Foot pain 

  • Overview

Introduction 

Tendonitis: an animation

Tendonitis is a painful condition caused by swollen or injured tendons in the body. This animation explains the condition in detail.

Foot pain is a common problem with a wide range of possible causes. If it is severe or persistent, you should see your GP.

This page summarises the main possible causes of pain in the foot, toes or heel (heel pain is covered in more detail separately).

If you think your foot pain may be caused by shoes that don't fit or are uncomfortable, consider investing in flat-heeled shoes that provide enough space and support for your feet. You may find our advice on Choosing sports shoes helpful.

The below information focuses on foot pain caused by an underlying health condition or problem with the foot. It aims to give you an idea as to what the problem might be but shouldn't be used for self-diagnosis. Always see your GP for a proper diagnosis and treatment advice.

Common causes of foot pain

Sprain

If you have done more activity than you're used to, your pain may just be a foot sprain. This means that tissues in the foot have been stretched but aren't permanently damaged. Read more about sprains and strains.

An example of a sprain may be pain and swelling at the base of the big toe caused by spraining the ligaments around the big toe joint. This condition is known as turf toe and is commonly seen in dancers and footballers who play on artificial turf.

Gout

Gout is a type of arthritis caused by a build-up of uric acid (a waste product) in the body. Crystals of uric acid can form in the joint of your big toe, causing severe pain and inflammation even when you're resting.

Usually, gout affects the joint of the big toe first before it affects other joints. It can sometimes be hard to tell the difference between gout and a severely inflamed bunion.

Read about the treatment of gout.

Verruca

verruca is a growth on the sole of the foot, which can be painful because the weight of your body can force it to grow back into your skin.

It is fairly easy to spot a verruca. It  looks like small, flat white circle of skin that often has a black dot (a blood vessel) in the centre.

Read about how verrucas are treated

Bunion

bunion is a bony swelling at the base of the big toe that can be painful and difficult to walk on. It's a common condition, especially among women. The big toe points towards the other toes and the big toe joint sticks out, forming the bony lump.

Watch an animation showing how a bunion forms and is treated.

Infected ingrown toenail

An ingrown toenail occurs when the sides of the toenail grow into the surrounding skin. The toenail pierces the skin, which becomes red, swollen and tender. If it becomes infected, the toe will become painful and difficult to walk on.

Learn about the treatment of an ingrown toenail.

Plantar fasciitis

Plantar fasciitis is damage to the tough band of tissue running under the sole of the foot, which causes pain in the heel. It's brought on by activity such as jogging or sometimes happens after a gradual wearing down of the foot tissues.

Less common causes of foot pain

A nerve problem

Sometimes, the nerve that divides between the toe bones becomes irritated or squashed, leading to a sharp, severe pain in the base of the toes. This painful condition is called Morton's neuroma. The exact cause isn't always known, although a number of problems seem to aggravate it, such as wearing high-heeled shoes or having flat feet.

The pain usually affects the third and fourth toes and will suddenly start when you're walking. Pain is relieved by removing the shoe.

Read about the treatment of Morton's neuroma.

Strain or pressure on the ball of your foot

When foot pain comes from the ball of your foot, it's likely to be a condition called metatarsalgia, which has a range of possible causes.

Metatarsalgia is described as a burning or aching pain that ranges from mild to severe and often gets worse when you move. It can affect one or two toes near the ball of your foot or sometimes the whole foot.

Anything that puts extra strain or pressure on the ball of the foot can bring it on - for example, wearing tight-fitting shoes for a long period of time, high-impact sports, or being overweight. Older people are also more susceptible. 

Read about the treatment of metatarsalgia.

Arthritis

In older people, repeated attacks of foot pain can be a sudden worsening of osteoarthritis, the most common type of arthritis in the UK.

Osteoarthritis causes swelling of the tissues in and around the joints, including the big toe and heel joints. Learn about the treatment of osteoarthritis.

Less commonly, foot pain can be caused by rheumatoid arthritis, a crippling type of arthritis caused by the immune system attacking the joints and causing the joint tissues to become inflamed. It almost always affects other joints too, so foot pain won't be your only symptom.

Achilles tendonitis

If you have damaged the Achilles tendon at the back of your heel (for example, after twisting your ankle), it may lead to inflammation of the tendon, otherwise known as tendonitis.

Achilles tendonitis causes pain and stiffness in the back of the heel, which can usually be relieved by painkillers and an ice pack.

You can learn more about tendon injuries by watching the animation on this page (see left), and you can read about the treatment of tendonitis.

Oedema

If the whole foot is painful, heavy and swollen, it may be a sign of oedema. This is a build-up of fluid (mainly water) in the body's tissues, causing swelling to occur in the affected area. Oedema will usually affect the whole lower leg too. See your GP or, if the pain and swelling is severe, go to your nearest hospital A&E department.

An object embedded in your foot

Foot pain can sometimes be caused by an object that has become embedded in the foot. Therefore it may be worth considering whether you have stepped on something sharp with bare feet, and examining your foot for a wound.

A cracked bone (stress fracture)

If you do a lot of high-impact sports, such as long-distance running or basketball, the cause of your painful and swollen foot may be a small crack in one of the foot bones. This is known as a stress fracture.

Stress fractures most commonly occur in the:

  • bones leading to the second and third toes (metatarsals)
  • heel
  • outer bone of the lower leg
  • bone on top of the midfoot

The fracture area will be tender to touch and the skin may be bruised. You should stop all activity immediately and try not to put weight on the foot until you see a doctor.




Last reviewed: 12/08/2011

Next review due: 12/08/2013

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Comments are personal views. Any information they give has not been checked and may not be accurate.

beatriceca25 said on 15 February 2013

I've been walking loads recently as i'm living in New York. i walk a minimum of 3 miles a day and sometimes very quickly to get to work. A week a go i noticed my foot was feeling a little sore on the top and bottom but i didn't think anything of it and i've continued to walk to work. It's progressively got worse and now i feel a strong aching pain a bit like a cramp throughout my foot after walking. It also hurts when i walk and i get a sort of stretching sensation inside my foot so i have to limp a bit. It's also swollen on the top and the bottom and when I press down on the top of my foot it hurts and feels quite bruised. Any ideas what it could be? If it persists I'll go to a doctor but i just wanted to get an idea as to whether it's some sort of a sprain or damage to a tendon.

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Col9R said on 29 December 2012

In August or September I went to see my doctor after nearly a year of having unexplainable problems with my left foot. Since at least the begining of this year in the Metatarsal area of my foot.

Every time I bought a new pair of shoes after a while it would feel like the shoe sole itself was weak and I can feel everything underneath much more heavier than it does with my right foot, like stones, rough ground. It isn't as much painful but just very tender and the skin feels like it is burning.

I explained to my mum who told me that the problem couldn't be with my shoes and to go and see the doctor. She gave me a rubber pad which I have been using since. Again, I explained to the doctor and he said that it was an inflamed Metatarsal. The doctor sent me to the hospital where I had an X-Ray of my left foot but showed nothing out of the ordinary. After not much joy I am waiting tgo hear from a podiatrist having since been referred. In the meantime I want to find cures or treatments and woulg be grateful if anyone could help Thanks!

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dimples777 said on 19 July 2012

Hiya, i woke up this morning and the top of my left foot is very swollen and painful. i have not hurt it by exercise or any other way that i can think of because I have trouble walking anyway because of a back injury. I keep getting strange pins and needles and pains in my ankle too. i would be grateful for any ideas or help.

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abs4040 said on 19 April 2012

Thank you for the great article, I just wanted to share a little of more story with the readers with the hope that it may help somebody. I had suffered from really severe heel pain for years as I am a nurse and I am constantly on my feet. Being a nurse and working in a hospital were the podiatrist department was based and having access to any number of Drs to ask for advice I tried everything to try and stop this pain which was at one time excruciating. I would wake up and would be hoping around the house and then after a long days work the pain sometimes bought me to tears.

After the advice of the podiatrist I tried some NHS orthotics, these were plastic hard orthotics and were very uncomfortable. They made the condition worse so I went to see a Dr I knew based in the hospital, he recommended a hydrocortisone injection. The injection was very painful but the pain from the heel stopped for 3 months but when it came back oh boy was it painful. I was then advised that the only other course of treatment I could try was surgery and to release the plantar fascia, as you can imagine I was not keen on that too.

After my frustration and desperation I went to see a private podiatrist who told me that I was over pronating and that I need orthotics that would cost £300! The NHS doesn’t pay us nurses that well that I can afford them! I then purchased some orthotics online, I don’t want to post the url in these comments as I think I will break some rules but they were called dr foot pro insoles. These were not as hard as the NHS insoles and no were near the price that the private podiatrist was going to charge me. They have eased the pain almost 70% but it’s still not gone. I’m now at a stage where im thinking of surgery but I have heard so many horror stories that it’s putting me off. I just hope that in time with these orthotics they will stop all the heel pain.

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