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The foot is made up of an intricate network of nerves, lymphatics, blood vessels, ligaments, tendons, more than 100 muscles, 26 bones, and 33 joints. All these components are responsible for sustaining your body weight and keeping you moving throughout the day.
So, when you experience pain or discomfort, it is often hard to pinpoint the exact cause or severity of the condition. According to a study by the American Podiatric Medical Association, nearly four in every 10 individuals indicate that they are unable to perform everyday tasks due to severe foot pain.
This guide explores everything you need to know about the condition, in addition to how and when it occurs, to help you identify what could be causing it.
How Does It Hurt?
Not all foot pain is created equal. The type of pain sensation you get is the number one indicator of what could be ailing you. For instance, experiencing pulsing pain in foot vs. a sharp pain that occurs during movement could mean two entirely different things.
An aching pain could be the result of a chronic condition you may or may not be aware of, whereas a sharp pain could be the result of an injury to the foot muscle. Here’s what you need to know about it.
What Causes Foot Numbness and Pain?
Your body is made up of a complex network of nerves that traverse every inch of your being. They run from the tips of your fingers and toes, all the way up to your brain, and back down again.
These nerve cells – also known as neurons – communicate with each other by transmitting electrochemical signals between the brain and the different muscles and glands in the body.
This intricate system is what directs your body to perform different functions like movement and breathing. If something gets in the way of how these signals are transmitted in the nerve network, it often manifests as pain.
Foot numbness, for instance, might be due to an infection, blockage, or compression of a nerve that travels down to the foot. A sharp burning pain in foot that occurs even while at rest could be the result of pinched, damaged, or irritated nerves.
In other instances, foot pain could originate from inflamed joints and tendons. So, it’s important to be aware of the kind of pain that you’re experiencing to give you an idea of what could be causing it.
What Causes Foot Numbness?
You might experience numbness for several reasons. Here are some of the top causes:
- Chronic or excessive alcohol consumption
- Injuries to the spine, hips, torso, ankles, and feet that may put pressure on nerves
- Multiple sclerosis
- Nerve damage resulting from diabetic neuropathy
- Peripheral artery disease
- Postural habits that inhibit blood flow to the lower limbs
- Sciatica – the irritation of the sciatic nerve that runs from the lower back to the legs
- Strokes or mini-strokes
- Tarsal tunnel syndrome
- Tumors, cysts, benign growths or abscesses
What Causes Sudden Foot Pain and Swelling?
It’s perfectly normal to experience swollen feet from time to time, especially after standing, walking, or running for long periods. The remedy for this is to simply rest and elevate those tired dogs.
It’s a red flag, however, if the swelling persists and is accompanied by sudden foot pain when movement is involved. It could indicate a more serious underlying problem. Some of these include:
- Phlebitis – inflammation of the veins in the foot
- Deep-vein thrombosis – clots form in the deep veins of the legs
- Bone and tendon conditions like arthritis, tendinitis or fractures
Foot swelling without pain, on the other hand, could be the result of:
- Venous insufficiency which may cause blood to pool in the leg veins
- Heart failure – the heart doesn’t pump blood as it should causing blood to pool in the leg veins as well
- Kidney disease – poor kidney function causes excess fluid retention
- Liver disease – causes low albumin production which causes excess fluid build-up in the tissues
- Side-effects of certain medications can cause edema. Calcium-channel blockers, for instance, a medicine used to treat high blood pressure is a common culprit
High Uric Acid and Foot Pain
Uric acid is a by-product that results from the digestion of foods that have purines. Purines are a type of chemical compounds that occur naturally in foods and certain drinks and form part of any normal diet. However, there are certain types of foods that contain unusually high concentrations of purine. They include:
- Organ meats or “sweetmeats” like kidney, liver, heart, gizzard, etc.
- Foods and meat that are high in saturated fats like beef, fish, poultry, lamb, and pork
- Seafood particularly shellfish, sardines, herring, anchovies, mackerel, and scallops
- Dried beans
- Alcoholic beverages particularly beer
- Food and drinks like sodas that contain high fructose corn syrup
Normally, your body is pretty efficient at breaking down purines to form uric acid, which is then filtered out through the kidneys and passed out in urine – as long as it is in what would be considered “normal” amounts.
Given that your body isn’t a machine, consuming too much purine in your diet will eventually lead to an excessive amount of uric acid build-up. This happens when your body can’t get rid of this by-product fast enough.
Does High Uric Acid Cause Foot Pain?
Having high uric acid levels in your system is called hyperuricemia, which, in the long run, leads to the formation of kidney stones as well as a disease known as gout. Gout is a type of arthritis (joint inflammation) that comes about when uric acid solidifies into crystals in the joints as the body attempts to remove high levels of this waste product from the bloodstream.
Gout flares can be extremely painful and can come on quickly at any time, often after a meal with high purine levels or without warning as you sleep. It commonly affects the joints in the big toe, although it can affect other joints, particularly those in the toes and fingers.
Can Tight Hip Flexors Cause Foot Pain?
Your hip flexors are the group of muscles located near the top of your thighs that allow you to move your lower body. They let you bend, kick, walk, and swivel your hips. If these muscles become too tight, they might stretch or tear if you move suddenly. Tight hip flexors can cause foot pain in addition to lower back and knee pain.
Foot Pain Based on Activities
The most common causes of foot pain are those that result from the overuse of or injuries to the foot. Here are some typical ones that you might encounter.
What Causes Foot Pain After Sitting?
Pain in the foot when you stand after sitting for a while or when you get out of bed is a classic symptom of plantar fasciitis. It is characterized by the inflammation of the tissue beneath the heel of the foot, which can cause intense stabbing pain and, in some cases, swelling in the heel.
Foot Pain from Driving
If you’ve experienced pain or cramping in either the heel or ball of your foot, across the top or around the joint in the big toe while driving, then you may have a condition called “Driver’s Foot.” It is brought on by sustained and repetitive stress on the foot, particularly when driving for long distances.
Foot Pain Worse When Resting
If you experience foot pain while sleeping or resting, that lessens if you get up and walk around for a bit, you might be suffering from a nerve disorder known as peripheral neuropathy. It usually starts with a feeling of some numbness in the balls of your feet and your middle toes; that’s often intense enough to rouse you from a deep slumber.
Peripheral neuropathy is often the result of underlying medical conditions, including shingles, kidney failure, vitamin deficiency, diabetes, certain cancers, and immune disorders.
Bad Foot Pain When Walking
Experiencing pain in the ball of foot after running, when walking or during prolonged jumping activities, are all classic symptoms of Metatarsalgia. This condition is characterized by a sharp or achy pain in the ball-of-foot area between your toes and the arch.
It is caused by the increased stress load on the metatarsal bones causing them to become inflamed, which in turn leads to extreme pain, particularly when walking or running.
Pain When Squeezing Foot – Morton’s Neuroma
If you feel a mild or, in some cases, severe pain when squeezing your foot, particularly on the sides, it could be the result of a muscular injury due to overuse in activities like running, walking, kicking, jumping, or wearing tight-fitting shoes. This typically subsides after a few days of rest and keeping your feet elevated.
If the pain persists despite your best efforts, you might be suffering from a condition known as Morton’s Neuroma. It is characterized by an ache that occurs when the “overused” tissue inside the foot gets thicker, pressing against a nerve that leads to a toe. This irritates the nerve causing pain as a result.
Can Dehydration Cause Foot Pain?
Yes, it can. This is one of the most overlooked reasons for foot pain – that you’re simply not drinking enough water. Dehydration manifests in several ways, one of which may include pain in your feet. People who suffer from gout in particular experience severe pain when they don’t drink enough water to counteract arthritis.
Foot Pain During Menstruation
It is quite common for women to experience leg and foot pain during their period. Remember that old childhood song you would sing as kids? “…the thigh bone connected to the leg bone and the leg bone connected to the…” Well, it’s a great way to explain why that happens.
When you get menstrual cramps, the nerve network in the pelvic region may transmit these pain signals to your leg and foot nerves. So, you might feel your foot cramping up too. Fun, right?
Pain After Cast Removal Foot
Once you heal from a fractured foot, it is quite normal to experience some foot pain and discomfort in the regions that were immobilized.
Your foot heals by first forming a thick layer of new bone known as callus around the fracture to hold everything in place. Once the new bone mass forms, the body begins to remove the outer callus, which may cause some discomfort.
Puncture Wound Foot Pain
The common causes of this kind of pain include wood, small pieces of broken glass, wood splinters, nails, or pins. Any sharp object that could potentially puncture your foot and cause a wound would be responsible for causing this type of pain.
Foot Pain When Flexing
The ankle is the hinged joint at the base of your leg that allows you to flex your foot in different directions. If you experience ankle pain when flexing foot up or down, it could be due to an injury or, in some cases, a disease that affects this all-important joint.
The severity of the pain when flexing foot up or down ranges from mild, which can improve in the course of 24 hours, or severe, which may require surgical intervention.
Sprains, Fractures, and Diseases Affecting the Ankle
One of the most common musculoskeletal injuries that cause ankle pain when flexing foot down, up or to the sides, can be attributed to ankle sprains. These occur on either the inner or outer regions of the joint when injuries to the ligaments cause them to tear as a result of sudden stretching.
If the Achilles tendon of the calf muscle, which runs behind the ankle and connects at the back of the heel, also tears in the process, you might also experience pain in calf when flexing foot.
This type of pain in ankle when flexing foot is initially quite intense. A “popping” sensation usually accompanies it right before subsequent swelling over the area.
On the flip side, certain diseases or other medical conditions can be responsible for ankle pain. These include gout, rheumatoid arthritis, reactive arthritis, psoriatic arthritis, ankylosing spondylitis, and tendonitis.
Plantar Fasciitis Foot Pain
Plantar fasciitis pain on top of foot and heel is one of the most common causes of foot pain. However, experiencing pain in the top region could be the result of another condition called extensor tendonitis. Plantar fasciitis occurs when the thick band of tissue that runs across the bottom of your foot becomes inflamed as a result of repeated tension and stress, causing small tears.
This could be due to certain risk factors like age, certain types of exercise that put a lot of strain on this tissue, mechanics, obesity, and jobs that require you to spend long periods on your feet.
Can Plantar Fasciitis Cause Lateral Foot Pain?
Although plantar fasciitis can cause lateral foot pain, you should be feeling it a lot more along the bottom of your foot, specifically around the heel. The more likely cause of lateral foot pain includes ankle joint inflammation, tendon inflammation, arthritis, ankle bone fracture, and torn, pinched or stretched nerves.
Cuboid syndrome, bunions, peroneal tendonitis corns, and calluses are conditions that also cause lateral foot pain.
Where Does It Hurt?
To get the right treatment for foot pain, you first need to identify the source of the problem. Here are some of the different types of pain you may experience and what they mean.
Stabbing Pain in Arch of Foot
Flat feet (fallen arches) and plantar fasciitis are the most common causes of arch pain, although the latter can also affect the heel.
Arch of Foot Tight and Painful
If the arch of your foot feels tight and painful despite your best efforts to adjust your shoes, it could be due to fallen arches or plantar fasciitis.
Sharp Pain in Middle of Foot
The most likely culprit is an injury to the post-tib tendon, which passes along the inside of the foot and ankle.
Pain on Outside Middle of Foot
If it occurs towards the top, it could be due to Morton’s Neuroma (inflammation of a nerve at the ball of the foot) or Metatarsalgia (affecting the bones in the ball-of-foot region).
What Causes Heel Pain in One Foot
It could be due to plantar fasciitis, heel spurs (abnormal growth of the heel bone), or inflammation due to the heel bearing a significant amount of weight during various activities like walking, running, or standing for long periods.
Pain From Buttocks to Foot
This is caused by the inflammation of the sciatica nerve, which runs from the lower spine, through the buttock, down the back of the leg to the foot.
Inside of Foot Pain
Pain on the inside of the foot is the result of repeated strain or overuse. This causes a bunion to form on the inside of the forefoot.
Swollen Top of Foot With Pain
Swelling and pain on top part of foot can be the result of overuse leading to conditions like extensor tendonitis, sinus tarsi syndrome, or stress fractures.
Conditions like bone spurs and peroneal nerve dysfunction are also potential causes of extreme pain on top of foot.
Pain on Top of Foot by Toes
This could be the result of conditions like Hammer Toe, mallet toes, claw toe, and gout.
Pain on Bottom of Foot by Toes
Pain on bottom of foot under toes can be attributed to metatarsalgia – a condition caused by overuse, wearing high-heeled shoes, obesity and being overweight, Morton’s Neuroma, and claw foot.
Pain in the Pad of My Foot
It could be the result of foot deformities, poorly fitting shoes, stress fractures, or intense training, especially high-impact sports. It could also be the result of an underlying medical condition like Morton’s Neuroma.
Pain on Side and Bottom of Foot
Foot pain that moves around on the side and bottom of your foot and persists for a couple of days with no sign of improvement is most likely due to migratory arthritis – a condition that causes inflammation of the joints. It is called “migratory” since the pain appears to radiate from one joint to another.
Causes of Bottom of Foot Pain
Pain in the arch, ball, or sole of your foot could be due to any number of reasons. Some of these include a sprained foot, Morton’s Neuroma, plantar fasciitis, or flat feet (fallen arches).
Shooting Pain From Knee to Foot
Pain that feels like it is originating from the knee running down to the foot might be due to a condition known as deep vein thrombosis (DVT), which occurs when there’s a blood clot in a vein in the lower limbs.
It could also be a sign of shin splints, which is typically related to overuse.
Pain in Foot Going up Leg
The most common cause of this type of pain is foot tendonitis. It often feels like the pain starts from the foot and radiates up the leg, but in other instances, it may also feel like it’s moving down the leg.
Constant Pain on Outside of Foot
The most common causes of this kind of pain are peroneal tendonitis, calluses, and corns, stress fractures, bunions, or a ligament injury brought on by an ankle sprain.
Inner Ball of Foot Pain
Pain in the inner ball of your foot, particularly in the region under your big toe, is often due to metatarsalgia. This occurs when the padding in the area gets inflamed due to intense physical activity, stress fractures, bunions, and Hammer Toes, being overweight or obese, wearing shoes that are too small or arthritis.
Pregnancy and Foot Pain
Foot pain during pregnancy third trimester is due to an upsurge in specific pregnancy hormones like relaxin, which helps to relax ligaments and other structures to allow for a smooth vaginal birth.
Unfortunately, they also cause the ligaments in the feet to relax, leading to flat feet (fallen arches), which are among the leading causes of foot pain. Weight gain in the third trimester of pregnancy also puts more stress on already compromised feet, contributing to pain.
On the other hand, leg cramps are the most common type of foot pain during pregnancy second trimester. These painful spasms of the calf are due to tired muscles caused by weight gain, changes in the concentration of calcium, or the pressure that the growing womb exerts on blood vessels and the nerves.
When Does It Hurt?
Knowing when your foot hurts is just as important as knowing how, why, and where. Here’s what you need to know.
Foot Pain and Swelling in the Morning
Foot pain and swelling in the morning can be attributed to a condition known as plantar fasciitis. It is characterized by a shooting pain in the heel that occurs when you get out of bed in the morning or after long periods of rest.
Mild swelling might indicate poor blood circulation in the feet due to overly stretched-out veins. This leads to fluid retention in the ankles and feet.
Swelling could also be a sign of an underlying problem like heart, liver, or kidney disease. It could also be a side effect of medications like calcium channel blockers, which are used to treat high blood pressure.
Bad Foot Pain at Night
Excruciating foot pain at night is a classic symptom of peripheral neuropathy. It is often accompanied by numbness in the balls of your feet and the middle toes. It improves if you get up and walk around for a bit.
Gout is also a common cause of bad foot pain at night. Flares often happen in the middle of the night without warning while the individual is asleep. It commonly affects the joints in the big toe, although it can affect other toes and the joints in the fingers as well.