Unless you’re a gymnast or work for the circus, most of the time you spend walking or running is with your feet planted firmly on the ground. As a result, you’re probably like most people—you tend to experience foot pain on the bottom of your feet.
Consider this—your feet have to hold up all 100 plus pounds of you in perfect balance, when you’re moving, on uneven ground, and usually in shoes that are less than perfect. It’s no wonder many of us experience foot pain at some point in our lives.
Here are the 7 most common causes of bottom of foot pain.
1. Plantar fasciitis
Number one on our list is plantar fasciitis, the most common cause of heel pain in adults. Most often when plantar fasciitis first comes on, you’ll notice pain with first steps out of bed in the morning.
As you go about your day the pain will gradually lessen. That’s because tight calf muscles are often play a big role in developing this painful foot condition. Once you start walking your calf muscles will loosen up.
Other causes of plantar fasciitis are:
- Flat feet or high arches
- Feet that pronate
- High impact activities such as running or other sports
- Excess weight
- Wearing shoes that don’t properly support your feet
Treatment of plantar fasciitis focuses on correcting foot imbalances like flat feet and pronation, purchasing shoes that provide more support, and stretching the calf muscle. To prevent future flare-ups it's important to do the following: lose weight, warm up before high-impact activities, and build up activities like running, gradually. Learn more about plantar fasciitis treatment and prevention here!
Another painful foot condition experienced on the bottom of the feet is metatarsalgia. Metatarsalgia is centered on the ball of the foot and its symptoms vary greatly. Symptoms of pain, tingling or numbness can be felt on one or more of the metatarsal bones.
People at greater risk for this condition are those with high arches, participate in high-impact sports, wear non-supportive shoes, or stand all day on very hard surfaces.
Treatments for this condition are very similar to those for plantar fasciitis: stabilizing foot alignment with custom orthotics, wearing supportive and stable shoes (being sure to wear shoes designed for the sport you engage in), and losing weight to take pressure off the feet.
It’s also important to avoid high heels and flip-flops. Both of these shoe styles place more pressure on the front of the foot. Learn more about the treatment and prevention of metatarsalgia here!
3. Morton’s neuroma
If you’ve ever felt like you have a pebble in your shoe or walking with a bunched-up sock, you may have Morton’s neuroma. Morton’s neuroma occurs when the tissue around a bundle of nerves between your third and fourth toes becomes thickened.
When this occurs, these nerves can no longer transmit signals properly to your brain. As a result, you can feel:
- The strange symptoms mentioned above
- Pain and tingling in the ball of your foot
- A burning sensation
People most at risk for this condition are those who:
- Wear shoes that push the toes toward the front of the shoe such as high heels or shoes that are too tight or narrow.
- Have a foot structure such as high arches or flat feet or other foot deformities such as bunions or hammertoes.
- High impact activities like running
Treatments for Morton’s neuroma are:
- Alcohol injections to shrink the neuroma
- MLS laser therapy
- Changing footwear to accommodate the neuroma
4. Foreign Body
Particularly in the summer, not a week goes by when I don’t have to remove some foreign body from the bottom of my patient’s feet. Many people have no idea they’ve stepped on something until they come to the office, and I examine their feet. Instead, they believe there is another cause for their pain.
Some of the more common foreign bodies I have found in my patient’s feet are:
- Dog or other animal hairs
- Bee stingers
Perhaps this has happened to you, and you’ve tried to remove it yourself. When the thorn or splinter is more superficial it can be simple, but a deeply embedded foreign object should be removed by your podiatrist.
Other times when you should see your podiatrist to get it removed.
- The area has turned red, is swollen, feels warm, or has pus.
- You’ve tried to remove it and failed.
- You have diabetes or have a weakened immune system.
It’s important to go to your doctor as soon as possible if you see red streaks that are moving away from the wound site. This indicates the infection is moving through your body and can be extremely dangerous.
Sometimes pain on the bottom of your feet can come with numbness and tingling. If this is your experience, you could have peripheral diabetic neuropathy. Usually, these symptoms are felt in a much larger portion of the foot than Morton’s neuroma, a condition with these symptoms between the third and fourth toes (see above).
Neuropathy in your feet usually develops from diabetes but can also result from trauma to the foot, heavy alcohol use, chemotherapy, and other health conditions. In all cases the nerves in your feet and no longer sending proper signals to your brain which is why you’re having symptoms.
The symptoms of diabetic neuropathy generally get worse over time. Patients will notice changes beginning in the toes and gradually involving the whole lower leg.
Treatment of neuropathy includes using various types of medication, physical therapy, improved nutrition and vitamins, and specially designed shoes. In addition, MLS laser therapy can be helpful over time.
6. Plantar Warts
Painful growths you find at the bottom of your foot are often plantar warts. Most often you’ll notice them in areas where you bear weight. Plantar warts are caused by the human papilloma virus or HPV. The virus enters the body through small cuts or abrasions on the bottom of your feet.
They can also interfere with your daily activities.
People most at risk for warts are:
- children and teens
- those who go barefoot in locker rooms and at pools
- people with a depressed immune system.
Treatment for warts include:
- chemical treatments like salicylic acid
- Swift Immune Therapy
Our office uses Swift Immune Therapy to treat warts. This treatment destroys the virus instead of the wart tissue using microwave therapy. Because it attacks the virus, the recurrence of warts with this treatment is much lower than other treatments.
7. Corns or Calluses
Other painful growths you find on the bottom of your feet are corns or calluses. But instead of a virus they’re caused by a thickening of the skin in response friction or pressure.
Corns are deeper than calluses, have a hard center, and can be painful when you press on them. Calluses tend to form under the ball of the foot and are rarely painful.
Causes of corns and calluses are:
- Conditions that change the alignment of your feet like hammertoes or bunions.
- Wearing high heels
- Friction from shoes that are too big
- Wearing shoes with no socks
- Family history
Corns and calluses are treated by your podiatrist by:
- Trimming – often several times a year
- Recommendations for shoes and socks that fit properly
- Diabetic shoe prescription for patients with diabetes – these shoes are specially designed to minimize pressure points.