If you experience pain in the bottom of your foot, the chances are likely that you are reminded of it much more often than you’d like to be!
Whether the pain starts as soon as your heels hit the floor out of bed or tends to bother you more during or after activity, the symptoms can be a constant obstacle to your willingness to get things done.
The good news is that the vast majority of conditions that cause pain along the bottom of your foot can be treated effectively with conservative methods. The key is determining what exactly is causing the trouble.
There are several potential causes of bottom-of-foot pain – and we’ll be discussing a few here – but one thing will always ring true: any persistent foot pain that doesn’t clear up after a day or two is worth coming to see us about!
Foot pain is never something you should feel you must grit your teeth and accept. Not only will trying to ignore your symptoms make you feel miserable, but it also risks the problem becoming more severe and chronic in the future.
And you deserve better than that.
Where on the Bottom of the Foot is Your Pain?
Location matters, and the bottom of your foot is a relatively wide area – at least anatomically speaking.
Different areas along the bottom of the foot contain different bones, muscles, and soft tissues. By narrowing down which of these elements may be injured or strained, we can recommend more direct approaches to finding relief.
We can divide bottom-of-the-foot pain into three general areas.
Pain in the Heel Area
Heel pain is one of the most common symptoms podiatrists see. If your heels are suffering, you are far from alone – and we have a ton of experience in helping patients just like you!
Common causes of heel pain include:
Plantar fasciitis
Arguably the most frequent cause of heel pain, this condition focuses on a thick band of tissue that stretches from the heel bone to the base of the toes, called the plantar fascia.
Too much strain or repetitive stress on the plantar fascia can cause microtears to form, leading to pain. This is more likely to occur to people who are consistently pounding the pavement (e.g. runners) or people whose jobs or hobbies require them to stand or walk on hard surfaces for long periods of time.
The symptoms of plantar fasciitis tend to be at their worst first thing after getting out of bed or moving after a long period of inactivity. Once you have a few minutes to move, the pain tends to recede.
Achilles tendinitis
The Achilles tendon connects the back of the heel bone to the calf muscles. When overstrained, the tendon can become inflamed, causing pain.
The pain of Achilles tendinitis is typically felt more toward the back of the heel, and can sometimes be felt just above it. While this condition can cause some pain and stiffness in the morning, it also tends to worsen after activity and feel worse the day after activity.
Achilles tendinitis can also be caused by repetitive motion and overuse, but tight calf muscles can also be causing excess stress on the tendon.
Pain in the Arch Area
We now move to the center of the foot, between the heel and the ball of the foot.
Common causes of pain in this region include:
Plantar fasciitis
Wasn’t this just mentioned as a cause of pain in the heel? Yes, but its expanse across the underside of the foot means it could cause pain in the arch area as well.
Posterior tibial tendinitis
The posterior tibial tendon connects the bone on the inner side of the foot to the calf muscles.
When this tendon becomes inflamed, it can cause pain along the inside of the foot. The inside of the ankle might also be involved.
In more progressive cases of posterior tibial tendinitis, the arch of the foot can start to collapse, leading to flat feet. This can cause further pain and problems.
Abnormalities in the arch structure
Conditions such as flat feet and high arches do not necessarily need to be caused by tendon dysfunction. They can simply be a genetically inherited way that the feet have developed over time.
Unfortunately, such structural abnormalities can still cause an uneven distribution of weight and forces across the feet, leading to pain in the arches or other areas. Stretching and custom orthotics can often help provide conditioning and corrective support for relief.
Pain in the Ball of the Foot
This is the area right at the base of your toes.
The general umbrella term for pain in the ball of the foot is “metatarsalgia.” This is in relation to the metatarsals, the longer bones that make up the front part of the foot.
Overuse injuries, structural abnormalities, excess weight, and other factors can contribute to general metatarsalgia.
A condition more specific to the area, however, is Morton’s neuroma. This is a non-cancerous growth of tissue around a nerve, often as a response to irritation. The pain from a neuroma can often feel “burning” or “tingling,” and it may also feel like you have a pebble in your shoe as you walk. It is typically located near the base of the toes between either the second and third or between the third and fourth digits.
Treating Pain Along the Bottom of Your Foot
The conditions above are not an exhaustive list of all possible conditions that could be causing your bottom-of-foot discomfort. There are some, such as stress fractures, that have the potential to pop up just about anywhere!
Fortunately, most forms of pain along the bottom of the foot can be treated effectively through conservative methods. These may include:
- Simple rest (switching to lower-impact activities in the meantime)
- Changes in footwear, activity levels, or environment (such as using anti-fatigue mats)
- Custom orthotics to redistribute excess pressure away from injured areas
- Laser therapy to relieve pain and accelerate natural recovery of soft tissue injuries
- Medications to reduce pain and inflammation
But to determine the most effective plan for your specific situation, we must first determine the source of the problem. That requires a thorough examination and learning more about how your symptoms are affecting your life.
No two causes of foot pain are exactly alike, and the same treatment won’t be equally effective for everyone. That’s why we pride ourselves on working closely with patients to find the best way to address their needs.
