Why The Bottoms of Your Feet Hurt So Much

bottom-of-foot-pain

Pain in the bottom of the foot is a common complaint among people at some point in their lives. It can range from mild discomfort to a severe ache. The pain is often felt when someone is weight-bearing wearing shoes or walking barefoot.

A lot of people wonder why the bottom of their foot hurts. In fact, data shows that 77% of adults say that foot pain has impacted their life to some degree.
Whether your foot pain is near the toes or at the heel, the pain may affect you with every step. Depending on the injury or condition, you may feel symptoms that range from a shooting pain to a constant ache.
 

What causes pain in the bottom of the foot?

Your feet are fairly complex, and there are a variety of reasons why you may be experiencing pain in your feet. For example, plantar fasciitis is a condition that can cause pain at the heel. A neuroma is another condition that can cause pain at the toes. Treatment for foot pain will vary depending on the underlying cause of the pain.
 
The complexity of the structure of your foot is due to the elements that make up your foot. Each foot has 26 bones, 30 joints, and almost 100 muscles and ligaments connecting them.
 
Pain in any of these parts of your feet can cause you to have pain any time you stand or take a step. This can lead to problems with your balance and stability. It’s important to know what the symptoms of pain in your feet are and to take care of your feet to avoid any problems.
 
This complex structure can cause pain in different ways, for example, if you put pressure on it or only at night. But it might also be worse when you do something that is normal for you, like brush your teeth or get out of bed.

Common conditions affecting the bottom of the foot

There are a lot of different parts to the foot, and so there are also a lot of different things that can go wrong and cause pain in the bottom of the foot. some common conditions are:

Plantar Fasciitis

The plantar fascia is a band of tissue that helps support your arch and stretches from your heel bone to your toes. It’s an important part of your foot that helps you walk, run, and jump.
 
A plantar fasciitis diagnosis is one of the most frequent explanations for heel or foot pain in the middle of the foot along the arch. This is due to the inflammation caused by excessive pressure and overuse. The plantar fascia becomes inflamed when it is overworked, causing a lot of pain.
 
Factors that increase your chances of developing plantar fasciitis include:
 
  • Having flat feet or a very high arch
 
  • Being overweight or obese
 
  • Wearing shoes with poor arch support
 
  • Walking, running, or standing a lot on hard surfaces
 
  • Walking barefoot
 
  • Being pregnant
 
  • If you have pronated feet, which means your feet roll inward each time you take a step.
 
Plantar fasciitis symptoms are often at their worst in the morning, causing intense pain in the bottom of your foot as soon as you wake up. The sharp pain can be so bad that you may feel it with the first step you take out of bed.
 
For more about Plantar Fasciitis see our article on heel pain here
 
 

Metatarsalgia

 
There are five metatarsal bones in each foot, one for each toe, which attach your ankle to your toes. These long bones are called metatarsals. The metatarsals: are important for balancing the weight of the foot on the ground.
 
Metatarsalgia is the medical term for pain in the ball of the foot, which is often closer to the toes. This can be caused by a variety of problems, including arthritis, bunion, nerve damage, and a variety of other conditions.
 
It can be caused by excess stress on the metatarsal bones and can be worsened by walking or standing on hard surfaces. It often feels like a persistent ache in the ball of the foot and is worse when standing or walking.
The pain can also be described as burning, stabbing, aching, or tingling.
 
Metatarsalgia may also be accompanied by other symptoms, including a feeling of swelling in the foot.
 
A study suggests that 80% of people experience metatarsalgia at some point.
 
It is more common in people who do high-impact activities that stress the bottoms of the feet, like running or jumping.
 
 
 

Older adults are more likely to develop metatarsalgia. Other factors that increase your chances of developing it include:

  • Having high arches or hyperflexible flatfoot (both these conditions increase the pressure on the ball of the foot).
 
  • If your 2nd or 3rd metatarsal bones are longer than your big toe.
 
  • Having hammertoes—a deformity in your second, third, or fourth toes, in which the toe’s middle joint bends down instead of lying flat
 
  • Playing high-impact sports that involve running or jumping
 
  • Being overweight or obese
 
  • Frequently wearing high heels or shoes that don’t fit right
 
  • Having problems with blood flow
 
  • Having gout
 
  • Having diabetes

Peripheral Neuropathy

Peripheral neuropathy is defined as damage to the nerves that are responsible for feeling.
 
The symptoms of peripheral neuropathy can include:
 
  • numbness
  • tingling
  • pins and needles
  • burning sensation
  • weakness
  • muscle wasting.
 
The symptoms of peripheral neuropathy are often related to the site where the nerve is being affected.
For example, if the nerves that supply the calf are being affected, you may experience tingling in the leg.
If the nerves that supply the hand are being affected, you may experience numbness, tingling, or pain in the fingers.
 
Diabetes, severe alcohol misuse, Lyme disease,
or autoimmune diseases like lupus can all cause peripheral neuropathy.
 
Diabetes is the most common cause of peripheral neuropathy and can be caused
by damage to the nerves that supply the foot.
This damage can happen when the blood sugar levels in the body are too high.
 
It is also a risk factor for peripheral neuropathy if you are overweight or obese.
Other causes include injury to your peripheral nerves, such as physical trauma resulting in nerve damage.
 
If you have any of these symptoms be sure to get in touch with your doctor.

Neuroma

A neuroma is a swelling or lump on a nerve. When it occurs in the feet it is more often
referred to as Morton’s Neuroma.
 
A neuroma can occur when pressure builds up on a
nerve in the area where it joins the nerve trunk (a nerve is a bundle of nerve fibres that carries signals from the nerve cell to the muscles and other organs).
 
The pressure can occur from:  
• wearing shoes that are too small
repeatedly rubbing or pinching the nerve in the area where it joins the nerve trunk, such as when you run.
 
They occur commonly in the feet between the toes, most often between the second and third toes. Affecting females more often than males. Other factors that increase your chances of developing a neuroma include:
 
  • Playing high-impact sports that involve running or jumping
 
  • Wearing shoes without proper support
 
  • Frequently wearing high heels
 
  • Frequently wearing tight shoes or restrictive footwear, such as the shoes worn in ballet or for rock climbing
 
  • Having hammertoe or a bunion
 
The experience of a neuroma may feel like a stone in your shoe.
Other symptoms that may be experienced include burning pain in the ball of the foot and/or
numbness and tingling that radiates down your toes.

Sesamoiditis or Sesamoid Stress Fracture

The sesamoids are two small bones beneath the pad of the big toe. They help support the tendon that flexes the toe.

These bones can get irritated when overloaded. That causes sesamoiditis causing symptoms including dull pain and inflammation, with pain at the base of the big toe.

It can also cause a sesamoid stress fracture, where the bone is damaged.
Both of these injuries can be painful and interfere with your ability to walk and run.
They are common in runners who overtrain and in athletes who play sports that involve a lot of jumping, such as basketball or volleyball.
 

A Podiatrist can help relieve the pain and inflammation by creating custom orthotics that provide support for your big toe.

 
Factors that increase your chances of developing sesamoiditis include:
  • Frequently walking or running on hard surfaces such as asphalt or concrete.
  • Playing a sport that puts a lot of pressure on the ball of the foot, like running, ballet, or tennis
  • Having high arches
  • Frequently wearing high heels

Tarsal Tunnel Syndrome

The tarsal tunnel is a narrow space on the inside of the ankle.
Many arteries, veins, tendons, and nerves that allow the foot to move in different directions run through the tarsal tunnel.
 
One of these nerves is the posterior tibial nerve.
The posterior tibial nerve is responsible for the sensations you feel on the bottom of your foot and in your toes.
The tarsal tunnel is narrow and this nerve runs through it.
 
Tarsal tunnel syndrome occurs when the posterior tibial nerve gets compressed (squeezed) in the tarsal tunnel.
 
This causes pain, numbness, and tingling in the foot.
 
Factors that increase your chances of developing tarsal tunnel syndrome include:
 
  • Having flat feet
     
  • Swelling in your ankle due to an ankle sprain
     
  • Having diabetes, arthritis, or another disease that causes swelling and nerve compression
     
  • Having a varicose vein (a twisted and enlarged vein), a ganglion cyst (a noncancerous cyst over a joint or tendon), a swollen tendon, or a bone spur that presses on the posterior tibial nerve

 

If you want to learn more about Tarsal Tunnel Syndrome Treatments click here

When To See A Podiatrist

Sometimes, the pain in the bottom of the foot goes away on its own after a few days. Other times, it becomes a chronic condition that impacts your daily life. It’s important to have an accurate diagnosis and begin treatment and avoid matters getting worse.
 
See a Podiatrist if the pain in the bottom of your foot persists or if you have:
 
  • New pain that lasts more than a few days
 
  • Loss of sensation or tingling
 
  • Existing chronic foot pain that gets worse
 
  • Pain that makes it uncomfortable and difficult to walk or do other activities
 
  • An injury that causes foot pain
 
  • Dizziness or nausea related to foot pain (which could indicate a bone fracture)
 
  • Fever or swelling with foot pain (which could indicate an infection)
 
  • Diabetes or another condition that affects your nerves
 
In general, your Podiatrist (foot specialist) should be the first person you see for any foot pain, injury, or other condition you are experiencing.

Diagnosis

To identify the cause of your foot pain, your Podiatrist will examine your foot.
 
  1. They’ll look for areas of pain or tenderness.
  2. Complete a medical history from you which will help in diagnosis.
  3. They’ll also perform an observational examination for inflammation, bruising, or other injuries.
  4. A Podiatrist will watch to see how the bottom of your foot hurts when you examine your biomechanics (foot movements).
 
If your podiatrist suspects you have peripheral neuropathy or another condition related to your nerves, they may perform refer for a nerve conduction study (NCS) depending on the underlying cause.
 

Imaging

 
Although Your Podiatrist in most cases will be able to get to a diagnosis without the need for imagery.
 
Sometimes, depending on what your Podiatrist finds during the physical examination, they may order special imaging tests to diagnose bottom-of-foot pain and rule out other causes.
Possible imaging studies include:
 
  • X-ray to detect the occurrence of fractures, infections, or arthritis
     
  • Computed tomography (CT) scan to check for changes in bones due to fractures, infections, arthritis, and deformities, along with soft tissue problems.
     
  • Ultrasound to check for neuroma, metatarsalgia, tarsal tunnel syndrome, plantar fasciitis, injuries in ligaments, tendons, and cartilage, and other soft tissue problems.
     
  • Magnetic resonance imaging (MRI) to check for plantar fasciitis, metatarsalgia, neuroma, sesamoiditis, tarsal tunnel syndrome, and changes in soft tissues and bones due to arthritis, fractures, and infections
 
X-rays and CT scans both involve radiation. If you are pregnant, make sure to let your healthcare provider know so that they can consider their diagnostic imaging recommendations.
 
 

Differential Diagnoses

A differential diagnosis develops a diagnosis of disease based on types of available medical tests, symptoms, and relevant history.
 
A differential diagnosis is composed of tests, symptoms, and relevant history.
Your podiatrist may do several tests based on each possibility.
 
For example, if your provider suspects you have plantar fasciitis, they may also order medical imaging to rule out a heel spur.
 
That’s because each of these conditions can result in the same kind of symptoms you are experiencing.
 
Conditions that cause similar symptoms to neuroma include intermetatarsal bursitis (inflammation of the bursa sacs between the metatarsals), instability in the metatarsophalangeal (MTP) joint, and a tear in the plantar plate ligament.
 
There are more than 100 causes of peripheral neuropathy.
 
The differential diagnosis means identifying the cause of the nerve damage.
 
The most common causes include diabetes and chronic alcohol abuse.
 
If you have never been tested for diabetes, your Podiatrist will refer you for your glucose (blood sugar) level with a blood test.
 
Conditions that cause symptoms that are similar to metatarsalgia include Morton’s neuroma, intermetatarsal bursitis, or stress fractures in the metatarsals.
 
An MRI or ultrasound can help your provider rule out these other conditions.
 
 
 

Treatment

Treatment for foot pain depends on your diagnosis.
Podiatrists in Australia mostly recommend starting with
conservative options and moving to other treatments as needed.
 
Many of the above conditions are treated with Custom Orthotic Shoe inserts by a Podiatrist.
 

Custom Orthotic Shoe Inserts

Custom orthotic inserts can help relieve your foot pain, particularly for conditions like plantar fasciitis, metatarsalgia, and neuroma.
 
By adding met domes and increasing arch correction or inserting gait plates depending on your foot movements and needs.
 
Your pain areas will be relieved of pressure and your body will be able to heal without constant future aggravation to the affected areas of your foot.
 
Custom Orthotics Help Posture
 
Your feet are first to contact the ground and help balance the rest of your body.
Custom orthotics alter your centre of mass
meaning if you have a foot problem it can cause your body to naturally tilt forward.
Your body generally compensates for this by tilting your pelvis forward as well which arches your lower back.
 
By correcting your foot posture with custom orthotics your body can stand straighter and distribute your weight more evenly. As well as take in the excess pressures away from heels and the balls or your feet.

Prevention

You can’t always prevent from developing some types of foot problems from injury or illness, but there are lifestyle changes you can make to reduce your risk of discomfort.
 
You can:
  • Wear orthopedic inserts or supportive shoes
     
  • Carefully walk and stretch after an injury
     
  • Avoid excessive running, jumping, or high-impact activities
     
  • Strive to maintain a healthy weight
     
  • Work on having great posture
     
  • Listen to your body and take pressure off your foot when you need it
     
Taking good care of your overall health is a key part of preventing foot pain.

A Word From your Podiatrist

Foot pain can cause a lot of limits. Luckily, many problems that commonly affect the feet are treatable and then preventable from re-occurrence.
Work with your Podiatrist to figure out what’s going on, then follow the treatment plan.
 
You don’t need to “just live with” foot pain.
 
To speak with a Podiatrist click here