The anatomy of the foot is highly complex. More than 20 muscles, tendons and bones work together to enable us to stand, walk and run. Our feet are made up of different parts, which is why foot pain is so common.
Whether you’re suffering from pain on the bottom, top, heel or back of the foot, in this article we look at the various possible causes of foot pain and, above all, suggest solutions to alleviate your pain and treat it.
Pain under the soles of the feet can be a symptom of a variety of foot problems. Precisely identifying the origin of the pain is essential to implementing the right treatment and providing lasting relief.
Metatarsalgia is a burning, sometimes stabbing pain in the forefoot, at the level of the heads of the metatarsals (the bones of your feet).
The pain occurs when walking, running or standing for long periods, and is accompanied by a sensation of a bump under the foot or an uneven floor. Palpation can also be painful
The main causes include a forefoot that’s too hollow, a biomechanical imbalance, wearing shoes with thin heels or soles that are too hard, and being overweight.
Pain towards the front of the foot: Metatarsalgia
A stress fracture is a partial crack or break in the bone caused by progressive over-use. It often occurs after repetitive stress, such as a sudden change of activity or footwear, thus weakening the bone. Athletes, particularly those involved in high-impact sports such as running, are frequently affected.
Symptoms include localized pain, especially during physical activity, and sometimes even at rest. This pain is often accompanied by variable swelling, usually felt in the forefoot area. It may resemble other pathologies such as metatarsalgia or Morton’s neuroma, underlining the importance of a precise medical diagnosis.
Treatment of stress fractures generally involves partial or complete immobilization of the foot. Recovery time varies from 4 to 12 weeks.
Morton’s neuroma results from chronic compression of the intermetatarsal nerve, usually between the 3ᵉ and 4ᵉ metatarsals.
Patients experience throbbing, tingling or electric shocks in the forefoot, sometimes accompanied by numbness in the toes. Narrow shoes, excessive pronation and repetitive shocks accentuate this nerve irritation.
Morton's neuroma
Foot pain in the heel or arch of the foot can be very disabling. Whether it’s acute on waking or throbbing after a day on your feet, it often signals a mechanical or inflammatory problem. To treat it properly, we need to differentiate its causes and adapt our treatment.
Plantar fasciitis is an inflammation of the tendon on the bottom of your foot, the plantar fascia. Often caused by over-solicitation of the tendon, poor foot position or poor footwear, plantar fasciitis can lead to severe pain on the underside of the foot at the arch and heel.
Plantar fasciitis usually manifests itself as heel pain in the morning (burning sensation) or after prolonged rest. Repeated micro-tearing of the fascia can lead to swelling and aggravation, forming a heel spur.
Plantar Fasciitis
Heel spur is a bony growth on the calcaneus, often associated with chronic plantar fasciitis. Microtears will provoke a natural reaction by the body to defend itself, leading to calcification, which naturally takes the form of a small thorn. It is this calcification that exerts pressure on your tendon and heel, causing acute pain. Visible on X-ray, this bony deformity aggravates local irritation and requires treatment similar to that for plantar fasciitis.
Heel panniculitis is an inflammation of the subcutaneous fatty tissue. It can be caused by a variety of factors, including infection, trauma, exposure to intense cold, collagen disorders such as scleroderma or systemic lupus erythematosus, or unsuitable footwear.
Symptoms of panniculitis include the appearance of red, painful nodules under the skin, often sensitive to touch. Pain is often felt when walking or wearing shoes, making these activities difficult. Bruising may also appear in the affected area, increasing pain when pressure is applied.
Heel panniculitis
Sagging arches (flat foot) or excessive arches (cavoid feet) disrupt the normal distribution of pressure on the forefoot and heel. In the case of flat feet, the lack of support alters posture, leading to overcompensation by other parts of the foot. With cavoid feet, on the other hand, excess curvature exerts excessive pressure on specific areas, increasing stress on the plantar fascia and other joints.
Common symptoms include pain under the forefoot and heel, muscle tension, swelling, and sometimes radiating pain down the legs. This condition can make it difficult to perform physical activities such as walking or running.
Pain localized on the top of the foot occurs when musculo-tendinous or articular structures are stressed beyond their tolerance, or crushed by inadequate footwear. To find an effective remedy, first determine whether the source is bony, tendinous or mechanical.
Bunion, also known as hallux valgus, is an outward deviation of the big toe, causing a painful bump on the side of the foot. This can cause severe pain and affect walking.
The main symptom is localized pain in the big toe, accentuated when walking. At the same time, the deformity makes it difficult to wear certain shoes, as they exert additional pressure on the affected joint. The condition can also lead to redness and inflammation. Over time, complications such as corns, bursitis or osteoarthritis can develop, aggravating the symptoms.
Hallux valgus
Hammer toe is a condition where the middle joint of the toe flexes while the distal joint straightens, creating a fixed angle. This results in pinching of the tendons and soft tissues above the foot, causing pain and callus formation, especially when walking.
The causes of this deformity can be varied, including biomechanical imbalances or foot disorders, often exacerbated by poor footwear choice. Symptoms include persistent pain in the toes and arch, and discomfort when walking.
Exostosis of the foot is a benign tumour that mainly affects the feet. It often develops from cartilage and can appear as bumps on the top of the foot. Generally painless, it can cause pain if it affects certain areas (head of the metatarsals, base of the toes or heel).
In some cases, exostosis may be painless and completely asymptomatic. In others, pain may occur as a result of repeated rubbing against shoes or pressure exerted. A thorough medical examination is often necessary for a precise diagnosis.
Exostosis of the foot
Pain in the back of the foot can result from a number of common pathologies, from tendonitis to bone deformities. These conditions often affect tendons and joints, leading to pain that manifests itself during certain physical movements or exercises. Here are some of the pathologies that can cause this type of pain.
Foot tendonitis occurs when the tendons (often Achilles) are overworked by repetitive activities, sudden movements or excessive stress. This condition results from prolonged tension on the tendon, leading to inflammation.
It is frequently linked to excessive physical activity, particularly among athletes. Poor posture, inadequate footwear and insufficient warm-up also increase the risk.
Pain is often felt in the area of the affected tendon, often at heel level or on the side of the ankle. Swelling and stiffness may be observed around the inflamed tendon, and the pain may be sensitive to touch.
Foot tendinitis
Haglund’s disease is a bony growth located behind the heel bone, at the insertion of the Achilles tendon. It develops slowly, causing friction with shoes and resulting in pain, particularly during physical activity.
Haglund’s disease can be caused by a number of factors, including cavoid feet, ill-fitting shoes, shoes that are too tight or too rigid. Depending on how the disease progresses, a lump may become visible behind the heel, although it is sometimes difficult to detect in the early stages. Other symptoms include redness or swelling around the growth. Repeated friction can lead to retro-achilles bursitis and tendonitis in the foot, causing increased pain, stiffness and thickening of the Achilles tendon.
When pain is not confined to a specific point, but becomes diffused under the foot, it is often due to structural, inflammatory or metabolic disorders. Identifying the right cause is essential to adapting treatment and regaining comfort.
Foot arthritis, whether osteoarthritis or rheumatoid arthritis, leads to chronic inflammation of the foot joints, both in the hindfoot and forefoot. The symptoms are stiffness, swelling and pain, particularly in the morning.
Diabetic foot, or neuropathy, is a common complication of diabetes, affecting around 50% of sufferers, even with strict glycemic control. It is characterized by loss of sensation, numbness and tingling in the feet, often due to poor circulation and weakening of the muscles and arches of the foot. The condition can lead to ulceration, infection and, in some cases, amputation.
Endogyrism is a common deformity in children. This condition causes the feet to turn inward, often due to medial tibial torsion, metatarsus adductus, femoral anteversion, or other less common anomalies such as clubfoot.
Children with this deformity may experience premature fatigue during activity, an increased tendency to fall, and excessive pronation of the foot and ankle. This can lead to flat foot, and in some cases, knee, hip or lower back pain. In the long term, this can increase the risk of developing problems such as patellofemoral syndrome or premature osteoarthritis of the hip.
Exogyrism (duck walking) is a postural anomaly characterized by a gait with the feet turned outwards. Frequently observed in children, this condition can also affect adults. It results from incorrect positioning of the hip, femur, tibia or foot. Common causes include external femoral torsion, external tibial torsion, or conditions such as flat foot or calcaneovalgus foot.
In both children and adults, this gait can lead to increased fatigue, reduced sporting performance and increased risk of falls.
Foot pain requires a targeted approach. Typically, this includes customized foot orthotics, adapted footwear, regular stretching and rest. These solutions can help relieve inflammation and improve comfort.
Tired of those twinges and tensions that spoil your every step? Take action today! At one of our 20 Medicus locations in Quebec, our orthotists draw on over 65 years of expertise to assess your situation and propose a customized relief plan.
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