Foot Pain - Cause

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What causes foot pain?

Foot pain may be caused by many different diseases, biomechanical conditions, or injuries. Acute or repeated trauma, disease, or combinations of the problems are the most common causes of foot pain and are commonly seen in sports and workplace environments that require physical activity Trauma is a result of forces outside of the body either directly impacting the body or forcing the body into a position where a single or combination of forces result in damage to the structures of the body. Poor biomechanical alignment may lead to foot pain. Wearing shoes that are too tight or high heels can cause pain around the balls of the feet and the bones in that area. Shoes that are tied too tightly may cause pain and bruising on the top of the foot.

Injuries such as ligament sprains, muscle strains, bruises, and fractures typically occur suddenly (acutely). Sprains, strains, bruises, and fractures may be the result of a single or combination of stresses to the foot. A sprain of the foot or ankle occurs when ligaments that hold the bones together are overstretched and their fibers tear or stretch too far. The looseness of ligaments in the joints of the foot may lead to foot pain.

The muscle's bursa and fascia of the foot can be strained by overstretching, overuse, overloading, bruising, or a cut (such as by stepping on a sharp object). Achilles tendonitis is a common injury of the tendon that attaches at the back of the heel.

Injury to the bones and joints of the foot can be caused by a single blow or twist to the foot, or also by repetitive trauma that can result in a stress fracture. A blunt-force injury such as someone stepping on your foot may result not only in a bruise (contusion) injury but also damage to the muscles and ligaments of the foot. Direct blows to the foot can cause bruising, breaking of the skin, or even fracturing of bones. Metarsalgia is the irritation of the joints of the ball of the foot. The term "stone bruise" is commonly referred to as a specific localized pain and tenderness of the bottom of the foot. "Turf toe" is a common athletic injury in which the tendon under the joint at the base of the big toe is strained. Trauma to the toenail can cause pooling of blood under the nail and the temporary or permanent loss of a toenail. Repetitive trauma to the bones, muscles, and ligaments can result in extra bone growth known as spurs or exostoses.

Sprains, injuries to the ligaments of the foot, occur when ligaments are overstretched. The ligaments that attach the foot to the ankle are also commonly sprained.

Injuries to both the skin covering and the internal structures may also be caused by multiple small repetitive traumas. Microtrauma injuries can be caused by running on uneven surfaces or surfaces that are too hard or too soft, or by wearing shoes that have poor force-absorption qualities or fit incorrectly. Thickenings of tissue of the outer foot and toes are commonly known as bunions, corns, and calluses. These are often caused by poor-fitting shoes. Morton's neuroma caused by thickening of tissue around a nerve between the toes can cause toe numbness and pain and may also be aggravated by poor-fitting shoes. Footwear can be a contributor to foot pain. Poor-fitting shoes in the short term can cause blisters, bruising, and be a source of athlete's foot. The long-term effects may be bunions, corns, irritation of nerves and joints, misalignment of the toes, and the source of microtrauma injuries to the foot.

Repeated overstressing of the same structure of the foot may cause stress fractures, tendonitis, plantar fasciitis, and acute and chronic osteoarthritis. Stress fractures commonly occur in the metatarsal bones, the long bones of the foot.

The arches of the feet absorb and return force to and from the body to the outside world when we are standing on our feet. Injury to the plantar fascia is a common cause of arch pain. The plantar fascia is a tough fibrous sheath that extends the length of the bottom of the foot and lends support to the arch. When the plantar fascia is damaged, the resulting inflammatory response may become a source of arch pain. High and low arches (flat feet) may cause pain because of strain to the feet.

Disease, viruses, fungi, and bacteria may also be the sources of foot pain. Diabetes, Hansen's disease, arthritis, and gout are common diseases that affect the foot. Disorders of the nerves to the feet may cause numbness and burning sensation in the feet known as peripheral neuropathy.

Plantar warts on the bottom of the foot are caused by a virus and can cause irritation. Athlete's foot, which is caused by a fungus, also can lead to foot irritation. A common cause of foot pain is the ingrown toenail. Ingrown toenails occur when the edges of the nail grow through or into the skin, resulting in irritation and sometimes leading to infection.

Return to Foot Pain

See what others are saying

Comment from: hanna, 45-54 Female (Patient) Published: October 08

I ran into my dog's foot and it split my pinkie and toe beside it at a great force. It bent them and he also stepped on the top of my foot. He is a 45-pound dog and a bit rough. I have thin feet and osteoporosis. The top of my foot and the two smaller toes immediately turned black and blue and were very painful. I could not walk without hobbling for a few days. I didn't go for an x-ray for two weeks as I figured there was nothing to be done but buddy tape. X-ray showed no break but a dislocation. I continue to have pain and numbness and tingling under my second to pinkie toe. The toe is misshapen and when I was walking at a fair a few days ago, I got a terrible pain in between those toes like a Charlie horse, and couldn't walk. I wonder if there is some kind of nerve or ligament damage, since it's been 10 weeks since the injury and I'm still having issues. It wasn't so bad with summer weather I could wear open shoes, but I can't wear a closed shoe without pain.

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Comment from: Pamala, 55-64 (Patient) Published: April 01

After twisting my ankle, two months later I experienced terrible arch foot pain in both feet. I sought counsel from a podiatrist who prescribed inserts. The pain continued and I saw an internist who diagnosed plantar problems. This was the wrong diagnosis, since no x-rays or MRIs were done. Finally I went to a foot specialist who after x-rays and MRIs diagnosed edema on the HCL tendon. I had a cortisone shot which did not help. My pain continues when I stand for any length of time. I am 55 and I walked over 2 miles and swam three times a week before this incident. It is going on six months to no avail. I think it is important to have the correct diagnosis so you can proceed with the correct information.

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