Foot pain affects between 13% and 36% of adults, depending on the population studied, and its causes range from overuse injuries to poorly fitting shoes to underlying health conditions. The foot contains 26 bones, 33 joints, and more than 100 muscles, tendons, and ligaments, which means there are many structures that can become irritated, inflamed, or damaged. Where you feel the pain is often the fastest clue to what’s causing it.
Heel Pain
The most common source of heel pain is a condition called plantar fasciitis, which involves the thick band of connective tissue running along the bottom of the foot from the heel to the toes. Despite its name suggesting inflammation, the condition is primarily a degenerative process. Repetitive stress from standing, walking, or running causes microtears in the tissue. Over time, those tiny tears lead to collagen breakdown and thickening rather than true inflammation, which is why the pain tends to build gradually rather than appear after a single injury.
Plantar fasciitis is especially common in runners, people who stand for long hours at work, and older adults. Having flat feet, very high arches, limited ankle flexibility, or excess body weight all increase your risk. The hallmark symptom is sharp heel pain with your first steps in the morning or after sitting for a long time. The cushioning pad on the heel also thins naturally with age, which can make heel pain worse or create its own discomfort independent of the fascia.
Achilles tendonitis is the other frequent cause of pain at the back of the heel. The Achilles tendon connects your calf muscles to the heel bone, and overuse or sudden increases in activity can strain it. Pain may settle right where the tendon attaches to the bone, sometimes alongside a bony bump at the back of the heel.
Ball of the Foot and Toes
Pain under the ball of the foot, broadly called metatarsalgia, happens when the long bones in your forefoot absorb more pressure than they can handle. Distance runners are at high risk because the front of the foot absorbs the bulk of impact force during running. A high arch concentrates pressure on the ball of the foot, and having a second toe that’s longer than the big toe shifts extra weight onto that area. Excess body weight also plays a role, since most of your weight transfers to the forefoot during movement.
Morton’s neuroma causes pain in a similar spot but for a different reason. A nerve between the third and fourth toes becomes irritated and develops a thickening of fibrous tissue around it. The result is a burning or shooting pain in the ball of the foot, sometimes with numbness extending into the toes.
Stress fractures, tiny cracks in the metatarsal bones, are another source of forefoot pain. They develop from repetitive force rather than a single traumatic event, making them common in runners and athletes who ramp up training too quickly. Pain typically worsens with activity and improves with rest.
Toe Deformities
Bunions (a bony bump at the base of the big toe) and hammertoes (toes that curl downward at the middle joint) both generate pain and can worsen metatarsalgia by changing how weight distributes across the foot. These deformities develop when something pushes the toes out of their natural alignment over a long period, often from narrow or poorly shaped footwear. Sesamoiditis, inflammation of two small bones embedded beneath the big toe joint, causes pain in that localized area and is common in dancers and people who spend time on the balls of their feet.
Arch and Midfoot Pain
Arch pain often traces back to either plantar fasciitis (described above) or a problem with the posterior tibial tendon. This tendon runs from behind the inner ankle down into the arch and is the primary structure supporting the foot’s shape. Repetitive strain causes tiny tears in the tendon fibers, and if those tears don’t get a chance to heal, the tendon weakens progressively. As it fails, other structures in the foot and ankle pick up the slack, eventually becoming overstressed themselves. The cycle continues until the arch visibly flattens, the ankle rolls inward, and the heel and toes may turn outward.
People with flat feet, high arches, or an abnormal walking pattern are more prone to this type of tendon strain because even normal walking places uneven stress on the tendon. Pain typically appears along the inner side of the foot and ankle, worsening during activities like walking, running, or climbing stairs.
Midfoot pain after an injury could signal a Lisfranc injury, which is disruption of a strong ligament in the middle of the foot that helps hold up the arch. This is more serious than a typical sprain and can be easy to miss on initial evaluation.
Top and Outside of the Foot
Pain on the top of the foot near the ankle may come from a stress fracture of the navicular bone, one of the small bones near the ankle joint. Tendonitis affecting the tendon that runs along the top of the midfoot is another possibility, especially in people who lace their shoes too tightly or increase activity suddenly.
On the outside of the foot, a fracture of the fifth metatarsal (the bone running along the outer edge) is a common culprit, particularly after an ankle-twisting injury. Peroneal tendonitis, affecting the tendons on the outer side of the ankle, causes pain along the outside of the foot and often stems from repetitive motion or an unstable ankle. Cuboid syndrome, where a small bone on the outer midfoot shifts slightly out of alignment, can also produce pain in this area.
Systemic Health Conditions
Foot pain isn’t always a foot problem. Several whole-body conditions show up first in the feet.
Gout causes sudden, intense pain, warmth, redness, and swelling, most commonly in the big toe joint. It happens when uric acid crystals build up in a joint, triggering a severe inflammatory response that can wake you up at night.
Diabetes damages nerves over time, leading to diabetic neuropathy. This typically causes burning, tingling, or numbness in both feet, starting at the toes and progressing upward. In advanced cases, the loss of sensation can lead to joint damage that goes unnoticed because you can’t feel the pain that would normally signal a problem.
Rheumatoid arthritis and other inflammatory joint diseases frequently target the small joints in the feet and toes. The resulting pain, stiffness, and swelling tend to affect both feet symmetrically and are often worse in the morning.
How Footwear Contributes
Shoes are one of the most modifiable causes of foot pain, and the problem is more widespread than most people realize. Research has found that 88% of women wear shoes narrower than their feet by an average of 1.2 centimeters. That constant compression of the toes contributes directly to bunions, hammertoes, poorly developed arches, and general foot pain.
High heels shift the body’s center of gravity forward, forcing the knees and ankles into unnatural positions. This increases joint stress, raises pressure under the ball of the foot, and is associated with the development of bunions and toe deformities. The higher the heel, the more pronounced the effect.
Interestingly, the conventional wisdom about arch support and cushioning is not well supported by evidence. A 2025 review of footwear research found no empirical evidence that built-in arch support provides health benefits for the general population, and some evidence suggests it may actually hinder natural arch development. Similarly, heavy cushioning in everyday shoes reduces stability and dulls the foot’s ability to sense the ground, without clear mechanical benefits. The most important shoe features for avoiding pain are a toe box wide enough for your toes to spread naturally and a fit that matches the actual shape and size of your foot.
Overuse and Biomechanical Factors
Across nearly every type of foot pain, overuse and biomechanics are recurring themes. Repetitive strain is the most common cause of foot tendonitis. The mechanism is straightforward: repeated stress creates tiny tears in a tendon. If you keep loading the tendon before those tears heal, the damage accumulates. The tendon weakens, becomes easier to injure, and enters a cycle of chronic breakdown.
Your foot structure plays a significant role. Flat feet, high arches, overpronation (feet rolling too far inward), and supination (feet rolling outward) all change how force distributes across the foot during every step. These patterns are sometimes inherited and sometimes develop from years of wearing certain shoes. Sudden changes in activity level, like starting a running program, switching to a new type of shoe, or spending a week on your feet during vacation, are among the most common triggers for the onset of foot pain. Excess body weight amplifies all of these forces, particularly at the heel and ball of the foot.
Warning Signs That Need Prompt Attention
Most foot pain responds to rest, better footwear, and time. But certain symptoms signal something more urgent. Pain that is completely out of proportion to an injury could indicate compartment syndrome, a dangerous buildup of pressure in the tissues. Numbness, tingling, or loss of a pulse in the foot after an injury suggests compromised blood flow or nerve damage. An open wound over a fracture, visible deformity, or skin that looks devitalized or tented over displaced bone all warrant immediate evaluation. If you can’t bear weight on your foot after an injury and have tenderness over specific bones in the midfoot, imaging is typically indicated to rule out a fracture.