Foot Pain
Article by John Miller

Foot Pain
Foot pain and injury are widespread. You can source foot pain from local structures such as muscles, ligaments, bones and joints, or it can be referred from other sources, including your lower back and other systemic diseases such as diabetes.
Because foot pain can have many causes, it is crucial to assess foot pain by a health professional with a particular interest in managing foot pain. Only then can you be confident that your foot pain treatment addresses the “right” cause of your foot pain.
When Should You Worry About Foot Or Ankle Pain?
Some cases of foot and ankle pain require urgent attention.
Sudden Onset Foot Or Ankle Pain
Traumatic injuries that occur at speed or involve a multi-direction component such as twisting may result in foot or ankle fractures or significant soft tissue injuries, e.g. syndesmosis or high ankle sprains.
The Ottawa Ankle Rules determine the need for X-rays in acute ankle or foot injuries.
Ankle X-ray is only required if:
- There is any pain in the malleolar zone; and,
- Any one of the following:
- Bone tenderness along the distal 6 cm of the posterior edge of the tibia or tip of the medial malleolus, or
- Bone tenderness along the distal 6 cm of the posterior border of the fibula or end of the lateral malleolus, or
- An inability to bear weight immediately and in the emergency department for four steps.
Foot X-ray is indicated if:
- There is any pain in the mid-foot zone; and,
- Any one of the following:
- Bone tenderness at the base of the fifth metatarsal (for foot injuries), or
- Bone tenderness at the navicular bone (for foot injuries), or
- An inability to bear weight immediately and in the emergency department for four steps.
Chronic Ligament Instability
Chronic ligament instability in your foot and ankle can cause premature osteoarthritis and joint deformity. Some conditions can be safely rehabilitated without surgery, whereas other conditions, such as a Lisfranc injury, may require surgical repair.
Please consult your doctor or physiotherapist for specific foot or ankle injury advice.
Gradual Onset Pain That Fails to Improve
Stress Fractures
Stress fractures can be serious. While you may not have had a sudden traumatic injury, the ankle and foot are highly susceptible to stress fractures. Several bones in your foot can have their blood supply compromised by a stress fracture, leading to bone necrosis (death). These potentially life-changing conditions should seek an early assessment from your doctor or physiotherapist.
The good news is that most ankle and foot pain is not sinister and improves with physiotherapy and other non-surgical options.
Please ask your physiotherapist or doctor for advice.
What Are 7 Common Foot, Ankle & Heel Injuries?
- Sprained Ankle
- High Ankle Sprain
- Plantar Fasciitis
- Heel Spurs
- Severs Disease
- Achilles Tendinopathy
- Metatarsalgia
Why Does It Hurt Under Your Feet?
One of the most common patient questions we receive is, “Why does it hurt under my feet?”. While there can be many causes of pain under your foot, most symptoms arise from a few common conditions.
Based on many potential sources of your foot pain, the treatment will always vary depending upon your specific diagnosis, and rehabilitation needs to return you to the functional activities in your life.
For specific advice regarding the cause of your foot pain and the best treatment plan, please consult your trusted healthcare practitioner with a special interest in foot pain.
Common Foot Pain Causes
Various factors, ranging from injuries and tendon problems to degenerative conditions and systemic diseases, can cause foot pain. Some common causes of foot pain include foot injuries, plantar fasciitis, bunions, metatarsalgia, Morton's neuroma, tendon injuries, bone injuries, degenerative conditions like arthritis, biomechanical issues, nerve-related sources such as tarsal tunnel syndrome, and muscle injuries.
Certain systemic conditions like fibromyalgia, lupus, rheumatoid arthritis, and psoriatic arthritis can also contribute to foot pain. This comprehensive list covers a wide range of foot pain causes, encompassing different areas of the foot and various underlying conditions.
Foot Injuries
Tendon Injuries
- Achilles Tendon Rupture
- Achilles Tendinopathy
- FHL Tendinopathy
- Peroneal Tendinopathy
- Tibialis Posterior Tendinopathy
Bone Injuries
- Ankle Fracture (Broken Ankle)
- Stress Fracture
- Stress Fracture Feet
- Severs Disease
- Osteochondritis Dissecans
- Heel Spur
- Shin Splints
Traumatic Ankle Ligament Injuries
Degenerative Conditions
Soft Tissue Inflammation
Biomechanical Conditions
Nerve-Related Sources
Muscle Injuries
Systemic Conditions
Soft Tissue Inflammation
Other Useful Information
Foot, Ankle & Heel Pain FAQs
Welcome to our comprehensive FAQ guide on Foot, Ankle & Heel Pain. In this guide, we aim to address common questions and concerns related to foot, ankle, and heel pain. We will cover various topics, including ankle injuries, heel pain, Achilles pain, foot pain, shin pain, youth injuries, and balance and proprioception. Whether you're experiencing discomfort or seeking preventive measures, this guide will provide valuable insights and advice to help you understand and manage these conditions effectively.
Ankle Injuries
- What are the Common Ankle Injuries?
- Which are the Most Commonly Injured Ankle Ligaments?
- How to Strap an Ankle?
- What Causes Ankle Impingement?
- What is a High Ankle Sprain?
- What Constitutes a "Simple" Ankle Sprain?
- Why Do Your Joints Click?
Heel Pain
- What are the Common Causes of Heel Pain?
- How Do You Treat Heel Pain in a Child?
- How Can You Tell the Difference Between Heel Spurs and Plantar Fasciitis?
Achilles Pain
Foot Pain
- What are the Common Causes of Foot Pain?
- How Can You Relieve Foot Pain?
- What are the Disadvantages of Barefoot Running?