Bottom of Foot Pain: Causes, Seriousness, Relief

Bottom of Foot Pain: Causes, Seriousness, Relief


Pain on the bottom of the foot can occur anywhere from the heel to the toes. Wearing poorly fitting or unsupportive shoes or engaging in physical activity that puts a lot of strain on the feet are common causes. The pain can also be a sign of an injury or underlying condition affecting the foot’s bones, muscles, nerves, or ligaments.

Depending on the cause, you may feel sharp pain, dull aching, throbbing, stiffness, or a burning sensation.

If you have severe or ongoing pain in the bottom of your foot, seek medical attention for a diagnosis and treatment. Left untreated, the pain can cause balance issues and instability when standing or walking. This can lead to pain in your back, ankles, knees, or hips and increase the risk of falls. 

Different parts of the bottom of your foot might be causing pain. Here’s where the pain can be located—and what it might feel like at each location:

  • Heel: Pain can occur at the back of the foot, near the bottom of the heel bone. It may feel like a sharp or stabbing sensation, deep aching, or stiffness that worsens in the morning or after standing or walking for prolonged periods. 
  • Arch: Discomfort can occur along the foot’s arch, which stretches from the heel to the ball of the foot. The pain may feel like a dull ache, throbbing, sharp, or burning sensation.
  • Ball of foot: This pain occurs in the padded area between the arch and toes. It may feel like burning or sharp shooting sensations, particularly during running or jumping. Some people may experience numbness or tingling in the toes.
  • Toes: You can have pain in one or multiple toes. They may feel sore, numb, or burning.

Your feet are complex structures that contain 26 bones, 33 joints, and more than 120 muscles, nerves, tendons, and ligaments. They keep you balanced and absorb the impact of everyday activities like walking and standing.

Because the feet bear significant stress, pain on the bottom of the foot is a common experience with many possible causes. 

Plantar Fasciitis 

Plantar fasciitis—inflammation of the plantar fascia, a thick band of tissue that connects the heel bone to the toes—is one of the most common causes of pain in the bottom of the foot. The plantar fascia creates the foot arch and acts as a shock absorber during physical activity. Repetitive strain or overuse can cause microtears in the plantar fascia, causing symptoms such as: 

  • Burning, aching, or sharp pain on the bottom of the foot, including the arch and heel 
  • Morning stiffness or tightness that improves with light activity 
  • Pain that worsens after prolonged activities like standing, walking, or playing sports

Plantar fasciitis risk factors include:

  • Having flat feet
  • Having high arches 
  • Standing on hard surfaces for prolonged periods 
  • Engaging in high-impact activities, such as long-distance running or jumping
  • Having obesity 
  • Wearing shoes with poor arch support or ill-fitting shoes  
  • Increasing your activity level 

Plantar Warts 

Plantar warts are noncancerous growths that develop on the bottom of the feet and undersides of the toes. Caused by the human papillomavirus (HPV), these warts are highly contagious and spread through skin-to-skin contact or by stepping barefoot on contaminated surfaces at places like pools. 

Unlike other warts that grow outward, plantar warts are pushed inward because of the pressure on your feet when you walk or stand. When you put pressure on the warts, they can hurt. Besides pain, other symptoms of plantar warts include: 

  • Tenderness when touched
  • Rough, thickened skin on the sole 
  • Tiny black or brownish dots on the surface of the wart

Plantar warts are most common in adolescents. Among adults, people with weakened immune systems, such as people with HIV, have a higher risk of developing plantar warts. 

Morton’s Neuroma 

Morton’s neuroma involves thickened tissue around the nerve between the third and fourth toes. Thickened tissues surrounding the digital nerve that supplies sensation to the toes can cause pain and discomfort on the ball of your foot. Symptoms typically develop gradually, can worsen over time, and may include: 

  • The feeling as though there is a pebble under your foot as you walk 
  • Sharp pains or burning sensations that radiate to the toes, especially during activity 
  • Numbness or tingling in the toes 
  • Difficulty wearing certain shoes that put pressure on the ball of your foot, such as high heels or narrow shoes that push the toe bones together and pinch the nerve

Anyone can develop Morton’s neuroma, but it is most common in people 30-60. It often develops in response to excessive pressure on the feet from wearing tight shoes or repetitive stress on the ball of the foot from activities like running.

Metatarsal Fractures 

The metatarsal bones are the long bones in the middle of your foot that connect the toes to the ankle. Two types of fractures can affect metatarsal bones: traumatic and stress.

A traumatic fracture is caused by a direct blow, sudden twist, or heavy impact that causes the bone to break. Symptoms include bruising, swelling, a crooked or misshapen toe, and pain at the site of impact that persists for several hours before fading.

A stress fracture is a small crack that develops due to overuse or repetitive stress on the foot. Stress fractures are common in athletes and people with flat feet and other structural abnormalities. Symptoms include pain during physical activity that goes away during rest, pain and tenderness at the fracture site, and swelling.

Tarsal Tunnel Syndrome 

The tarsal tunnel is a narrow space on the inside of the ankle covered with a ligament that protects the blood vessels, tendons, and nerves that pass through the tunnel. Tarsal tunnel syndrome involves compression of the posterior tibial nerve, which supplies sensation and movement to the sole and toes.

Tarsal tunnel syndrome can cause a sharp, shooting, or burning pain on the bottom of the foot or inside of the ankle that may extend to the toes, heel, and calf muscle. You may also feel tingling, numbness, or electrical shock sensations. Symptoms may appear suddenly or gradually and typically develop from overuse or prolonged stress on the foot from standing, walking, or intense exercise.

Risk factors include: 

  • Flat feet
  • A problem with the structure of the foot, such as a varicose vein or bone spur 
  • Injury that causes swelling of the tissues in or near the tunnel, such as an ankle sprain 
  • Underlying conditions that cause inflammation and swelling, such as diabetes and arthritis

Sesamoiditis 

The sesamoids are pea-shaped bones beneath the big toe joint. Sesamoiditis is inflammation of the tendons surrounding the sesamoid bones. It can cause pain and tenderness in the ball of the foot under the big toe. 

The pain can develop gradually and worsen over time. You may experience it when walking, running, or flexing your toes. You might also have difficulty bending or straightening the big toe.

Sesamoiditis develops from overuse or injury to the tendons surrounding the sesamoid bones. It is most common among athletes who play sports that place a high demand on the toes. 

Other Causes

Pain on the bottom of the foot can also develop due to: 

  • Osteoarthritis: The disease can affect the joints in the foot, particularly the metatarsophalangeal joint at the base of the big toe. It can cause pain during physical activity as well as morning stiffness.
  • Peripheral neuropathy: Diabetes can damage the nerves in the feet, leading to burning, stabbing, or shooting pain; sensitivity to touch; and numbness. 
  • BursitisWhen your bursa (a small, fluid-filled sac that provides cushioning between the joint bones and soft tissues) gets inflamed, you can have pain when walking as well as stiffness, swelling, and tenderness. 
  • Rheumatoid arthritis (RA): The inflammatory arthritis can cause pain, swelling, and stiffness in the foot joints. RA can also cause foot deformities, such as a painful bump on the ball of the foot. 

Pain on the bottom of your foot may resolve with rest and home care. However, some situations and symptoms warrant a trip to a healthcare provider, such as your primary care physician or a podiatrist (a doctor specialized in foot problems), to determine what’s causing your pain.

See a healthcare provider when: 

  • Pain persists for more than a week or two 
  • You cannot put weight on your foot or carry out your daily activities
  • You have a medical condition that can affect your feet, such as diabetes or arthritis 
  • Foot pain develops after an accident or injury 
  • You have other symptoms, such as swelling, bruising, redness, or an open sore on your foot 

To determine what’s causing pain on the bottom of your foot, your healthcare provider will perform a physical examination and review your medical history. They may: 

  • Ask about your foot pain, including when it started and what activities worsen or relieve it 
  • Review your medical history and ask if you have any medical conditions associated with foot pain
  • Examine your foot to look for signs of injury or inflammation
  • Press or gently squeeze your foot to check for tenderness or pain
  • Observe your posture when standing to check for flat feet or high arches
  • Ask you to move your foot in specific ways, such as flexing your toes forward or backward, to assess your foot’s range of motion and strength

Depending on what your healthcare provider observes during the physical examination, they may order imaging tests like an X-ray to visualize your foot’s bones, muscles, ligaments, tendons, and nerves and identify abnormalities in the foot, such as fractures.  

Treatment for pain on the bottom of the foot varies depending on the underlying cause. Sometimes, a combination of at-home and medical treatments may be necessary.

At-Home Treatments

Self-care measures can help relieve foot pain. These include: 

  • Rest: Reduce or avoid weight-bearing activities that worsen pain to allow your foot to heal. 
  • Elevation: Keep your foot elevated to promote healing.
  • Ice therapy: Apply ice packs to the bottom of your foot for 15 minutes several times daily to relieve pain and inflammation. 
  • Supportive footwearWear shoes with arch support, cushioning, and some wiggle room for your toes. 
  • Orthotics: Custom-made or over-the-counter (OTC) shoe inserts or a brace can provide arch support for conditions like plantar fasciitis and tarsal tunnel syndrome. 
  • Taping: If you have pain in the arch of your foot, putting kinesiology tape across your foot can provide support and pain relief. Metatarsal fractures may also require taping to promote healing.
  • Over-the-counter (OTC) medications: Pain relievers such as Tylenol (acetaminophen) and Advil (ibuprofen) can provide short-term pain relief. 

Medical Treatments

Some causes of pain on the bottom of the foot require prescribed treatments to promote healing and prevent complications. These may include: 

  • Medication: Oral nonsteroidal anti-inflammatory drugs (NSAIDs) or cortisone (steroid) injections in the affected area can reduce pain and inflammation. 
  • Immobilization: A walking boot or brace that prevents foot movement may be necessary to allow broken bones or damaged tissues to heal.
  • Physical therapy: Strengthening and stretching exercises can improve the flexibility and strength of your foot. This may include gait training to help reduce pain during activity.
  • Surgery: Procedures may be necessary to repair severe fractures or when other treatments are ineffective in correcting structural abnormalities or repairing damaged tissues and bones.

Pain on the bottom of your foot can stem from problems with your foot’s bones, muscles, ligaments, tendons, or nerves. Overuse injuries, such as plantar fasciitis and tarsal tunnel syndrome, and acute injuries, such as metatarsal fractures, are common causes. In some cases, pain in the bottom of your foot is a symptom of an underlying condition such as osteoarthritis.

See a healthcare provider if you have severe or persistent pain in the bottom of your foot. Diagnosis and treatment can help relieve pain and promote healing. 

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