Foot pain tends to follow a pattern. Where it hurts, and when, usually points to one of a handful of common causes.
Seven of them are below, each with the signs that give it away and the steps that usually help.
Plantar fasciitis and stabbing heel pain
When you swing your legs out of bed and plant your feet, plantar fasciitis announces itself as a sharp pain in the heel. It is irritation of the thick band of tissue along the bottom of your foot.
It often follows overuse, worn-out shoes or flat feet. Ice, stretching and supportive shoes are the usual first steps. What to wear for walking starts with the right shoes and socks.
Ask your doctor or a podiatrist before you buy custom orthotics, because a stretching routine and a good shoe come first.
Stretching the sole itself seems to matter.
In a trial of 101 people with long-lasting heel pain, a plantar fascia stretch beat a calf stretch for first-step morning pain after eight weeks. Everyone also wore soft insoles and took a short course of an anti-inflammatory drug.
To try it:
- Get in position. Sit and cross the sore foot over the other knee
- Stretch the arch. Pull your toes back toward your shin until you feel a stretch along the arch
- Count slowly. Hold it for a slow count, then repeat
Achilles tendonitis at the back of the heel
When your calf muscles tighten or you suddenly add distance or hills, the thick cord that joins your heel to your calf takes the strain. That cord is the Achilles tendon.
You feel pain and stiffness along the back of the heel, especially after rest and at the start of a walk.
Rest and gentle calf work help many people. Pain that lasts more than a few weeks is worth a visit to your doctor or a physical therapist.
Strong calves help the tendon cope, and they are part of joint strength and endurance as you age. These habits protect it:
- Stretch your calves daily to keep the tendon flexible
- Add time or distance gradually, over several weeks
- Wear supportive shoes with a cushioned heel; walking shoes picked for sore heels shows what to look for in the store
Bunions and shoes that pinch
A bunion is a bony bump at the base of the big toe, and the toe often angles in toward the others. It can make every step in shoes uncomfortable.
Bunions tend to run in families, and tight, pointed shoes squeeze the toes and make them worse. Swelling and redness over the bump are common.
Start with shoes that have a wide, deep toe box, so nothing presses on the bump.
A wider shoe will not shrink a bunion, but it takes the pressure off and often eases the pain.
If shoes and padding no longer help, ask your doctor or a foot specialist what the options are, including surgery. That decision is theirs and yours, not something to settle from an article.
Morton’s neuroma and the pebble feeling
If you feel a sharp, burning sensation in the ball of your foot, it may be Morton’s neuroma. This is a thickening of nerve tissue, usually between the third and fourth toes.
Many people describe it as standing on a pebble. Shoes play a big part, because narrow toe boxes and high heels squeeze the nerve.
Common first steps:
- Switch to shoes with a wider toe box and lower heels
- Add a pad or insole that takes pressure off the ball of the foot
- See a doctor if the pain continues, since injections are one option they can offer
To shop, start from the best walking shoes for men over 60 or the best walking shoes for women over 60. Then check the toe box in the store.
Injections and surgery are decisions for your doctor. A review of 25 studies found steroid injections had the strongest evidence for easing neuroma pain. No single treatment was proven best.
Metatarsalgia and sore balls of the feet
Morton’s neuroma affects the tissue between your toes. Metatarsalgia covers a broader area across the ball of the foot, where the long foot bones meet the toes.
It feels like burning or aching that grows with walking or long stretches on your feet. Ill-fitting shoes, hard surfaces and the shape of your foot often play a part.
If the ache keeps coming back, ask your doctor whether an insole made for your foot would help.
Cushioned, supportive shoes, rest and ice take pressure off the area. Extra body weight adds load to the forefoot, so easing it down helps too.
When arthritis reaches the feet
Arthritis makes foot joints stiff and sore. The big toe joint is a common place for it, with tenderness and a smaller range of movement.
Age, old injuries and extra weight can all bring it on or make it worse.
Three things help many people keep moving:
- Physical therapy to strengthen the muscles around the joint and keep it flexible
- Anti-inflammatory medicine, if your doctor says it is safe for you
- Supportive shoes or insoles that take some load off the joint
Pain and stiffness that keep returning are worth bringing to your doctor early, because there is more to try the sooner you ask.
Flat feet and tired arches
With flat feet, the arch of the foot drops and most of the sole touches the ground. Many people have flat feet and no pain at all.
For others it shows up as aching arches and tired feet after long stretches of standing. It can also put extra strain on the heels, ankles and knees.
Shoes with built-in arch support are the simplest first step. Foot-strengthening exercises can help the arch hold its shape over time.
Strong ankles and knees steady the whole foot, and the ankle and knee exercises to prevent walking injuries are a good place to build that.
If your arches ache after every walk, ask your doctor or a podiatrist whether a custom insole is worth trying.
When foot pain needs a doctor
Pain that is sharp, new or in one foot only is a stop sign, not something to walk through.
If foot pain lasts more than a few weeks, or you cannot put weight on the foot, see your doctor.