Foot pain has a habit of starting small.
Maybe the ball of your foot aches after a long day. Your big toe has become uncomfortable in certain shoes. Or your feet feel fine in the morning but are sore by the time you get home from work.
It is easy to blame your shoes, your age or simply being on your feet too much. But persistent foot pain can have many different causes, and where you feel the pain can give important clues about what may be happening.
If you’re experiencing foot pain in Adelaide, here are seven common causes we see in the clinic and what those symptoms may be telling you.
1. Pain Under the Heel: Plantar Heel Pain
Pain underneath the heel, particularly when taking your first steps after getting out of bed or standing after sitting for a while, is commonly associated with plantar heel pain.
The plantar fascia is a strong band of tissue underneath the foot. When it becomes painful, people often describe a sharp or pulling sensation around the bottom of the heel.
Changes in activity, prolonged standing, footwear and the amount of load the foot is accustomed to can all be relevant.
Although plantar fasciitis is common, not every painful heel has the same cause. Persistent heel pain deserves a proper assessment rather than assuming the diagnosis based on where it hurts.
2. Pain Under the Ball of Your Foot
Does it feel as though you are walking on a pebble, even when there is nothing in your shoe?
Pain underneath the forefoot is often broadly described as metatarsalgia, which refers to pain around the metatarsal region rather than one specific diagnosis.
It can develop when pressure becomes concentrated beneath the ball of the foot. Activity levels, footwear, foot structure and the way forces are distributed while walking can all play a role.
Sometimes there is also thickened skin or a painful corn directly over the high-pressure area.
The important question is not simply how to cushion it. It is why so much pressure is reaching that particular part of your foot.
3. Burning or Tingling Between the Toes: Morton’s Neuroma
Forefoot pain does not always feel like an ache.
Some people experience burning, tingling, numbness or a sharp sensation that travels into the toes. Others describe feeling as though their sock is bunched underneath their foot.
One possible cause is Morton’s neuroma, which involves irritation and thickening of tissue around one of the nerves travelling towards the toes.
Tight or narrow footwear can aggravate symptoms because it compresses the forefoot.
However, several conditions can cause pain in this area, so persistent burning, tingling or numbness should be properly assessed rather than self-diagnosed.
4. Pain Around the Big Toe: Bunions and Big-Toe Joint Problems
A painful big toe can make something as simple as walking surprisingly uncomfortable.
A bunion develops when the big-toe joint gradually changes position, creating the characteristic prominence on the side of the foot. Shoes may begin rubbing against the area, and the joint itself can become painful or stiff.
But bunions aren’t the only reason a big toe hurts.
Arthritis and other joint problems can also cause pain and restricted movement, particularly when the foot needs to bend through the big toe during walking.
Treatment depends on what is actually causing the symptoms. Footwear changes, pressure management and orthotics may help some people, although conservative treatments cannot structurally reverse an established bunion.
5. Pain on the Top of the Foot
Pain across the top of the foot can be particularly confusing because there isn’t always anything obvious to see.
Sometimes footwear pressure or tightly tied laces are enough to irritate the area. In other cases, tendons, joints or bones may be involved.
A sudden increase in walking, running or other weight-bearing activity can also be relevant.
Importantly, pain that becomes increasingly severe, is associated with swelling, or makes weight-bearing difficult should not simply be dismissed as a shoe problem. Stress injuries and other conditions may need to be ruled out.
6. Aching Feet After Standing or Walking All Day
If your feet are comfortable in the morning but aching by the afternoon, you might assume that is simply the price of being on your feet all day.
Not necessarily.
Long hours of standing naturally place considerable demand on the feet. However, footwear, muscle capacity, hard working surfaces and how pressure is distributed across the feet can influence how well you tolerate that demand.
This is particularly relevant for people working long shifts in healthcare, hospitality, retail, construction and other occupations that involve hours of standing or walking.
If sore feet are regularly affecting your work or what you can do afterwards, it is worth finding out why.
7. Foot Pain That Keeps Coming Back
Sometimes the most important clue isn’t where your foot hurts.
It’s the fact that it keeps returning.
You rest it and it improves. Then you start walking or exercising normally again and the pain comes straight back.
Recurring foot pain can happen when the painful area settles temporarily but the factors placing stress on it have not changed.
That may involve activity load, footwear, strength, joint movement or foot mechanics. In some cases, several factors are contributing at the same time.
This is why repeatedly resting a painful foot isn’t always a long-term solution.
Do Insoles or Orthotics Help Foot Pain?
This is one of the most common questions we hear.
And the answer is: sometimes.
An insole or custom orthotic isn’t automatically the answer to every type of foot pain.
However, when the way forces are distributed through the foot is contributing to symptoms, an appropriately prescribed orthotic may help modify pressure and reduce load on sensitive areas.
At Adelaide Podiatry Centres, we assess whether orthotics are actually indicated rather than prescribing them simply because a foot hurts.
Depending on the individual, this may involve custom 3D-printed orthotics or Voxelcare orthotics made in-house.
For someone else, the more appropriate solution may be footwear changes, exercises, activity modification or another treatment entirely.
The diagnosis comes first.
When Should You See a Podiatrist for Foot Pain?
A minor ache after an unusually long day may settle on its own.
But foot pain deserves more attention when it keeps returning, is becoming more intense, changes the way you walk or begins stopping you from doing normal activities.
You should also seek assessment sooner if there is significant swelling, redness or warmth, a wound that is not healing, sudden severe pain, numbness, an injury that makes weight-bearing difficult, or if you have diabetes or circulation problems.
You don’t need to wait until walking becomes unbearable before having your feet assessed.
Finding the Cause of Your Foot Pain
One of the biggest mistakes people make with foot pain is treating the location of the pain without understanding why that area has become painful.
A sore heel doesn’t automatically need the same treatment as every other sore heel. Pain under the ball of the foot can have several causes. And buying softer shoes or a generic insole may help one person while doing very little for another.
At Adelaide Podiatry Centres, we look at the bigger picture.
That may include your symptoms, footwear, activity levels, joint movement, strength, foot structure, gait and how pressure is being distributed when you move.
From there, we can determine what treatment actually makes sense for your feet.
Because the best place to start with persistent foot pain isn’t guessing which product or exercise you need.
