Why the Bottom of Your Foot Hurts—and What to Do About It (2025)

Pain on the bottom of your foot can be due to your activities, such as jobs that keep you on your feet or sports like running. The structure of your foot or the shoes you wear also can contribute to symptoms of shooting or aching pain. Conditions like plantar fasciitis, an inflammation of the sole of your foot, or neuropathy (nerve damage) due to an underlying condition like diabetes, often lead to foot pain.

Flat feet or high arches may make pain more likely. Some at-home remedies may help the pain, but your symptoms may be due to damage of bones, nerves, cartilage, tendons, or ligaments. Your healthcare provider or a podiatry (foot) specialist can diagnose and treat bottom-of-foot pain.

1. Plantar Fasciitis

One of the most common causes of foot pain is plantar fasciitis. This is the inflammation of the band of tissue called the plantar fascia that stretches from the heel bone to the base of your toes.

• Having flat feet or a very high arch
• Being overweight or having obesity
• Overpronation (when feet roll inward with each step)
• Wearing shoes with poor arch support
• Walking, running, or standing a lot on hard surfaces
• Walking barefoot
• Being pregnant
  

2. Metatarsalgia

Metatarsalgia describes pain in the ball of your foot where the five metatarsal bones are situated. These long bones in your forefoot connect your ankle to each of your five toes. The metatarsals help form the arch of the foot, which are essential for walking and weight-bearing activities.

Metatarsalgia pain is often described as being sharp, aching, or burning. It can worsen when you stand, run, walk, or flex your feet.

Metatarsalgia is common in people who do high-impact activities, like running or jumping. Older adults, notably middle-aged females, often develop metatarsalgia.

Other risk factors include:

• Having high arches
• Having especially long bones in your feet
• Having hammertoes
• Being overweight or having obesity
• Wearing high heels or ill-fitting shoes
• Having problems with blood circulation
• Having gout
• Having diabetes
  

3. Peripheral Neuropathy

Peripheral neuropathy is pain caused by damage to nerves situated outside of the brain and spinal cord (called the peripheral nerves). This condition can cause pain and other abnormal sensations in the hands and feet.

Neuropathy pain is often described as tingling, burning, shocking, or stabbing. The pain often gets worse with walking or standing.

Damage to the peripheral nerves can be caused by many things, including diabetes, alcohol abuse, Lyme disease, autoimmune diseases like lupus, and certain medications.

4. Morton's Neuroma

A neuroma is an abnormal clump of nerve cells that can form between the toes (usually after an injury). Symptoms may include:

• Numbness and tingling in the space between the third and fourth toes
• Toe cramping
• Sharp, shooting, or burning pain in the ball of the foot and sometimes toes
• Pain that increases when wearing tight shoes, high heels, or pressing on the area
• Pain that gets worse over time

The neuroma can feel like a pebble in your shoe. It is most common between the third and fourth toes.

People who are assigned female at birth are more likely to be affected.

Other risk factors include:

• Playing high-impact sports that involve running or jumping
• Wearing shoes without proper support
• Wearing high heels, tight shoes, or restrictive footwear like work boots
• Having hammertoe or a bunion
  

5. Sesamoiditis

Sesamoiditis is the inflammation of the two small bones situated beneath the pad of the big toe, called the sesamoids. These bones help support the tendon that flexes this toe.

Symptoms of sesamoiditis include a dull, longstanding pain beneath the big toe joint. The pain comes and goes, usually occurring with certain shoes or certain activities.

Risk factors include:

• Activities that place pressure on the ball of the foot, like running, ballet, or tennis
• Having high arches
• Wearing high heels
  

6. Tarsal Tunnel Syndrome

Tarsal tunnel syndrome occurs when the nerve that services parts of the calf and foot, called the posterior tibial nerve, gets compressed in a narrow space inside the ankle, called the tarsal tunnel. This causes pain, numbness, and tingling in the foot.

Risk factors for tarsal tunnel syndrome include:

• Having flat feet
• Swelling in your ankle due to an ankle sprain
• Having diabetes, arthritis, or other diseases that cause nerve compression
• Avaricose vein, ganglion cyst, swollen tendon, or bone spur

7. Guillain-Barré Syndrome (GBS)

Guillain-Barré syndrome (GBS) is a rare disorder that causes your immune system to attack your peripheral nerves. It is often triggered by a respiratory or digestive infection and occasionally by certain vaccines.

For many people, the first signs of GBS are pain, weakness, or tingling in their toes, feet, or legs. These sensations tend to progress and gradually spread to the arms and upper body. In rare cases, GBS can cause permanent nerve damage, paralysis, or death.

Anyone can get GBS, but it is more common in adults over 50. Your risk is also higher if you've had a recent surgery or have a preexisting autoimmune disease.

8. Trauma or Injury

Foot pain can be caused by a sprain or strain, but there's a reciprocal relationship, too. You may be more likely to experience an ankle sprain if you have weakened foot muscles, loose ligaments, or wear shoes that can make the injury more likely.

Some studies suggest that the shape of your foot (high arches, flat feet) or the pressure on the plantar surface is a risk factor for injury in people who play volleyball and other sports. While rest and over-the-counter remedies are often enough to treat an isolated injury, your healthcare provider may recommend physical therapy or other interventions.

9. Osteoarthritis

People diagnosed with osteoarthritis of the knee often have changes in their walking gait that affects foot pressure. This can sometimes lead to pain on the bottom of the foot or structural changes that make the knee pain worse.

A small 2023 study found plantar fasciitis was common in people diagnosed with knee osteoarthritis, including pain at the heel affecting more than half of the cases evaluated. Your healthcare provider may consider treatment for both conditions, including shoe inserts.

10. Heel Spurs

Heel spurs are growths that form over time on the bone of the heel. The body builds extra bone because of repetitive stretching of the plantar band due to:

• Sports overuse
• Being overweight
• Wearing ill-fitting shoes

Rest and over-the-counter pain relief are among the home remedies for heel spurs. Properly stretching before a workout or new shoes can help, but some people may need steroid injections or surgery.

When to See a Healthcare Provider

Sometimes, bottom-of-the-foot pain goes away on its own in a few days. At other times, it becomes a chronic condition that impacts your quality of life.

See a healthcare provider if you have:

• Sudden pain, or new pain that lasts more than a few days
• Loss of sensation or abnormal sensations like tingling or burning
• Chronic foot pain that suddenly gets worse
• Pain that makes it difficult to walk or do everyday activities
• An injury that causes foot pain, or bleeding or bruising
• Fever, chills, and swelling of the foot (indicative of an infection)

Based on your symptoms, your healthcare provider may refer you to a podiatrist, orthopedist (bone specialist), or neurologist (nerve specialist).

Diagnosis

To identify the cause of your foot pain, your healthcare provider will first examine your foot for signs of pain, tenderness, infection, or a loss of range of motion. They will also check for any abnormal sensations or signs of deformity (including bunions, overpronation, or flat feet).

Based on the findings, your healthcare provider may order imaging tests, like X-rays, to check the structure of your foot and other procedures that measure nerve activity.

Other tests to determine the cause of foot pain can include nerve conduction studies (NCS) if Guillain-Barré syndrome or peripheral neuropathy is suspected. Electromyography to measure nerve activity can help to determine if your pain is related to your muscles, nerves, or some other cause.

Your provider also may need to rule out another condition. Conditions that mimic neuroma include:

• Bursitis of the bones at the base of the toes
• Instability in the metatarsophalangeal (MTP) joint
• A tear in the ligamentin the ball of your foot

Conditions with similar symptoms to metatarsalgia include:

• Morton's neuroma
• Bursitis of the bones at the base of the toes
• Stress fractures in the metatarsals

Treatment

Treatment for foot pain depends on your diagnosis. Healthcare providers usually recommend starting with conservative options and moving to other treatments as needed.

Lifestyle

The more significant your pain is, the more you might think that lifestyle won't have much of an effect. That's simply not true. There are many effective strategies that can help.

Shoe Inserts: Supportive shoes or inserts can help relieve some foot pain, particularly for conditions like plantar fasciitis, metatarsalgia, and neuroma.

In some cases, your healthcare provider may prescribe custom orthotic shoe inserts designed to fit and support your foot's distinct curves.

Diet: Starting an anti-inflammatory diet is ideal for anyone experiencing pain. It focuses on reducing processed and high-fat foods while increasing your intake of fruits and vegetables, fish, nuts, and whole grains. Foods with turmeric, lemon water, and antioxidants may help reduce foot inflammation.

Weight Loss: Being overweight or obese is linked to an increased risk of pain, inflammation, and other problems in your feet. Losing weight, if needed, can reduce the stress on your feet.

Losing weight is especially important if you also have diabetes, which is a risk factor for peripheral neuropathy, metatarsalgia, tarsal tunnel syndrome, and more.

Posture: Many people find that improving their posture lessens the stress on their feet and improves their pain. Even if you have had poor posture for years, you can still improve it by making sure that your shoulders are pushed back and your weight is balanced evenly on both feet.

If you tend to slouch, you can try wearing a posture brace to pull your shoulders back. You might also find it helpful to set a frequent alarm to remind you to correct your posture.

Exercise: Last but not least, stretches and strength-building exercises are a must for correcting posture. Stretching will release tension in your back, hips, and glutes and help you stand more evenly. Exercises that strengthen your core, back, and shoulders will help you stand taller and align your spine.

Medications

Over-the-counter pain relievers are commonly used to ease foot pain, including:

• Tylenol (acetaminophen)
• Advil/Motrin (ibuprofen)
• Aleve (naproxen)
• Aspirin

If conservative treatments fail, a cortisone injection can quickly ease inflammation in people with plantar fasciitis, sesamoiditis, or neuromas. Alternatives include shockwave therapy and platelet-rich plasma (PRP) injection.

For severe pain, you may be given a prescription opioid painkiller like:

• Tylenol with Codeine (acetaminophen/codeine)
• Vicodin (hydrocodone/acetaminophen)
• OxyContin (oxycodone)

Opioids can be highly addictive and are only intended for short-term use.

Peripheral neuropathy can be harder to treat. It is generally managed with medications such as anti-seizure drugs and antidepressants. These drugs change how your nervous system functions.

Complementary and Alternative Therapies

Certain complementary or alternative treatments may help relieve foot pain, including:

• Acupuncture
• Foot and ankle massage and stretching
• Movement therapies like yoga or tai chi to improve muscle strength, flexibility, and balance

You can also try applying a cold or hot compress to your foot to reduce pain. Use ice for only 20 minutes at a time up to three times a day. Don't place ice packs directly against your skin.

Physical Therapy

Your healthcare provider may refer you to a physical therapist if your foot pain interferes with your daily life, activities, or mobility. The goal of physical therapy is to reduce your symptoms and the effect they have on your quality of life.

To accomplish this, your physical therapist will put together a program that rehabilitates your foot so that you can walk and stand without pain. Your rehab program may involve stretches and exercises that improve your foot and ankle strength, balance, and range of motion.

Physical therapy can help you manage your plantar fasciitis, metatarsalgia, neuroma, or sesamoiditis. In some cases, it may help with peripheral neuropathy.

Surgery

Surgery is typically a last resort when all other treatment options fail to reduce your pain and other symptoms. These options include:

• A surgical procedure called a sesamoidectomy may be necessary for very severe cases of sesamoiditis that do not respond to physical therapy. This surgery involves removing the sesamoid bone.
• Surgery for plantar fasciitis is uncommon, but it may be necessary if your pain persists despite six to 12 months of physical therapy. The surgery involves cutting part of the plantar fascia to release tension and ease swelling.
• Severe neuromas that don't get better with therapy can be treated with a minimally invasive procedure called a neurectomy. A small incision is made in the foot and the affected nerve is removed.
• Several possible surgeries can be done for severe metatarsalgia, depending on what has caused it. If a deformity is to blame, a metatarsal osteotomy can be done to realign the metatarsal bone(s).
• Surgery may be done for peripheral neuropathy, also depending on the cause. The minimally-invasive procedure involves dividing the affected nerve to relieve pressure. It can be done in an outpatient setting.

Prevention

You can't always prevent a foot injury or an illness that leads to foot pain. But there are lifestyle changes you can make to reduce your risk of discomfort:

• Wear orthopedic inserts or supportive shoes.
• Carefully walk and stretch after an injury.
• Avoid excessive running, jumping, or high-impact activities.
• Strive to maintain a healthy weight.
• Avoid foods that trigger inflammation, such as sugar and highly processed foods.
• Work on improving your posture.
• Listen to your body and take pressure off your feet when needed.

Taking care of your overall health goes a long way in preventing foot pain. In addition to eating a healthy diet and exercising regularly, carefully managing any chronic conditions is key.

Summary

There are several possible causes of bottom-of-the-foot pain. Plantar fasciitis is one of the most common causes, but they range from simple sports injuries to bone or nerve conditions that are linked to a co-occurring illness like diabetes or osteoarthritis.

Symptoms can vary depending on the cause. Diagnosing why the bottom of your foot hurts may include a physical exam and X-rays or other imaging. Treatment may involve pain relief, lifestyle changes, physical therapy, and in severe cases, surgery.