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Foot Pain Overview

Foot pain involves discomfort in any part of your foot, including your ankle, heel, sole, arch or toes. Foot pain can result from a number of conditions and can affect you regardless of your level of activity.
Foot anatomy
Feet are amazingly complex. Each foot contains 26 bones, 33 joints and more than 100 muscles, tendons and ligaments. They handle a great deal of stress every day.

Your feet are designed to absorb the impact of the body's weight. They also have the flexibility to move that weight for a lifetime.

The bones of your lower leg (tibia and fibula) connect to your foot at the ankle bone (talus) and ankle joint. The heel bone (calcaneus) is below the ankle bone and is the largest bone in your foot. In front of the heel are five more tarsal bones that form the arch. These tarsals connect to the five metatarsals, the long bones that give your foot much of its length.

In front of the metatarsals, more bones and joints form the toes. The big toe has two joints, and the other toes have three. The joint at the base of the big toe forms the ball of the foot.

Each joint is surrounded by a joint capsule or bursa, a fluid-filled sac around which ligaments and other soft tissue are found. Ligaments are strong connective tissues that join bones together and stabilize the foot.

In addition to ligaments, many muscles and tendons surround the bones of your foot. Muscles help the foot move and provide padding, especially along the sole (bottom) of your foot. Many of your foot muscles are in four layers along the sole. Tendons are similar to ligaments but connect muscles to bones. The largest tendon in your foot is the Achilles tendon, which connects the muscles of the calf to the heel bone.

What can go wrong
When all the parts of your feet work right, they can support your body's weight and move it through near-constant activity. If there is damage or injury to any part of a foot, it can quickly affect other parts of the foot or leg and disrupt the foot's function, making it painful to walk or even stand.

Conditions that may cause foot pain include:

Pressure-related problems. Pressure on your feet from ill-fitting shoes causes skin to rub and can even shift the bones. This may result in numerous foot conditions, such as:

Callus. Area of hard skin that forms from excess pressure.
Corn. Area of hard skin that forms on the toes.
Bunion. Occurs when compression forces the big toe joint to enlarge and turns the big toe toward the other toes.
Hammertoe. Occurs when compression forces the lesser toes to bend over in a claw shape, shortening their tendons. This is usually caused by shoes that press the toes together.
Metatarsalgia. Pain in the ball of the foot, which may be caused by bunions, hammertoes, poorly fitting shoes or high-impact sports such as running.

Traumatic injuries. The feet and ankles are susceptible to breaks or stress fractures of the bones and to strains and tears of the ligaments and tendons. The most common tendon injury in the foot is to the Achilles tendon, which connects the calf muscle to the heel. Although most of the tendon is in the calf and ankle, the injury usually causes heel pain. The tendon can become strained or tear from jumping, running or abrupt movements.
Ingrown toenails. The border of a nail sometimes gets pinched under the flesh. Sometimes ingrown nails can be treated at home, but you might need help from a podiatrist or other doctor, especially if your nail becomes infected.
Plantar warts. These warts are caused by a virus on the sole (plantar surface) of the foot. A wart on a finger will grow outward, but because of the pressure of standing, plantar warts grow inward. They become painful and may spread to form other warts.
Arthritis. Arthritis is inflammation of the joints, and each foot has 33 joints. Gout (a type of arthritis in which deposits of uric acid build up in joints) often causes severe pain in the big toe.
Heel conditions. Pressure on the heel causes specific types of pain:

Heel spurs. Small outgrowths on the heel bone.
Plantar fasciitis. The fascia is connective tissue that runs along the bottom of the foot from the heel to the ball of the foot. When the fascia is overstretched, tiny tears may cause inflammation or breakdown over time. The condition causes pain in the heel and just in front of it, usually after getting out of bed or after standing for long periods of time. It is common in athletes and people with flat feet.
Haglund's deformity. A painful bump on the back of the heel caused by shoes with rigid backs.
Inflammation. The soft tissues and sacs of the foot are subject to pain from inflammation. Inflammation can occur in the sacs called bursae (as bursitis) and in the tendons (tendinitis). Both conditions may cause pain in the heel, and it may be difficult to distinguish between the two.

Athlete's foot. A fungal skin infection that usually occurs between the toes. The fungus grows in warm, moist places such as showers or locker rooms and can spread on the feet because shoes also provide an environment that encourages fungal growth. Athlete's foot involves itchy, scaly skin, followed by inflammation and blisters that can be swollen and painful.
Nerve problems. These include neuromas and tarsal tunnel syndrome. A neuroma is an abnormal swelling or growth on a nerve. It may cause a burning sensation in the foot, pain between the toes or a sensation of a stone in the shoe. Tarsal tunnel syndrome is caused by compression of a nerve in the foot and may cause pain along the bottom of the foot.
Diabetes. This disorder can damage the nerves and blood vessels of the feet. Impaired sensation increases the risk of ulcers, which, if not treated, can lead to amputation.
Congenital conditions. Many people are born with flat plantar arches or high-arched feet. These conditions themselves may not cause pain but may predispose people to a number of other problems that can cause pain.
What you can do
The source of most foot pain can be identified by a physical exam from your doctor or a podiatrist. X-rays or other imaging studies may be needed to confirm other conditions.

Although traumatic injuries and strains may require casts or even surgery, most foot pain can be alleviated with simpler measures. These may include wearing the right shoes, adding inserts to shoes, improving hygiene, doing stretching exercises and taking medications.

In many cases you can take action to relieve your foot pain and prevent it from happening again.



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