Table of ContentsView AllTable of ContentsCauses and SymptomsWhen to Seek CareDiagnosisTreatmentPrevention
Table of ContentsView All
View All
Table of Contents
Causes and Symptoms
When to Seek Care
Diagnosis
Treatment
Prevention
The pain may arise from problems with the bones, nerves, cartilage,tendons, orligamentsof your foot. Some people are predisposed to pain due to structural foot problems, such as having very high arches or flat feet. Depending on the condition, you may feel shooting pain or a constant ache.
Some at-home remedies may help the pain, but you may also need to see a healthcare provider for treatment.
Verywell / Theresa Chiechi
Here are some of the more common causes of bottom-of-the-foot pain.
Plantar Fasciitis
One of the most common causes of foot pain isplantar fasciitis. This is the inflammation of the band of tissue called the plantar fascia that stretches from the heel bone to the base of your toes.
Pain with plantar fasciitis may be dull or sharp. The bottom of the foot may also ache or burn.Symptoms tend to be most severe in the morning when taking your first steps out of bed.Risk factors for plantar fasciitis include:
Metatarsalgia
Metatarsalgiadescribes pain in the ball of your foot where the five metatarsal bones are situated.These long bones in your forefoot connect your ankle to each of your five toes. The metatarsals help form the arch of the foot, which are essential for walking and weight-bearing activities.
Metatarsalgia pain is often described as being sharp, aching, or burning. It can worsen when you stand, run, walk, or flex your feet.
Metatarsalgia is common in people who do high-impact activities, like running or jumping. Older adults are more likely to develop metatarsalgia due to long-term repetitive stress.
Other risk factors include:
Peripheral Neuropathy
Neuropathy pain is often described as tingling, burning, shocking, or stabbing. The pain often gets worse with walking or standing.
Morton’s Neuroma
A neuroma is an abnormal clump of nerve cells that can form between the toes (usually after an injury). Symptoms may include:
The neuroma can feel like a pebble in your shoe. It is most common between the third and fourth toes.
People who are assigned female at birth are more likely to be affected.
Sesamoiditis
Sesamoiditisis the inflammation of the two small bones situated beneath the pad of the big toe, called the sesamoids.These bones help support the tendon that flexes this toe.
Symptoms of sesamoiditis include a dull, longstanding pain beneath the big toe joint. The pain comes and goes, usually occurring with certain shoes or certain activities.
Risk factors include:
Tarsal Tunnel Syndrome
Tarsal tunnel syndromeoccurs when the nerve that services parts of the calf and foot, called theposterior tibial nerve, gets compressed in a narrow space inside the ankle, called the tarsal tunnel. This causes pain, numbness, and tingling in the foot.
Risk factors for tarsal tunnel syndrome include:
Guillain-Barré Syndrome (GBS)
For many people, the first signs of GBS are pain, weakness, or tingling in their toes, feet, or legs. These sensations tend to progress over the coming hours, days, or weeks and gradually spread to the arms and upper body. In rare cases, GBS can cause permanent nerve damage, paralysis, or death.
Anyone can get GBS, but it is more common in adults over 50. Your risk is also higher if you’ve had a recent surgery or have a preexisting autoimmune disease.
When to See a Healthcare Provider
Sometimes, bottom-of-the-foot pain goes away on its own in a few days. At other times, it becomes a chronic condition that impacts your quality of life.
See a healthcare provider if you have:
Based on your symptoms, your healthcare provider may refer you to apodiatrist(foot specialist),orthopedist(bone specialist), orneurologist(nerve specialist).
When to Call 911Severe foot trauma typically requires emergency care if there is:Visible deformity of the footA bone protruding through the skinA severe laceration causing bleedingPain that makes it impossible to walkThe loss of sensation in the foot
When to Call 911
Severe foot trauma typically requires emergency care if there is:Visible deformity of the footA bone protruding through the skinA severe laceration causing bleedingPain that makes it impossible to walkThe loss of sensation in the foot
Severe foot trauma typically requires emergency care if there is:
To identify the cause of your foot pain, your healthcare provider will first examine your foot for signs of pain, tenderness, infection, or a loss of range of motion. They will also check for any abnormal sensations or signs of deformity (including bunions, overpronation, or flat feet).
Based on the findings, your healthcare provider may order imaging tests to check the structure of your foot and other procedures that measure nerve activity.
These include:
Differential Diagnoses
Adifferential diagnosisis a process in which your healthcare provider rules out all the other possible conditions that could explain your symptoms. This is important to make a definitive diagnosis of your bottom-of-the-foot pain.
Conditions similar to sesamoiditis include:
Conditions that mimic neuroma include:
Conditions with similar symptoms to metatarsalgia include:
Treatment for foot pain depends on your diagnosis. Healthcare providers usually recommend starting with conservative options and moving to other treatments as needed.
Lifestyle
The more significant your pain is, the more you might think that lifestyle won’t have much of an effect. That’s simply not true. There are many effective strategies that can help.
Supportive shoes or inserts can help relieve some foot pain, particularly for conditions like plantar fasciitis, metatarsalgia, and neuroma.
In some cases, your healthcare provider may prescribe custom orthotic shoe inserts designed to fit and support your foot’s distinct curves.
Diet
Starting ananti-inflammatory dietis ideal for anyone experiencing pain. It focuses on reducing processed and high-fat foods while increasing your intake of fruits and vegetables, fish, nuts, and whole grains. Foods with turmeric, lemon water, and antioxidants may help reduce foot inflammation.
Weight Loss
Being overweight or obese is linked to an increased risk of pain, inflammation, and other problems in your feet. Losing weight, if needed, can reduce the stress on your feet.
Losing weight is especially important if you also have diabetes, which is a risk factor for peripheral neuropathy, metatarsalgia, tarsal tunnel syndrome, and more.
Posture
If you tend to slouch, you can try wearing a posture brace to pull your shoulders back. You might also find it helpful to set a frequent alarm to remind you to correct your posture.
Last but not least, stretches and strength-building exercises are a must for correcting posture. Stretching will release tension in your back, hips, and glutes and help you stand more evenly. Exercises that strengthen your core, back, and shoulders will help you stand taller and align your spine.
Medications
Over-the-counter pain relievers are commonly used to ease foot pain, including:
If conservative treatments fail, acortisone injectioncan quickly ease inflammation in people with plantar fasciitis, sesamoiditis, or neuromas.
For severe pain, you may be given a prescription opioid painkiller like:
Opioids can be highly addictive and are only intended for short-term use.
Peripheral neuropathy can be harder to treat. It is generally managed with medications such asanti-seizure drugsandantidepressants. These drugs change how your nervous system functions.
Complementary and Alternative Therapies
Certain complementary or alternative treatments may help relieve foot pain, including:
You can also try applying a cold or hot compress to your foot to reduce pain. Use ice for only 20 minutes at a time up to three times a day. Don’t place ice packs directly against your skin.
Physical Therapy
Your healthcare provider may refer you to aphysical therapistif your foot pain interferes with your daily life, activities, or mobility. The goal of physical therapy is to reduce your symptoms and the effect they have on your quality of life.
To accomplish this, your physical therapist will put together a program that rehabilitates your foot so that you can walk and stand without pain. Your rehab program may involve stretches and exercises that improve your foot and ankle strength, balance, and range of motion.
Physical therapy can help you manage your plantar fasciitis, metatarsalgia, neuroma, or sesamoiditis. In some cases, it may help with peripheral neuropathy.
Surgery
Surgery is typically a last resort when all other treatment options fail to reduce your pain and other symptoms.
A surgical procedure called asesamoidectomymay be necessary for very severe cases of sesamoiditis that do not respond to physical therapy. This surgery involves removing the sesamoid bone.
Surgery for plantar fasciitis is uncommon, but it may be necessary if your pain persists despite six to 12 months of physical therapy. The surgery involves cutting part of the plantar fascia to release tension and ease swelling.
Severe neuromasthat don’t get better with therapy can be treated with a minimally invasive procedure called a neurectomy. A small incision is made in the foot and the affected nerve is removed.
Several possible surgeries can be done for severe metatarsalgia,depending on what has caused it. If a deformity is to blame, ametatarsal osteotomycan be done to realign the metatarsal bone(s).
Surgery may be done for peripheral neuropathy, also depending on the cause. The minimally-invasive procedure involves dividing the affected nerve to relieve pressure. It can be done in an outpatient setting.
You can’t always prevent a foot injury or an illness that leads to foot pain. But there are lifestyle changes you can make to reduce your risk of discomfort, such as:
Taking care of your overall health goes a long way in preventing foot pain. In addition to eating ahealthy dietand exercising regularly, carefully managing any chronic conditions is key.
If you smoke cigarettes,do all you can to quit. Cigarette smoking promotes chronic inflammation.
Similarly, if you think you may bedependent on alcohol, consult with your healthcare provider. Resolving an alcohol dependence can reduce your risk of peripheral neuropathy along with many other health conditions.
Summary
There are several possible causes of bottom-of-the-foot pain. Symptoms can vary depending on the cause. Diagnosing why the bottom of your foot hurts may include a physical exam and X-rays or other imaging. Treatment may involve pain relief, lifestyle changes, physical therapy, and in severe cases, surgery.
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Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Medline Plus.Plantar fasciitis.Trojian T, Tucker A.Plantar fasciitis.Am Fam Physician. 2019 Jun;99(12):744-750.NHS UK.Pain in the ball of the foot.Arie EK, Moreira NS, Freire GS, Dos Santos BS, Yi LC.Study of the metatarsal formula in patient with primary metatarsalgia.Rev Bras Ortop. 2015 Jul;50(4):438-444. doi:10.1016/j.rboe.2015.06.018Winchester Hospital.Metatarsalgia.Medline Plus.Peripheral neuropathy.Johns Hopkins Medicine.Peripheral nerve injury.Medline Plus.Morton’s neuroma.Ruiz Santiago F, Tomás Muñoz P, Pryest P, Martinez Martínez A, Olleta Prados N.Role of imaging methods in diagnosis and treatment of Morton’s neuroma.World J Radiol. 2018 Sep;10(9):91-99. doi:10.4329/wjr.v10.i9.91American College of Foot and Ankle Surgeons.Sesamoid injuries in the foot.Foot Health Facts.Sesamoid injuries in the foot.Johns Hopkins Medicine.Tarsal tunnel syndrome.Medline Plus.Guillain-Barre syndrome.Centers for Disease Control and Prevention.Guillain-Barré syndrome.Sims AL, Kurup HV.Painful sesamoid of the great toe.World J Orthop. 2014 Apr;5(2):146-150. doi:10.5312/wjo.v5.i2.146Ganguly A, Warner J, Aniq H.Central metatarsalgia and walking on pebbles: Beyond Morton nueroma.AJR. 2018 Apr;210(4):821-833. doi:10.2214/AJR.17.18460Turchin O, Lyabakh A.The differential diagnosis of metatarsalgia. 2019;4(1):48-52. doi:10.15674/0030-59872018448-52De Gregori M, Muscoli C, Schatman ME, et al.Combining pain therapy with lifestyle: the role of personalized nutrition and nutritional supplements according to the SIMPAR Feed Your Destiny approach.J Pain Res. 2016;9:1179-1189. doi:10.2147/JPR.S115068Trinh K, Belski N, Zhou F, et al.The Efficacy of Acupuncture on Foot and Ankle for Pain Intensity, Functional Status, and General Quality of Life in Adults: A Systematic Review. Med Acupunct. 2021 Dec 1;33(6):386-395. doi: 10.1089/acu.2021.0006Yelverton C, Rama S, Zipfel B.Manual therapy interventions in the treatment of plantar fasciitis: A comparison of three approaches. Health SA. 2019 Sep 25;24:1244. doi: 10.4102/hsag.v24i0.1244Pearson JM, Moraes LVM, Paul KD, et al.Is fibular sesamoidectomy a viable option for sesamoiditis? A retrospective study.Cureus. 2019;11(6):1-12. doi:10.7759/cureus.4939University of Michigan Health.Plantar fasciitis: Should I have surgery for heel pain?.Penn Medicine.Morton’s neuroma treatment.Kaiser Permanente.Metatarsalgia.University of Michigan Health.Peripheral nerve surgery.Lee J, Taneja V, Vassallo R.Cigarette smoking and inflammation: cellular and molecular mechanisms.J Dent Res. 2012 Feb;91(2):142-149. doi:10.1177/0022034511421200
Medline Plus.Plantar fasciitis.
Trojian T, Tucker A.Plantar fasciitis.Am Fam Physician. 2019 Jun;99(12):744-750.
NHS UK.Pain in the ball of the foot.
Arie EK, Moreira NS, Freire GS, Dos Santos BS, Yi LC.Study of the metatarsal formula in patient with primary metatarsalgia.Rev Bras Ortop. 2015 Jul;50(4):438-444. doi:10.1016/j.rboe.2015.06.018
Winchester Hospital.Metatarsalgia.
Medline Plus.Peripheral neuropathy.
Johns Hopkins Medicine.Peripheral nerve injury.
Medline Plus.Morton’s neuroma.
Ruiz Santiago F, Tomás Muñoz P, Pryest P, Martinez Martínez A, Olleta Prados N.Role of imaging methods in diagnosis and treatment of Morton’s neuroma.World J Radiol. 2018 Sep;10(9):91-99. doi:10.4329/wjr.v10.i9.91
American College of Foot and Ankle Surgeons.Sesamoid injuries in the foot.
Foot Health Facts.Sesamoid injuries in the foot.
Johns Hopkins Medicine.Tarsal tunnel syndrome.
Medline Plus.Guillain-Barre syndrome.
Centers for Disease Control and Prevention.Guillain-Barré syndrome.
Sims AL, Kurup HV.Painful sesamoid of the great toe.World J Orthop. 2014 Apr;5(2):146-150. doi:10.5312/wjo.v5.i2.146
Ganguly A, Warner J, Aniq H.Central metatarsalgia and walking on pebbles: Beyond Morton nueroma.AJR. 2018 Apr;210(4):821-833. doi:10.2214/AJR.17.18460
Turchin O, Lyabakh A.The differential diagnosis of metatarsalgia. 2019;4(1):48-52. doi:10.15674/0030-59872018448-52
De Gregori M, Muscoli C, Schatman ME, et al.Combining pain therapy with lifestyle: the role of personalized nutrition and nutritional supplements according to the SIMPAR Feed Your Destiny approach.J Pain Res. 2016;9:1179-1189. doi:10.2147/JPR.S115068
Trinh K, Belski N, Zhou F, et al.The Efficacy of Acupuncture on Foot and Ankle for Pain Intensity, Functional Status, and General Quality of Life in Adults: A Systematic Review. Med Acupunct. 2021 Dec 1;33(6):386-395. doi: 10.1089/acu.2021.0006
Yelverton C, Rama S, Zipfel B.Manual therapy interventions in the treatment of plantar fasciitis: A comparison of three approaches. Health SA. 2019 Sep 25;24:1244. doi: 10.4102/hsag.v24i0.1244
Pearson JM, Moraes LVM, Paul KD, et al.Is fibular sesamoidectomy a viable option for sesamoiditis? A retrospective study.Cureus. 2019;11(6):1-12. doi:10.7759/cureus.4939
University of Michigan Health.Plantar fasciitis: Should I have surgery for heel pain?.
Penn Medicine.Morton’s neuroma treatment.
Kaiser Permanente.Metatarsalgia.
University of Michigan Health.Peripheral nerve surgery.
Lee J, Taneja V, Vassallo R.Cigarette smoking and inflammation: cellular and molecular mechanisms.J Dent Res. 2012 Feb;91(2):142-149. doi:10.1177/0022034511421200
Franettovich Smith MM, Collins NJ, Mellor R, et al.Foot exercise plus education versus wait and see for the treatment of plantar heel pain (FEET trial): a protocol for a feasibility study.J Foot Ankle Res. 2020;13(1):20. doi:10.1186/s13047-020-00384-1Menz HB, Dufour AB, Casey VA, et al.Foot pain and mobility limitations in older adults: the Framingham Foot Study.J Gerontol A Biol Sci Med Sci. 2013;68(10):1281-1285. doi:10.1093/gerona/glt048Menz HB, Dufour AB, Katz P, Hannan MT.Foot pain and pronated foot type are associated with self-reported mobility limitations in older adults: The Framingham foot study.Gerontology. 2016;62(3):289-295. doi:10.1159/000442089Riskowski JL, Dufour AB, Hagedorn TJ, Hillstrom HJ, Casey VA, Hannan MT.Associations of foot posture and function to lower extremity pain: results from a population-based foot study.Arthritis Care Res (Hoboken). 2013;65(11):1804-1812. doi:10.1002/acr.22049
Franettovich Smith MM, Collins NJ, Mellor R, et al.Foot exercise plus education versus wait and see for the treatment of plantar heel pain (FEET trial): a protocol for a feasibility study.J Foot Ankle Res. 2020;13(1):20. doi:10.1186/s13047-020-00384-1
Menz HB, Dufour AB, Casey VA, et al.Foot pain and mobility limitations in older adults: the Framingham Foot Study.J Gerontol A Biol Sci Med Sci. 2013;68(10):1281-1285. doi:10.1093/gerona/glt048
Menz HB, Dufour AB, Katz P, Hannan MT.Foot pain and pronated foot type are associated with self-reported mobility limitations in older adults: The Framingham foot study.Gerontology. 2016;62(3):289-295. doi:10.1159/000442089
Riskowski JL, Dufour AB, Hagedorn TJ, Hillstrom HJ, Casey VA, Hannan MT.Associations of foot posture and function to lower extremity pain: results from a population-based foot study.Arthritis Care Res (Hoboken). 2013;65(11):1804-1812. doi:10.1002/acr.22049
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