Health / Expert Advice

Common Causes of Foot Pain—and Treatments Options to Help

From injuries to your shoes, find out what's causing that pesky foot pain.

You probably don’t pay much attention to your feet, but if you start noticing foot pain, you’re reminded of them every step you take. Foot pain is a common problem that can occur as a result of a myriad of conditions. In most instances, rest and TLC can take care of the issue, but sometimes recovery may require more extensive treatment. Here are six of the most common causes of foot pain plus treatment options that can help alleviate the pain.

Achilles Tendinitis

The Achilles is the largest tendon in the body and connects your calf muscles to your heel bones. Activities such as rapid increases in running mileage, running up a steep incline, or quick, repetitive movements can overstress the tendon, causing pain in the heel and ankle. Symptoms include aching, swelling, and tenderness between the heel and calf and increased pain with activity.

Treatment involves taking a nonsteroidal anti-inflammatory medication such as Advil or Aleve, resting, applying ice to the painful area several times a day, and slowly returning to activity. If nonsurgical treatment doesn’t help, surgery may be done to break up scar tissue in the tendon. If needed, one of the rear ankle tendons can be transplanted to the heel bone to provide more support to the Achilles tendon. Cortisone injections aren’t recommended because of the risk of tendon breakdown.

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Bursitis

Your joints have fluid-filled sacs called bursae that provide cushioning and reduce friction with joint movement. If the sacs become injured, they swell and cause pain in and around the joint. The most common site in the foot bursitis is the area between the heel bone and Achilles tendon. Although, your body may also create bursal sacs as a result of trauma in the toe joints and the base of the foot.

An injury, overuse, or repetitive high-impact activities can cause bursitis. There’s a normal age-related decrease in bursa function that increases the risk of this condition ins older people. The symptoms of bursitis are redness, pain, and stiffness with walking or running; a red, warm, painful area; and increased pain when standing on tiptoe.

In most cases, bursitis resolves with rest, icing, and anti-inflammatory medications. You can reduce the chance of bursitis returning by having a professional shoe fitting and adding a heel cushion insert. A custom orthotic may help, and research has shown that wearing padded socks with a well-defined heel and toe fit can protect the foot from soft- tissue injuries.

Bunions

Bunions result from a misalignment of bones in the big or little toe, forming a painful, bony swelling that gets more severe with activities that put pressure or stress on the bunion. The risk of developing a bunion is higher if you have flat feet or osteoarthritis, and they’re more common in women, especially those with a history of wearing pointed high heels. Bunions can lead to bursitis in the toe joint if left untreated.

The first line of treatment is to switch to shoes that have a wide toe box and don’t compress the toes. Bunion pads can help reduce pain by providing a cushion between the swelling and the shoe. In some cases, toe spacers and a night splint may relieve pain. Taking nonsteroidal anti-inflammatory medications and icing the painful area for 15 minutes several times a day will help reduce swelling.

A surgical procedure called a bunionectomy is done if the pain gets to the point where nothing offers relief and if walking becomes difficult. The surgery corrects the misalignment by cutting away the enlarged portion of the bone and realigning the toe.

Morton’s Neuroma

Morton’s neuroma first starts with a strange feeling of having a pebble under your toe. The condition usually occurs between your third and fourth toes and is the result of a thickening of the nerve at the base of the toes. Trauma, constant irritation, and pressure causes the nerve to become irritated, creating the pebble sensation under the foot and, in some instances, pain and numbness at the site. Women have ten times greater risk of developing this condition—wearing high heels or poorly fitted shoes contributes to the development of Morton’s neuroma.

Treatment consists of properly fitted footwear and avoiding narrow high heels or tight shoes. Some people find relief by wearing pads that separate and cushion underneath the toes or by getting a custom orthotic. In some cases, several corticosteroid injections are done to reduce swelling in the nerve. The good news is that the majority of people with Morton’s neuroma respond to nonsurgical treatment. If all else fails, a surgery to resect part of the nerve and remove adhesions of the tissue around it can be done.

Osteoarthritis

More than half of us will have some signs of arthritis in the foot by our sixties. The wear and tear of age can reduce joint cartilage, causing bone-on-bone rubbing with movement. The affected joints can become painful, inflamed, and stiff, especially when moving after rest.

Arthritis in the foot causes stiffness and limited movement within the joint, pain, swelling, and difficulty walking. It can flare with joint overuse or trauma. The first line of treatment includes nonsteroidal anti-inflammatory medications to ease pain and swelling. Then, try orthotics that provide support and cushions the foot, as well as icing the painful joint. Don’t let osteoarthritis stop you from exercising—keep the joint moving to maintain mobility.

Steroid injections can be helpful in reducing swelling and pain but don’t offer long-term relief. If the pain gets to the point where walking becomes too difficult, surgery is an option. The surgery consists of cleaning out debris within the joint and, in some cases, replacing the damaged joint with an artificial one.

Plantar Fasciitis

The hallmark of plantar fasciitis is a severe pain when you first step onto your foot in the morning. An inflammation of the fascia (a fibrous band of tissue) between your heel bone and the lower toe joints causes this. It can start with a feeling of mild discomfort at the base of the heel, but without treatment, it may develop into a more painful condition that can limit movement.

The causes of plantar fasciitis can range from being overweight (which puts more stress on the fascia) to repetitively walking or standing on hard surfaces. Women and those who have flat feet or high arches tend to have a higher risk of developing this condition. The best way to treat plantar fasciitis is with daily stretching, rest, ice, and nonsteroidal anti-inflammatory medicines.

Stretches to help reduce plantar fasciitis pain:

Check out the Aaptiv app for more stretches. If at-home exercises don’t improve your pain level, a referral to a physical therapist can help provide more intensive treatment.

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