Written By: Chloe Wilson BSc(Hons) Physiotherapy
Reviewed By: FPE Medical Review Board
Pain on the outside of the foot, aka lateral foot pain, is a common problem.
There are a number of different structures on the outer side of the foot and problems in any of them can cause pain.
There may be a sharp pain or a dull ache on the outer foot. Symptoms may have come on gradually over time, or developed suddenly with an injury and they may get better with rest or with movement. There may also be some swelling or a lump on the side of the foot.
Thinking about the location and onset of side foot pain can give us a good indication of what the problem is. Here we will focus on pain on the outside of your foot, but if your pain is more on the inner side of your foot, check out the Inner Foot Pain article.
There are a number of different things that can cause pain on the outside of the foot. Here we will start by looking at the most common causes, then we'll go on to look at the diagnosis process and the best treatment options for lateral foot pain.
The most common cause of pain on the outside of the foot is peroneal tendonitis. This is where there is inflammation and degeneration in the peroneal tendon that runs down the back of the ankle and along the outer side of the foot.
Lateral foot pain from peroneal tendonitis is usually caused by repetitive tension through the tendon from frequent overuse e.g. long distance running, abnormal foot position, muscle imbalance, or an ankle injury.
Typical symptoms of peroneal tendonitis include a gradual onset of lateral foot pain that gets worse with activity and eases with rest. The outer foot pain is often worse when you first get up or when you twist your foot inwards.
Pain on the outside of the foot from peroneal tendonitis is usually treated with a combination of RICE (rest, ice, compression & elevation), medication, rehab exercises, orthotics and physical therapy.
You can find out loads more about peroneal tendonitis, how it causes pain on outside of foot and how to treat it in the peroneal tendonitis section.
The most common cause of lateral foot pain near the ankle following an injury is a ligament sprain. Ligament tears account for 85% of all ankle injuries.
Ligaments are tough, fibrous bands of tissue that support joints, and the ankle ligaments are the main stabilising structures of the foot.
The ankle ligaments are very strong but if they are suddenly stretched too far, then they can tear. This typically happens when you roll over on your ankle and it twists inwards sharply. Ankle sprains are common in sports, when walking on uneven ground or when wearing high heels.
Pain on the outside of the foot from a ligament sprain is usually felt immediately at the time of injury. Symptoms will depend on how much damage there is to the ligament, ranging from a grade 1 ankle sprain where only a few of the ligament fibres are torn, to a grade 3 rupture where the ligament tears completely. There is often some bruising and swelling on the outer side of the foot as well as ongoing instability and weakness.
You can find out all about the causes, symptoms and how to treat instability and pain on the outside of the foot from ligament injuries in the ankle sprain section.
Cuboid syndrome is a common cause of ongoing lateral foot pain. It develops when one of the small bones on the outer side of the foot gets shifted out of position, typically following a twisted ankle or with repetitive jumping or running.
Cuboid syndrome causes pain down the outer side of the foot which may extend across the top of the foot and into the toes. The lateral foot pain typically gets worse when weight-bearing, especially first thing in the morning, when walking on uneven ground or quickly changing direction, and may cause you to limp.
There is often weakness in the foot with cuboid syndrome making it difficult to push-off properly when walking, running or jumping.
Cuboid syndrome is particularly difficult to diagnose and often goes undetected, causing the pain on the outside of the foot to persist for months, despite treatment. Successful treatment requires a combination of rehab exercises and joint manipulation to relocate the cuboid bone back into the correct place.
You can find out all about the causes, symptoms and treatment options and how to avoid ongoing lateral foot pain in the Cuboid Syndrome section.
A common cause of outer foot pain in athletes, particularly in adolescents, is a fifth metatarsal fracture.
There are lots of different types of fifth metatarsal fracture, depending on the location of the break, which are all treated slightly differently.
Typical symptoms of fifth metatarsal fractures include lateral foot pain that gets worse with activity, localised swelling and tenderness. Walking is often affected and you may not be able to take any weight through your foot.
You can find out all about the common causes, symptoms, diagnosis and treatment options in the Stress Fracture Foot section.
There are a few other possible causes of pain on the outside of the foot:
Any new incidence of pain on the outside of the foot that doesn't settle down within a few days should be assessed by your doctor. At your appointment the doctor will:
If you have injured your foot, have severe lateral foot pain, are unable to walk, have lost sensation in your foot, or your foot has changed colour, see your doctor immediately.
The best treatment for lateral foot pain will usually involve a combination of:
You can find out more about specific treatment techniques for each of the different causes of pain on outside of foot by reading the full articles about your specific foot problem.
So as you can see there are lots of possible causes of lateral foot pain each of which present slightly differently:
If you have noticed a lump on the side of your foot which may or may not be painful, check out the Lump On Side Of Foot article.
If you are having trouble working out what is causing the pain on the outside of your foot, or your foot pain is more widespread, visit the foot pain diagnosis section for help working out what is going wrong.
You may also be interested in the following articles:
Foot Pain Treatment
October 2, 2024
Diagnosis Chart
October 2, 2024
Foot & Ankle Exercises
December 9th, 2023
Page Last Updated: 26th November, 2024
Next Review Due: 26th November, 2026