Foot Pain Diagnosis

Author: Chloe Wilson - BSc(Hons) Physiotherapy

Accurate foot pain diagnosis is essential in order to decide what the best treatment options are for your foot, ankle or toe pain.  Without it, treatment tends to be general rather than specifically targeted to your problem, and whilst the pain may settle down in the short term, it is likely to return at some point.

This guide goes through the different parts of the foot, ankle and toes and looks at the problems that can cause pain in each of these areas to help to make an accurate foot pain diagnosis.  Pain can often radiate to more than one part of the foot, but start by thinking where your biggest area of pain is, or where it started and go from there. 

You can find out more about each specific area of foot pain diagnosis by clicking on the relevant links. It is not intended to be a substitute for medical advice and any new incidence of pain should be assessed by your doctor. 

Top of foot pain is often caused by damage to the muscles, tendons or nerves running along the top of the foot

Pain that is mostly on the top of the foot, which often extends into the toes is a common problem that can be caused by a number of different conditions. 

Repetitive overuse from activities like running, jumping and kicking is also a common cause of top of foot pain.  This can lead to small breaks in the bone or inflammation and degeneration in the muscles and tendons. 

There may be a problem with the positioning of the bones which places excess stress on the surrounding structures. A heavy impact onto the top of the foot can result in a bone fracture or damage to the tendons on the top of the foot.

Wearing inappropriate footwear can often exacerbate or even cause pain on top of the foot as  shoes that are narrow or tight place excess pressure on the bones, muscles, tendons and nerves on the top of the foot where there is little padding. 

To find out more about the most common causes of pain on the top of the foot and how to treat them, visit the Top of Foot Pain diagnosis section.

Pain underneath the foot or in the foot arch is particularly common in people who spend long periods on their feet. 

Foot Arch Pain

The arches of the foot are formed by the way the foot bones are supported by various muscles, ligaments and tendons and they control how forces are transmitted through the foot.  Pain on the bottom of the foot often results from a problem in the position of the foot arches e.g. having flat feet.

Muscle weakness, tightness or overloading often causes pain along the bottom of the foot.  They may result in damage to the soft tissues or bones.

Poor foot hygiene can also lead to various conditions including Trench Foot and Athletes Foot affecting the bottom of the foot.

To find out more about the ten most common causes of pain on the bottom of the foot and how to treat them, visit the Arch Foot Pain diagnosis section.

Foot pain can also occur on the inner or outer side of the foot and toes and may come on gradually over time or very suddenly.

Inversion injuries of result in side of foot pain from a ligament sprain

Side foot pain which develops slowly over time is often caused by repetitive activities causing problems such as tendonitis or stress fractures.  Pain that comes on suddenly following an injury, particularly if you have rolled over on the ankle is usually a result of a ligament sprain. If outer foot pain continues for a number of months after a sprain, you may also be suffering from the often misdiagnosed Cuboid Syndrome.

Adolescents with side of foot pain may be suffering from tarsal coalition, whereas people over the age of 50 may instead have symptoms of arthritis.

Skin irritation is another common cause of side of foot pain be it from blisters, calluses/corns or a bunion. These problems all tend to stem from poor footwear.

In the Side of Foot Pain diagnosis section we look at each of these common causes including the symptoms, causes and treatment options for each

Toe pain most commonly affects the big toe

Pain in the toes most commonly involves the big toe and often affects our daily activities such as walking. 

It may be that there is a problem with the position of the toe bones such as with hammer toe and bunions and arthritis. Alternatively, sporting activities may put undue stress through the toes leading to problems such as Turf Toe. 

Alternatively, there may be a problem with the nerves supplying the toes like Morton's Neuroma, a soft-tissue injury or a problem with the toenails which results in pain.

You can find out about these and other common causes and how to treat them in the toe joint pain section.

Heel pain may occur at the back of or underneath the heel.  Thinking about the location of your pain can help make an accurate foot pain diagnosis

Heel pain usually occurs either at the back of the heel or under the heel.  Our heels absorb most of the force going through our feet so it is a common place to get foot pain. 

Heel pain may originate from the muscles and tendons, such as Achilles Tendonitis or Plantar Fasciitis or the bone itself such as stress fractures or bone spurs. 

Foot pain diagnosis for heel pain should take into account muscle length and strength, foot biomechanics and any previous injuries to the foot.  Heel pain is rarely serious and usually settles down in a few weeks to months, often with simple exercises. 

To find out more about the most common causes of heel pain, visit the Heel Foot Pain diagnosis section.

Problems in the calf muscles often cause knee, calf and foot pain.

Calf pain is often linked to foot and knee problems and is usually a result of a problem in the calf muscle. 

It may be due to an injury, muscle weakness or tightness or from poor foot positions.  It can also be caused by problems in the neural or vascular structures in the lower leg.

To find out more about calf pain and how to treat it, visit the Calf Pain Diagnosis section on our sister site.

Nerve Pain

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 such as pins and needles or numbness and decreased balance.  In some instances, it can indicate a serious medical problem, so any incidence of nerve pain should be reviewed by your doctor. 

You can find out loads more in the nerve pain section.

Why Is Foot Pain Diagnosis Important?

Accurate foot pain diagnosis is such an important part of treatment and recovery from foot and ankle pain.

Let me give you an example.  You have pain in your foot so you rest it and ice it for a few days, take some painkillers and ease off the exercise.  After a few weeks, it feels better so you go back to your usual activities but then the pain returns.  Because you never found out why it started to cause pain or made an accurate foot pain diagnosis in the first place e.g. muscle imbalance or altered foot biomechanics, you didn’t treat it properly e.g. exercises or shoe orthotics. 

Effective treatment of any problem relies not on simply treating the SYMPTOM of the problem e.g. instability or pain but at treating the underlying CAUSE of the problem e.g. muscle imbalance or poor foot biomechanics.

By thinking about the location of your foot pain, we can help you work out what your problem is, make an accurate foot pain diagnosis and find out the best way to treat it - simply choose from the links above.  Alternatively, visit the Foot Symptom Guide to use your symptoms to help you work out what is wrong.

Go to Foot Pain Guide

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