Causes of Foot Pain

There are many causes of foot pain with approximately 20% of people suffering from some form of foot problem at some stage during their life. 

Pain in the foot may come on gradually over time or develop immediately due to a specific injury.  It can be caused by a medical condition such as gout, as the result from repetitive trauma, incorrect footwear or from a specific injury. 

Here you will find an overview of the most common causes of foot pain.  They have been linked into groups: bone problems, soft tissue problems (muscles, ligaments and tendons), nerve problems, skin problems, medical conditions, foot syndromes and other rare causes of foot pain to make it easier for you to find what you are looking for.  

Use the relevant links to find out more comprehensive information including the causes, symptoms and treatment options for each.

Bone Problems

The foot is made up of twenty six bones divided into three sections, the forefoot, midfoot and hindfoot.  If any of the bones sit slightly out of place, or parts of them grow abnormally or excessively, this can result in pain.

1) Bone Spurs

Heel bone spurs are a common cause of foot pain

Bone spurs develop when the body lays down extra layers of bone.  This is normally a protective mechanism in response to excessive friction on the bone.  Bone spurs may develop due to muscle tightness, friction from footwear or from repetitive overuse activities. 

The most common locations for bone spurs are at the back of the heel e.g. Haglunds Deformity or underneath the heel (in response to plantar fasciitis). 

You can find out more about these causes of foot pain, the symptoms and treatment options in the bone spurs section.

Bunions are common causes of foot pain

2)  Bunions

Bunions are most common around the big toe.  Instead of sitting straight, the big toe diverts inwards.  The joint and surrounding structures can become inflamed.  They are most commonly the result of wearing tight fitting shoes with a narrow toe box. 

You can find out about these common causes of foot pain, symptoms and treatment options in the Bunions section.

3) Os Trigonum Syndrome

Here, a small extra piece of bone behind the heel gets stuck in the ankle joint during plantarflexion, causing inflammation of the surrounding soft tissues.  It tends to affect ballet dancers and athletes who do repetitive plantarflexion movements.  Find out more about the causes, symptoms and treatment options in the Os Trigonum section.

4)  Mallet, Claw & Hammer Toe

The toes consist or two or three bones which should sit in an aligned position.  If one or more of the joints rests in a hyperflexed or hyperextended position, it can cause problems. 

Mallet Toe, Claw Toe and Hammer Toe are similar conditions but demonstrate slightly different toe joint positions.  They can develop due to neurological or muscular problems, but are frequently caused by wearing ill-fitting shoes.  Find out more about these causes of foot pain by using the links above.

5)  Fractures

Bones in the feet can break for a number of reason.  Fractures can occur when the bones are crushed by a heavy object or impact fractures can occur if you fall from a height, landing on your feet.   Another common cause of fractures is repetitive overloading of the foot, usually when playing sports resulting in a stress fracture.

Soft Tissue Problems

If problems develop in the muscles, tendons or ligaments, it can cause pain and weakness, making daily activities difficult.  Problems can develop from an injury, overuse, or may be related to a medical condition.

1)  Ligament Sprain

An injury to the ankle ligaments is known as a sprain

The most common ligament injury in feet is an ankle sprain.  This is when the foot is suddenly forced into an abnormal position which overstretches one of the ligaments. 

There are a number of ligaments around the ankle which are extremely important in providing stability for the lower limb. 

The most common of causes of foot pain from an ankle sprain is from sudden inversion (foot turning inwards).  There are three grades of ligament sprain, depending on how much of the ligament is damaged.  Effective rehab is essential to prevent long term instability around the ankle.  Visit the ankle sprain section to find out more.

2)  Foot Tendonitis

Tendonitis is one of the most common causes of foot and ankle pain. It occurs when one of the tendons (the structures that connect muscles to bone) are damaged.  This usually occurs either through repetitive overuse or from over stretching.  Small tears develop in the tendon resulting in inflammation.  If left untreated, the tendon can start to degenerate, which is known as tendonosis.  Tendonitis can occur in a number of locations around the foot including:

Achilles tendonitis is one of the common causes of foot pain

a) Achilles Tendonitis: occurs at the back of the heel.  It can develop in a couple of different locations, at the teno-osseous junction where the tendon attaches to the heel bone or at the musculotendinous junction when the calf muscle meets the Achilles Tendon.  It is one of the most common causes of foot pain at the back of the heel

b)  Peroneal Tendonitis: occurs towards the back and outer side of the feet and is often worse first thing in the morning

c)  Extensor Tendonitis: occurs over the top of the feet and causes pain when running

Find out more about these and other different types of tendonitis as causes of foot pain by clicking on the links above or visit the Tendonitis section.

3) Foot Cramps

Cramps are common causes of foot pain and calf pain.  They are caused by strong, involuntary spasms in muscles and can be extremely painful.  They are usually short-lived but can become frequent or even last for a few days.  Whilst cramps are often no cause for concern, they can be a sign of an underlying condition.  Find out more in the Cramps section.

4) Plantar Fasciitis

Plantar fasciitis is one of the common causes of pain underneath the foot

Plantar fasciitis, whilst not technically a tendonitis, it is extremely similar, this time affecting the thick band of tissue under the sole of your feet, the plantar fascia. 

It can cause pain at the back of or underneath the heel, worsening whenever you are on your tiptoes.  It is one of the most common causes of foot pain affecting one-in-ten people. 

Find out more about symptoms, causes and treatment options in the Plantar Fasciitis section.

5) Turf Toe

Turf toe is a sprain of the big toe caused by the big toe is bending back too far, usually from a sporting injury.  Symptoms include pain, stiffness and inflammation around the big toe.  Find out more in the Turf Toe section.

Nerve Problems

Nerve problems usually cause pins and needles, burning or cold sensations in the feet as well as weakness

Problems in the nerves are common causes of foot pain.  It may stem from an issue in the back placing pressure on the nerves which can result in referred pain and altered sensation down the leg.  Or the problem may be more localised to the feet e.g. from compression or reduced blood supply. 

Nerve problems are common causes of foot pain, weakness, altered sensation and decreased balance.  In some instances, it can indicate a serious medical problem, so any incidence or nerve pain should be reviewed by your doctor.  You can find out more in the nerve pain section.

Skin Problems

Skin conditions are another of the common causes of foot pain, particularly around the toes

Corns and calluses can cause toe pain

1) Calluses

Calluses are areas of hard, thickened skin that usually develop due to repetitive friction on an area.  They tend to develop on the sole of the feet, particularly around the toes, can cover quite a large area and tend to be painless.  

2) Foot Corns

Corns tend to be smaller than calluses, circular in shape, yellowy/white in colour and can be quite painful.  They penetrate deep into the skin and can lead to the formation of ulcers.  

3) Foot Eczema

Eczema is a common problem, particularly in children. There are a number of different types  but they generally all cause intense itching and inflammation. The most common type of foot eczema is atopic dermatitis. You can find out all about the causes, symptoms and treatment in the foot eczema section.

4)  Athlete’s Foot

Athlete's Foot is a fungal infection usually caused by poor hygiene.  The skin becomes flaky and dry and the foot may itch.  Good hygiene, going barefoot and anti-fungal medications are the best athlete’s foot cure.  Find out more in the foot rash section.

Ingrown toe nails can be really painful

5) Ingrown Toe Nail

If the edges of a toe nail push into the surrounding skin, it can cause swelling, redness and pain, known as an ingrown toenail.  They can develop for a number of reasons including wearing inappropriate footwear, an injury or from cutting nails incorrectly.  Find out more in the Ingrown Toenail section.

6) Blisters

Blisters are really common causes of foot pain.  Small pockets of fluid form under the skin in response to intense friction.  They tend to be filled with clear fluid, plasma, but can also contain blood and/or pus. You can find out more about the best ways to treat them in the foot blisters section.

7)  Trench Foot

Trench foot is one of the more rare causes of foot pain

Trench Foot is one of the less common causes of foot pain.  It develops when the feet are exposed to prolonged cold and damp conditions.  The feet turn a whitish/grey colour and feel cold, prickly, heavy and numb as the blood vessels constrict in an attempt to keep warm. 

Originally seen mainly in soldiers in the trenches, it is now a more common problem for builders, extreme-sports enthusiasts, at music festivals or even in people with excessively sweaty feet.  Find out more about this cause of foot pain including which famous celebrities have suffered from it in the Trench Foot section.

Medical Conditions

There are a few medical conditions that are causes of foot pain.

1) Foot Gout

Gout often causes pain in the big toe, known as podagra

Gout is one of the common causes of foot pain around the big toe but can also affect the ankle and the hands.  It develops when the body has a problem breaking down uric acid. 

Symptoms of intense pain, swelling, redness, heat and tenderness often come on quickly over a few hours, usually starting at night.  60% of gout sufferers have recurrent episodes of gout.  

Find out more about the causes of foot pain from gout, how the condition affects the body and how to prevent attacks in the gout section.

2) Charcot Marie Tooth Disease

This is a group of inherited disorders due to gene mutation that causes weakness and sensory loss in the feet, legs and sometime hands.  Symptoms usually start in childhood and get progressively worse over time.  Find out more in the Charcot Marie Tooth section.

3) Arthritis

There are two types of arthritis that are common causes of foot pain:

a)  Osteoarthritis: This is when there is “wear and tear” of the joints.  The cartilage thins and the bone thickens resulting in rough surfaces rubbing on each other causing pain, inflammation and stiffness.  It most commonly affects people over the age of 65
b)  Rheumatoid Arthritis: This is a systemic inflammatory condition which can affect the body as a whole, joints, organs and skin. It causes inflammation around the joints and erosion of the joint surfaces.  Joints tend to be swollen, red and painful, particularly first thing in the morning or after prolonged rest.

Foot Syndromes

There are a few different syndromes that are causes of foot pain. 

1)  Sinus Tarsi Syndrome

Sinus Tarsi Syndrome often goes undiagnosed

The Sinus Tarsi is a small cavity on the outer part of the hindfoot, through which a number of structures such as nerves and blood vessels pass through. 

Inflammation of the area, usually either due to instability following an ankle sprain, abnormal foot position or repetitive force through the area causes localised deep pain, stiffness and instability which gets worse with any weight bearing activity. 

This is a frequently misdiagnosed cause of foot pain.  You can find out more in the Sinus Tarsi Syndrome section

2)  Tarsal Tunnel Syndrome

The tarsal tunnel sits on the inner side of the ankle and through it passes a number of structures including the tibial nerve.  Anything which decreases the space in the tunnel e.g. swelling or cysts places pressure on the tibial nerve.  This results in pain, pins and needles and numbness on in the inner side of the foot and heel which can spread into the calf.  It tends to be worse at night.

3) Cuboid Syndrome

This is when the cuboid bone on the outer side of the midfoot gets displaced from its normal position, known as cuboid subluxation.  It causes pain on the outer side of the foot making it difficult to walk.  It may develop suddenly due to an injury such as an ankle sprain or come on gradually overtime from repetitive overuse.

4) Blue Toe Syndrome

This is a condition where the small blood vessels of the feet become blocked which reduces the flow of blood and oxygen to the tissues.  The toes turn blue and if left untreated, the tissues begin to die.  It is usually a sign of problems in one of the main blood vessels around the groin or abdomen.

Other Causes of Foot Pain

There are a few other less common causes of foot pain:

Ganglions are small lumps that form that may or may not cause pain

1)  Ganglions: these are small, usually pea-sized areas of swelling that can occur anywhere.  They are caused by jelly-like fluid collecting in soft tissues and tend to be painless unless they are pressing on a nerve.  They are harmless and usually resolve in time. Some people choose to have them removed, either surgically or having the fluid drained but there is a high recurrence rate in both.

2) Plantar Fibromatosis: this presents similar to a ganglion with a small nodule in the middle of the foot arch, usually on the inner side.  It is caused by a benign growth on the plantar fascia and can become extremely painful when you are on your feet.  You can find out more about the common causes of foot pain from this condition, symptoms, diagnosis and treatment in the plantar fibromatosis section. 

Tennis Toe tends to affect athletes

3) Tennis Toe: Also known as Runners Toe, it is a condition where blood pools underneath the big toe nail, due to repetitive pressure on the toe.  It most commonly affects athletes.  Find out more about the causes, symptoms and treatment options in the Tennis Toe section.

4) Foot Rash: Rashes can also be causes of foot pain and itching.  They can be due to a number of conditions including allergic reactions and eczema. 

Skin irritation tends to be caused by ill-fitting footwear, especially if you are on your feet for long periods making shoes common causes of foot pain.  Treatment options include wearing appropriate footwear, good hygiene, using a pumice stone and wearing toe stretchers.  Find out more about these causes of foot pain by clicking on the links above.

5) Retrocalcaneal Bursitis: This is where there is inflammation of the bursa at the back of the heel, usually due to repetitive friction. It causes most problems when standing on tiptoes or running uphill. Find out about the common causes, symptoms, diagnosis and treatment options in the retrocalcaneal bursitis section.

Need Some Help?

If none of these common causes of foot pain is sounding quite like your problem, visit the foot pain diagnosis section.  There, we will help you work out what is causing your problem by looking at the location of your pain, what the symptoms are and how they started. 

Go to Foot Pain Guide

Your Comments

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See Also

Diagnose Your Foot Pain

Common Causes of Foot Pain

Foot & Ankle Anatomy

Treatment Options for Foot Problems

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