Foot pain is generally caused by using high heels or tight shoes for a prolonged period of time, as well as excessive physical activity or pregnancy. Pain in these cases is usually not an urgent finding, and can be treated at home with rest, ice and massage.
However, foot pain can also be a sign of a more serious condition, like plantar fasciitis, tendinitis or rheumatoid arthritis, especially if pain interferes with walking or worsening over time.
It is important to consult your family doctor or an orthopedic surgeon if your foot pain does not improve, if you experience other symptoms, or if you notice foot pain after a fall or injury. The doctor will assess your condition to confirm a diagnosis, which will guide the appropriate treatment.
What causes foot pain?
The most common causes of foot pain are:
1. Overloading the feet
Foot pain is often caused by overloading the feet, which can occur from being overweight, from using high heels or using tight footwear.
You can also overload your feet following very long walks, intense exercise or standing for prolonged periods.
What to do: Soak your feet in cold water, apply ice to the feet for 15 minutes and massage the feet to relieve pain. It is important to wear comfortable footwear and to avoid standing for prolonged periods. Maintaining and ideal weight and resting when appropriate are also advised to prevent pain in the future.
Foot pain is very common during pregnancy, and may be related to increased weight, inadequate venous return, poor blood circulation and swelling in the legs and feet. These symptoms can lead to intense foot pain, especially at the end of the day.
What to do: Avoid prolonged periods of standing, and be sure to rest your feet above heart level when resting. This will promote adequate circulation and help to relieve leg and foot swelling. Soaking your feet in cold water can also help to relieve foot pain.
3. Plantar fasciitis
Plantar fasciitis is associated with inflammation of the plantar fascia, which is a tissue at the bottom of the foot that runs from the heel to the toes. It provides the arch with adequate support and helps to absorb shock impact when walking. When this tissue becomes swollen, it can cause intense pain at the bottom of the foot, as well as burning and discomfort that is especially felt upon waking.
This condition may occur with long-distance running, using inadequate footwear for running, or in those with an anatomically flat foot.
What to do: Apply a cold compress for 15 minutes twice a day to the bottom of the feet. Patients with plantar fasciitis should use orthotics as prescribed by a doctor, and can use topical or oral anti-inflammatories to relieve discomfort. It is important to regularly stretch the feet to help promote recovery.
4. Achilles tendinitis
Achilles tendinitis is characterized by inflammation in the Achilles tendon, which is located in the heel. It causes heel pain and pain at the back of the foot, as well as burning and heel stiffness that worsen with physical activity. Some patients may report more intense symptoms in the morning.
This condition is generally caused by repetitive stress on the tendon, and is common in people who run. It can also be caused by weight gain or calf muscle stiffness.
What to do: Apply cold compresses to reduce inflammation, or use anti-inflammatories as prescribed by your doctor. The doctor may also recommend physiotherapy. If this condition does not show signs of improvement within 6 months, surgical repair of the tendon may be considered.
Bunions are an overgrowth of the bone that occurs in the lateral bone of the big toe, the hallux. This overgrowth is caused by joint malalignment and can lead to foot pain, redness and numbness in the affected toe.
Bunions can occur after using tight shoes or from malformation of the foot. They may also develop as a result of rheumatoid arthritis.
What to do: Treatment should be oriented by an orthopedic surgeon, and is aimed at relieving symptoms and promoting repositioning of the toe. The doctor may advise comfortable shoes, orthotics or toe spacers, as well as anti-inflammatories and corticosteroids in more serious cases.
Foot pain is a common symptom of gout, and can occur when uric acid levels become elevated. This leads to the formation of uric acid crystals which deposit along the joints and cause inflammation. The big toe joint is the most commonly affected joint with gout, and patients often report pain that lasts for days and worsens with movement.
What to do: Treatment for gout should be directed by an orthopedic surgeon or rheumatologist. The doctor may prescribe medication to relieve symptoms, like anti-inflammatories, corticosteroids and medication that lowers uric acid levels. It is also important to change dietary habits, and consume more foods that can decrease uric acid levels, like apples, beets, carrots and cucumber. Read more about the gout diet and which foods to eat and avoid.
7. Diabetic neuropathy
Diabetic neuropathy is a condition that occurs due to elevated blood sugars that are left untreated for prolonged periods of time. These high sugar levels can cause progressive nerve damage in the body, and can affect the feet, arms and hands. Common symptoms include mild pain, burning, numbness and tingling.
Diabetic neuropathy is often diagnosed in people who do not adhere to their prescribed diabetes treatment to manage their blood sugars. Read more about the causes of diabetic neuropathy and the types that can be diagnosed.
What to do: Treatment should be guided by an endocrinologist, who may prescribe antidiabetic medication (like insulin) to normalize blood sugar levels. The doctor may also prescribe medications to relieve pain, like anticonvulsants, antidepressants or opioids. t
See the other diabetes medications that your doctor may prescribe to manage this condition.
8. Diabetic foot
Diabetic foot is one of many complications from diabetes that can occur when this condition is left untreated. Diabetic foot is characterized by intense foot pain and the emergence of wounds that can easily become infected.
What to do: In addition to maintaining blood sugars within a normal range, diabetics are advised to wear adequate footwear and to assess their foot daily for any new wounds or lesions. Wounds may need to be treated with antibiotics, ointments and dressings to ensure speedy recovery.
Learn about the diabetic diet that patients are advised to maintain to ensure blood sugar remain normal.
Bursitis is an inflammation of the bursa, a small fluid-filled sac that serves to reduce friction and rubbing between bones, tendons and muscles.
Bursitis can occur in the heel bursa, leading to pain at the back of the heel, redness, swelling and burning.
What to do: Patients are advised to rest and apply cold compresses to the area for 15 minutes, two or three times per day. Bursitis can also be treated with oral anti-inflammatories, like ibuprofen or diclofenac, as well as corticosteroids directly in the bursa.
10. Tarsal tunnel syndrome
Tarsal tunnel syndrome occurs due to compression of the nerve that runs from the ankle to the bottom of the foot. It causes symptoms like foot pain, burning and tingling in the inner back of the foot and in the ankle. This pain worsens with walking and improves with rest.
This syndrome can be the result of a fracture, sprain or other health condition, like diabetes, rheumatoid arthritis or gout.
What to do: Treatment is aimed at decompressing the nerve to relieve symptoms. the doctor may advise immobilization, anti-inflammatory medication, physiotherapy and even surgery in serious cases.
How to relieve foot pain
In most cases, foot pain can be relieved with just rest and foot soaks, followed by a massage with a hydrating lotion. Other ways to relieve foot pain include:
- Using comfortable, flexible footwear
- Exercising the foot, like rotating at the ankle and flexing it up and down
- Avoiding tight shoes, high heels or prolonged periods of standing
- Massaged with a moisturizing lotion or oil, or with anti-inflammatory ointments, like diclofenac
Pain that is frequent and does not improve with the above measures should be assessed by a doctor. Based on the presenting symptoms, the doctor can confirm a diagnosis and indicate treatment as appropriate.