If spending more time at home due to COVID-19 has meant less time wearing shoes (or sporting your favourite pair of slippers, sandals, or flops), you may be experiencing more foot pain than usual. Or, if you’ve added at-home workouts to your schedule, not wearing the proper footwear or working out barefoot more often could also be causing issues with your feet.
Either way, foot pain is alarmingly common: 77 percent of people say they have experienced significant foot pain, according to research. Specifically within the current stay-at-home period, there’s been a rise in certain conditions involving heel pain and nerve pain in between the toes, in part because people aren’t wearing supportive shoes, says Dr. Grace Torres-Hodges, a podiatrist based in Pensacola, Florida, and APMA spokesperson.
There’s a lot going on in your feet, thanks to lots of bones, ligaments, and tendons. And causes of foot pain can range from injury and inflammation to structural issues and maladaptations.
If you have no underlying foot conditions, you might not have any foot pain from going barefoot in the house. But if you have previously diagnosed foot injuries, bare feet are not the best idea. Make sure you’re wearing a supportive moccasin or clean pair of sneakers in the house, or a supportive sneaker during high-intensity workouts, Dr. Torres-Hodges says. More importantly, pay attention to your body, learn what feels normal to your feet, and as soon as you notice something that feel normal, head to a podiatrist.
If your feet aren’t feeling too hot right now, these are the most common causes of foot pain that you should know about.
Some people naturally have flatter feet, but others develop a condition called a fallen arch, an injury to the tendon that connects the calf muscle to the inside of the foot, often from overuse or from sports. You may experience pain in the arch of the foot or even in the ankle.
In some extreme cases, a fallen arch may require surgery. Other times, wearing an orthotic in your shoes can be enough to keep the foot in place. But you should always check in with a podiatrist first before the tendon injury gets worse.
A fallen arch can sometimes contribute to other conditions, including tarsal tunnel syndrome. (Tarsal tunnel is similar to carpal tunnel syndrome in the wrist.) It mainly causes heel pain, specifically a burning sensation, because of a nerve impingement on the inside of the ankle, explains Dr. Torres-Hodges. The arch may look like it’s falling in some people’s feet, but not all tarsal tunnel cases are related to a fallen arch.
Orthotics may be one treatment option for tarsal tunnel, but it’s not necessarily going to fix the problem, especially if you have a related fallen arch that requires surgery. “If there is an underlying associated tendon tear, capsular tear or dislocation, that has to be addressed first and repaired if necessary, sometimes surgically,” Dr. Torres-Hodges says.
3. Cuboid syndrome
The cuboid is a bone in your foot, and this syndrome is characterised by pain in the outer middle part of the foot (think: that little bony part near the pinky toe).
This pain issue can also be related to a fallen arch, Dr. Torres-Hodges explains. “When someone’s foot collapses because of a fallen arch, it kind of pinches the joints on the other side of the foot together,” she says. And then, the support structure around that area on the outside of the foot doesn’t hold its proper shape. It can also happen if you twist your ankle without wearing shoes.
Cuboid syndrome might be mistaken for plantar fasciitis or an ankle sprain, Dr. Torres-Hodges says. But if the pain is on the of the foot, that’s a huge indicator. Wearing orthotics may be an option for holding the foot in the correct position, but if you think you have this injury, it’s definitely worth visiting your podiatrist to see what treatment plan may be necessary.
4. Arthritis
In younger individuals with no prior injuries, arthritis isn’t common. But if you’re a year-round athlete who doesn’t get sufficient rest between seasons of a sport, for instance, you may develop wear and tear in your joints. When you overuse the ligaments and tendons, it can affect the structure of the joints, which won’t be able to support the body properly, Dr. Torres-Hodges says.
The most important thing, especially if you are an elite athlete, is to use the proper supportive footwear. Also, giving yourself enough breaks in between seasons of a sport, marathon training sessions, or whatever your activity you take part in, is key.
5. Metatarsalgia
Heel pain may be a contributor to metatarsalgia. When pain elsewhere in your foot causes you to adapt how you walk, the ball of the foot starts to grip, resulting in pain at the metatarsal heads (which are basically the knuckles of the feet, at the bottom of the four smaller toes), says Dr. Torres-Hodges. Those joints then become inflamed or swollen, and you might feel pain in this area.
Wearing well-cushioned shoes is one way to prevent metatarsalgia, and your doctor may also suggest orthotics to fit inside those shoes. See your podiatrist if pain near the toes persists.
6. Turf toe
Technically turf toe can be classified as a metatarsalgia, Dr. Torres-Hodges says. But basically, it’s a form of arthritis in the big toe joint. The name originated from football players getting a toe injury from their cleats getting caught in the turf and hyper-extending the joint.
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You may develop turf toe from jamming your feet into a pair of heels, particularly if the heel is higher than two and a half inches. Because the ankle is pushing the foot forward inside the shoes, the joint of the big toe becomes inflamed.
It’s not that you can’t wear heels, Dr. Torres-Hodges says, but wearing higher heels in moderation is best for your feet. That may help to prevent turf toe in the first place. To avoid degenerative changes that could lead to surgery, it’s worth having checked out.
7. Calluses
Even if you’ve never had any other foot problems, you’ve likely experienced calluses. “They are the skin’s way of protecting itself from wherever you’re putting pressure,” Dr. Torres-Hodges says.
These blisters can develop anywhere on the foot, from the bottom of the foot, to the knuckles, or the toes. Most commonly, they’re found at the ball of the foot, she says. Calluses are normal, but cracked, exposed skin from calluses can lead to more pressure and pain in the foot.
The best way to prevent calluses is by minimising the friction inside the shoe you’re wearing — an orthotic may help with that. But, Dr. Torres-Hodges says, it’s important to address the root cause of the calluses, which could be related to the structure of your foot.
8. Plantar fasciitis
Heel pain is one of the most common types of foot pain, says Dr. Hillary Brenner, a New York-based podiatric surgeon and spokesperson for the APMA. “The plantar fascia is a thick ligament that runs from the heel to the front of the toe on the bottom of the foot,” she explains.
Plantar fasciitis occurs when that ligament gets inflamed, typically due to tension and stress on the heel, which can be caused by wearing shoes with high arches or high-impact activities like running. You may even feel heel pain when you get out of bed in the morning.
If you’re experiencing a sharp, stabbing pain in your heels, try switching to more supportive, wider shoes for a day or two, says Dr. Brenner. “But if the heel pain isn’t improving within that time — and over-the-counter pain meds, ice, or soaking your feet aren’t helping — then you should go to the doctor,” she says.
9. Morton’s neuroma
This condition isn’t very common but it has been linked to wearing high heels, says Dr. Brenner. “A neuroma is an enlargement of the tissue around the nerves between your toes,” she says. “If you wear very narrow, tight, high-heeled shoes that compress the foot, it causes rubbing, which then causes the nerve to thicken.” This can cause your toes to sting or go numb, or lead to a burning pain in the ball of your foot.
Switching to roomier, more supportive shoes can provide relief, but, again, if the pain lasts more than two days, go see a doc.
10. Bunions
A bunion is a bump at the joint of the big toe, says Dr. Brenner. “A lot of people think, ‘Oh, I put on a pair of shoes and now I have this big, red bump that’s painful at the base of my big toe.’ It doesn’t happen like that; shoes can aggravate the bunion, but they don’t cause it,” she says.
Rather, we all have different foot types — overpronator, oversupinator, flat feet, high arches — which, combined with genetics, stress, or certain conditions, can cause instability that shifts your bones and leads to the bunion, explains Dr. Brenner. It is possible to get a bunion on the side of the pinky toe, too — that’s called a bunionette.
“If your pain level reaches, say, a five on a scale of one to 10, you should see a foot specialist,” says Dr. Brenner. If the bunion is bad enough, it may require surgery to correct.
11. Hammertoes
Normally, your toes sit nice and straight, but when you have a hammertoe, your toe is sitting almost like a claw, with a bend in the middle. “What’s happening is that when you’re walking, the muscles are firing longer and harder through the gait cycle, so the muscle is constantly contracting, causing your toes to pull up into a hammer-like position,” says Dr. Brenner. That causes one part of the bone to stick out above the others, and when you run, it causes friction or can lead to a corn or more painful, smaller callous.
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“If you don’t treat it properly with medicine, it can ulcerate and open up,” she says. If that happens, you should see a doctor ASAP; for more serious cases of hammertoe, a doctor may recommend surgery to address the cause.
12. Rheumatoid arthritis
Rheumatoid arthritis (RA) is a chronic inflammatory disorder that can affect you all over — right down to your feet. “A side effect of rheumatoid arthritis is that your bones start to deviate, so they’re not sitting straight, they’re starting to angulate,” says Dr. Brenner.
Your toe joints will feel tender or swollen and stiff, and you can actually develop rheumatoid nodules, “which are growths that occur on the joint, like a ball coming out of the joint, and are very painful,” says Dr. Brenner.
If you suspect rheumatoid arthritis as the cause of your foot pain or if you have a family history of RA, you should go straight to a rheumatologist.
13. Gout
Gout is another form of arthritis. “It could be hereditary, or that your kidneys aren’t functioning correctly and you don’t have a certain enzyme to break down the uric acids found in meats, heavy sauces, and seafoods,” says Dr. Brenner. “What happens is those urate crystals harden and go to the coldest part of the body — typically the big toe joint.” Your joint will look red, feel hot, and swell, and be super sensitive to touch.
Since those things can also be signs of an infection, you should see a doctor ASAP. A podiatrist can help with the flare-up in your foot, but seeing an internal medicine doctor could help get to the root of the problem.
14. Tendinitis
Tendinitis, or inflammation or irritation of a tendon, typically comes down to wear and tear, says Dr. Brenner. “It really comes from lack of support and doing exercise on hard surfaces,” she says. “You can get it from yoga, running, pretty much anything.” Tendinitis typically feels like a dull ache, and comes with mild swelling, most often immediately after the offending activity.
The best ways to get rid of it are rest and physical therapy, says Dr. Brenner, but for persistent pain lasting more than a few days, head to your doctor for more options.
15. A Strain or sprain
When you’re active, it’s easy to write off a rolled ankle or other minor injuries. But those could actually be strains or sprains, which occur when you overstretch the ligaments or muscles and tendons, respectively, and you need time to recover from them. “When you stretch ligaments or tendons, it’s like stretching leather — they don’t just snap back like a rubber band; it takes them a long time,” Dr. Brenner says.
The best cure? “Good old R.I.C.E. — rest, ice, compression, and elevation,” she says. “You should start to feel better within a week or so.” Then you need to rebuild the strength of those tendons, muscles, and ligaments — physical therapy can be helpful here, but just take your time and ease back into your routine. “If you can’t push through something or your body won’t let you do something, you need to listen to your body,” she says.
When should I see a doctor for foot pain?
Basically, you should always have foot pain checked out if it persists. Having regular pain in your toes, heels, or the arches of your feet is not normal, Dr. Torres-Hodges says, so the best practice is to have a doc take a look. “Because the feet are the foundation for the rest of the body, they are a complex structure that needs to have good maintenance,” she says. In other words, foot pain could not only affect the way you walk but cause you other ailments, like back pain, too.
Keep in mind, Dr. Torres-Hodges says, that every foot is different. There are multiple variables when it comes to the cause of foot pain: For example, pain in the arch of the foot can then cause nerve pain in the heel. “Based on when you diagnose the problem and whether it has or has not already affected another component of the foot, each of the issues can be the result of multiple causes and have multiple treatments,” Dr. Torres-Hodges adds.
That’s why it’s the safest option to get your foot pain taken care of as soon as it’s bothering you, and on a consistent basis.
