Foot Pain Location Guide

Patterns of foot pain can tell you a lot about the cause of your discomfort. Mechanical stress tends to produce certain predictable pain patterns, whereas compression, inflammation, and generalized disease have other telltale signs.

Let’s review some common foot pain patterns and what they may mean for you.

Heel Pain and Plantar Loading

Pain in your heel often indicates a problem with how your foot absorbs weight while walking or standing.

Possible causes include tensile overload of your plantar fascia band, compression of the heel pad, or inflammation/injury within your heel bone (calcaneus).

Take note of when the pain occurs right after you get out of bed, upon heel strike, or after standing for long periods.

Worst with First Steps out of Bed: Plantar Fasciitis

When pain is severe with the first steps out of bed, it typically points to plantar fasciitis.

During sleep, your plantar fascia contracts. As you place your foot on the ground after waking up, your fascia rapidly stretches causing tiny tears and pain along the inside of your heel.

You will usually notice:

• Pain along the inside of your heel

• Stiffness after sitting or lying down

• Pain that decreases after you walk around

• Pain that returns after standing or sitting for long periods

Stretching your calves, wearing night splints, or supportive shoes often alleviate symptoms.

Pain with Each Heel Strike: Heel Pad Atrophy

If heel pain feels deep and bruised each time your heel strikes the ground, your heel pad may be thinning.

You will usually notice:

• Pain directly underneath your heel

• More pain when standing on harder surfaces (i.e. concrete)

• Relief when standing on softer surfaces

• Pain with jumping or marching in place

Shock absorbing shoes, heel cups, or heel pads often help relieve pain.

Ball-of-Foot Pain

Forefoot pain is often the result of abnormal forces across the ball of your foot while pushing-off.

Your forefoot and toes absorb most of the pressure while walking and running. A small change in foot mechanics can create high amounts of pressure in a localized area.

Pay attention to:

• Localized pain underneath your metatarsal heads (balls of your feet)

• Calluses

• Swelling underneath your ball of foot

• Pain is made worse by high heels or narrow toe boxes

Orthotics or metatarsal pads often help spread out your pressure.

Metatarsalgia

Aching or feeling like you have too much pressure under your metatarsal heads is known as metatarsalgia.

It is often caused by repetitive activities like running or jumping.

Characteristic features include:

• Pain when pushing-off

• Pain that decreases when resting or taking off your shoes

• Pain that is localized underneath your ball of foot

• Tenderness when pressing on the ball of your foot

Orthotics or metatarsal pads may help decrease loading underneath your metatarsal heads.

Morton’s Neuroma

Sharp, burning pain between your toes is often due to irritation or thickening of tissue around one of your interdigital nerves, also known as Morton’s Neuroma.

Characteristic features include:

• Pain is usually between your third and fourth toes

• Numbness or tingling in your toes

• Feeling like you are stepping on a pebble

• Pain with shoes that squeeze your toes together

Switching to roomier shoes and adding metatarsal padding can help symptoms. In severe cases, injections or surgery may be necessary.

Doctors at Treasure Valley Foot & Ankle commonly treat patients with Morton’s neuromas. Your provider can diagnose your condition during a physical exam and with imaging studies like ultrasound.

Midfoot / Arch Pain

Midfoot pain or arch pain can stem from problems with tendons, ligaments, or developing stress fractures.

Medial Collapse of Foot Arch (Posterior Tibial Tendon Dysfunction)

Pain along the inside of your foot and ankle often develops when your posterior tibial tendon becomes irritated and your arch begins to collapse.

Characteristic features include:

• Pain located toward the back of your inner ankle

• Progressively flattening arch

• Inability to do a single-leg heel raise

• Increased foot pronation when walking or standing

Orthotics or foot strengthening exercises may decrease pain if diagnosed early on.

High Arches and Risk for Foot Stress Fractures

If you have high arches, you are more likely to have stiff feet that don’t absorb shock very well.

This can lead to increased pressure throughout your metatarsals and the outside of your foot.

Keep an eye out for:

• Sharp pain with activity

• Localized tenderness over a bone

• Pain that is worse with each time you run or jump

If the condition is ignored, stress fractures can occur with continued repetitive activity.

Toe Pain and Deformity

Toe deformities can drastically alter normal pressures across your foot.

This can lead to inflammation and arthritis over time.

Bunions (Hallux Valgus)

Have you ever noticed that your big toe points toward your second toe? If so, you may have bunions.

Characteristic features include:

• Pain and swelling around your big toe joint

• Trouble fitting in your shoes

• Change in the appearance of your big toe

Buying wider shoes, orthotics, or toe spacers may help decrease your pain.

Gout

If you experience a sudden onset of severe pain in your big toe joint, it could be caused by gout.

Characteristic features include:

• Severe pain that comes on quickly

• Redness and warmth around your joint

• Swelling and tenderness of your joint

• Symptoms come and go

Your provider can usually diagnose your condition with joint fluid testing and blood work.

Burning or Numb Foot Pain

If you experience burning, tingling, or electric shock-like pain in your feet, this is often categorized as neuropathic pain.

Peripheral Neuropathy

Peripheral neuropathy often causes symmetric burning pain or numbness in both of your feet. It typically starts in your toes and spreads upward.

Potential causes are:

• Diabetes

• Vitamin deficiency

• Toxic exposures

• Metabolic diseases

Symptoms often present at night.

Tarsal Tunnel Syndrome

Compression of your tibial nerve as it passes along the inside of your ankle can cause symptoms to shoot or burn along the bottom of your foot.

Characteristic features include:

• Tingling or numbness in your sole

• Pain that shoots from your inner ankle downward

• Symptoms are provoked by standing or walking

Your provider may order special nerve studies or imaging to diagnose your condition.

When to Seek Medical Attention for Foot Pain

Some red flag symptoms that should be evaluated promptly by a medical professional include:

• Unable to put weight on your foot

• Severe swelling/deformity after injury

• Fever in addition to foot pain

• Redness or warmth that appears suddenly or becomes severe

• Persistent numbness or weakness

• Pain that awakens you at night

These types of symptoms can indicate a fracture, infection, or circulation problem.

Mechanical vs Systemic Foot Pain Patterns

Pain that is caused by mechanical irregularities often:

• Worsens with activity

• Improves with rest

• Is localized to one area

In comparison, foot pain that is caused by inflammation, compression, or generalized disease:

• Usually involves both feet

• Occurs with morning stiffness

• Is accompanied by swelling or other symptoms that affect the whole body

Conditions like inflammatory arthritis should be examined by a specialist.

When to See Your Podiatrist or Foot Specialist

If your foot pain:

• Persists for more than a few weeks

• Continues to become worse even when resting and changing footwear

• Is accompanied by numbness or tingling

• Is accompanied by a deformity of your foot

…it is time to schedule an appointment with a podiatrist, orthopedic foot and ankle specialist, or rheumatologist.

These types of providers can perform a comprehensive evaluation of your feet and order imaging studies to help determine the exact cause of your foot pain.

Foot Pain Location Quick Guide

Remember, the location and timing of your foot pain can tell you a lot about what is going on:

• Heel pain → plantar fasciitis or heel pad problem

• Ball-of-foot pain → metatarsalgia or neuroma

• Arch pain → tendon problems or stress fracture

• Toe pain → bunions or gout

• Burning/numb pain → nerve problem

Reviewing these common pain patterns can help you determine if you need to seek medical treatment right away or if home care is reasonable.

Frequently Asked Questions

Q1: What is the most common cause of heel pain?

A: The most common cause of heel pain is plantar fasciitis, but heel pad atrophy and stress fractures can also cause heel pain.

Q2: What does burning pain between my toes mean?A: If you have burning pain between your toes, you may have irritation or thickening of tissue around an interdigital nerve, also known as Morton’s Neuroma.

Q3: Why does my foot hurt along the inside of my arch? A: Pain along the inside of your foot and ankle often occurs when your posterior tibial tendon becomes irritated as your foot arch begins to fall.

Q4: What are some causes of burning or numb feet? A: Neuropathy, nerve compression, diabetes, vitamin deficiency, toxic exposures, and metabolic diseases can all cause burning or numb feet.

Q5: When should I seek medical attention for foot pain? A: If your foot pain persists for weeks, gets worse when resting and changing shoes, is accompanied by numbness, tingling, or deformity it is time to see your doctor.