the base of the third and fourth toes.
Neuromas mostly occur in women who wear high heels, says Dr. Sutera, though they can also develop as a result of injury, repetitive stress, or foot abnormalities like hammertoes, bunions, flat feet, and high arches. Shoes with low heels and a wide toe box prevent strain, and OTC shoe pads reduce pressure. Rest, ice, and NSAIDs can temporarily alleviate pain. If left untreated, neuromas tend to get worse, so see a physician if you think you have one. Physical therapy and cortisone injections can help, but ultimately surgery may be necessary.
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Top of foot pain: Tendonitis
Inflammation of the extensor tendons that straighten the toes is a very common cause of pain on the top of the foot. “This area is very bony, so it’s easy for all the tendons there to become inflamed,” explains Dr. Sutera. “It could be from wearing strappy or badly fitting shoes, tying your laces too tight, walking too long—really anything that causes pressure, because the area is so sensitive.”
Treatments include rest (limit walking and standing until the pain is gone), ice, NSAIDs, and compression. Supportive shoes are a must: “This is not the time to be in heels or flats,” says Dr. Sutera. Once the pain has subsided, ease back into high-impact exercise. Tendonitis is often an overuse injury, and doing too much too soon increases the chances of re-injury. If self-care doesn’t help, your doctor may recommend physical therapy.