Are you experiencing nagging pain on the bottom of your foot? Whether you’re an athlete, on your feet all day at your job, or you want to enjoy a walk in the park, pain on the bottom of your foot can put a damper on your lifestyle.
The reason the bottom of your feet are so vulnerable is they have a big job to do---they support your body weight, keep you stable, absorb shock, and enable you to move in many directions.
From the moment you take your first step in the morning to the last step before bed, your feet are working overtime. It’s important to understand common causes of pain on the bottom of the foot so you can take the necessary action.
In this video, I’ll discuss the six most common conditions that can cause pain on the bottom of your feet. Each of these conditions has unique risk factors and treatment approaches. By understanding these issues, you'll be better able to recognize, prevent, and address your foot pain before it becomes a significant problem.
Plantar Fasciitis
Let's begin with plantar fasciitis, the primary cause of heel pain. It's caused by an inflammation of the structure that runs along the bottom of your foot called the plantar fascia. It's usually most painful when you step out of bed first thing in the morning. That's because the plantar fascia tightens up during the night, and your first steps place sudden stress on it. After you get going and walk on it for a while, the tissue stretches out, and the pain subsides. High-impact activities like running, carrying excess weight, having flat feet or high arches, or wearing unsupportive shoes can all trigger this condition.
Treatment addresses the root causes of this condition. It’s essential to reduce your inflammation, obtain custom orthotics to correct your foot alignment, stretch tight calf muscles, and purchase stable and supportive shoes. I’ve put a link in the video above about how to test any shoe for stability and support.
To prevent plantar fasciitis, gradually build up high-impact activities like running by no more than 10% a week, wear your orthotics consistently, warm-up using Dynamic stretches beforehand, lose weight if necessary, and avoid going barefoot. Learn more about the treatment and prevention of plantar fasciitis here.
Metatarsalgia
Another common condition affecting the bottom of your feet is metatarsalgia. In this condition, you can experience pain under one or more of the bones located in the ball of your foot.
People most at risk include athletes, individuals who spend long hours standing on hard surfaces, and those with specific foot structures like high arches. It can affect anyone who places repetitive stress on the front of their foot. High heels and flip-flops are often culprits as they add more pressure to the front of your foot when you walk.
For treatment, it’s important to see a podiatrist to obtain custom orthotics to stabilize your foot alignment, choose supportive shoes with a wide toe box that are less than one inch in height, and use a metatarsal pad to offload the pressure on the painful spots.
Learn more about metatarsalgia here!
Morton’s Neuroma
If you’ve ever felt like you're walking with a pebble in your shoe or with a bunched-up sock in the ball of your foot, you may have Morton’s Neuroma.
This condition occurs when the nerves and tissue between your third and fourth toes become enlarged, resulting in the strange symptoms I just described. In addition, you can experience burning pain, numbness, and tingling.
It starts out with infrequent, mild symptoms with certain activities, progressing to more painful and constant symptoms over time.
An abnormal foot structure such as flat feet or high arches and conditions such as bunions, wearing high heels and pointy shoes are the main risk factors for developing this condition.
It can become exacerbated in activities such as running, basketball, hiking downhill, or dancing.
We offer alcohol injections to shrink the neuroma, custom orthotics to correct foot mechanics and metatarsal pads to remove pressure from the area, and MLS laser therapy to reduce inflammation. The key to prevent progression includes making smart shoe choices such as a lower heel, shoes with a wider toebox, and consistent wear of custom orthotics.
Learn more about Morton's neuroma here!
Foreign Bodies
Many of us love to walk barefoot, particularly in the warmer months. Unfortunately, it can lead to foot pain for those at risk for plantar fasciitis, but it can also increase the risk of getting foreign bodies. I regularly run across all kinds of foreign material in the foot including thorns, splinters, glass fragments, and even animal hair. Often, the foreign body is so small the patient can feel it but can’t see it. These tiny fragments can work their way into the skin and be hidden underneath it.
The most common symptoms are pain, redness, and swelling. If you notice red streaks moving away from the site, that’s an indication that the infection is serious and medical attention must be sought immediately.
While visible foreign bodies like thorns can be removed at home with tweezers, if they’re buried or if there is swelling and pus or the person has diabetes or a compromised immune system, it's imperative to seek attention with a specialist and have it removed as quickly as possible.
Diabetic Peripheral Neuropathy
Another condition causing pain in the bottom of the foot is peripheral diabetic neuropathy. This condition presents a more complex challenge. This isn't just about pain - it's about your nerves losing their ability to send proper signals to your brain. This can result in numbness, tingling, and pain. While these symptoms sound like Morton’s neuroma, they can cover a much larger area of the foot and ankle. Because the body can’t properly detect pain, patients with this condition are at greater risk for developing foot wounds, called ulcers, and other damaging foot complications.
While diabetes is the primary cause, other factors like trauma, alcohol consumption, and chemotherapy can also trigger peripheral neuropathy. Management of this condition often involves many different health care providers, including a podiatrist. My role is to prevent ulcers from developing through annual and bi-annual foot assessments, trimming of calluses and toenails, and providing proper footwear, orthotics, and socks. When ulcers do develop, our office treats them using special protocols to resolve these wounds and avoid amputations.
Learn more about diabetic peripheral neuropathy here!
Plantar Warts
Finally, a condition found on the bottom of the foot in children and adults is plantar warts. Caused by HPV or the human papilloma virus, it spreads easily in moist environments like locker rooms, swimming pools, and martial art studios—anywhere people go barefoot.
Plantar warts might sound benign, but they can be both painful and persistent.
Our office uses traditional treatments like chemicals and surgery and also technically advanced treatments like Swift Immune Therapy to eliminate plantar warts. The latter method utilizes microwave targeting the underlying virus without destroying the wart, which reduces healing time for patients. It also significantly reduces recurrence.
Learn more about plantar warts here!
In conclusion, you don’t have to suffer needlessly from pain on the bottom of your foot. Most foot conditions have effective solutions for stopping the pain and preventing further progression so you can get back to doing what you love.
