Foot pain is one of the most common complaints among adults – our feet carry us thousands of steps every day and are made up of 26 bones, 33 joints and over 100 muscles and ligaments. When something goes wrong, even simple walking can become painful.
In this article, we look at the most common causes of foot pain – from heel spurs and plantar fasciitis to Morton's neuroma and hallux valgus – and what treatments work.
Most common causes of foot pain
1. Heel spur and plantar fasciitis
The most common cause of heel pain. "Heel spur" is actually a misnomer – the underlying problem is usually plantar fasciitis: inflammation of the tendon-like band (plantar fascia) that runs along the sole of the foot.
Typical symptoms:
- Severe pain during the first steps in the morning
- Worse after prolonged sitting
- Throbbing or stabbing pain in the heel
- The pain eases somewhat after a few minutes of walking
Risk factors:
- Long periods of standing at work
- Running
- Flat feet or high arches
- Excess body weight
- Unsupportive shoes
- Tight calf muscles
2. Achilles pain
Pain in the Achilles tendon, between the heel and the calf. Common in runners and middle-aged people.
3. Morton's neuroma
Thickened nerve between the toes (most often the 3rd and 4th toes). Causes burning pain and feeling of "stone in the shoe". Read more about nerve pain.
4. Hallux valgus (bunion)
The big toe is angled towards the other toes. Causes pain, swelling and problems with shoes.
5. Osteoarthritis of the ankle or toes
Joint wear and tear that causes stiffness and stress-related pain. Read more about arthrosis.
6. Ankle sprain
Ligament injury after a twisted ankle. Common in sports.
7. Metatarsalgia
Pain under the ball of the foot.
8. Nerve entrapment
Tarsal tunnel syndrome – equivalent to carpal tunnel syndrome, but in the foot.
9. Gout
Sudden intense pain and swelling, usually at the base of the big toe.
10. Diabetic neuropathy
In diabetics – burning nocturnal foot pain. Read about nerve pain.
Plantar fasciitis – deep dive
Since heel spur/plantar fasciitis is the most common cause, it deserves extra focus.
Diagnosis
Diagnosed clinically:
- Typical symptoms (morning heel pain)
- Tenderness when palpating the front edge of the heel bone
- Ultrasound can show thickened fascia (>4 mm)
- X-ray sometimes shows a "heel spur" - but it is often a consequence, not the cause of the pain
Treatment
85-90% recover without surgery with proper treatment.
- Stretching of calf muscles and plantar fascia – several times daily
- Supportive shoes and heel inserts
- Night splint – keeps the foot stretched during sleep
- NSAIDs (ibuprofen) for inflammation
- Steroid injection in severe cases
- Shock wave therapy (ESWT) – good evidence
- Physiotherapy – structured training
As a last resort: surgery (very rarely necessary).
When should you seek care?
Contact a doctor if you:
- Have foot pain for over 2-3 weeks despite rest
- Can't walk normally
- Have swelling, redness and heat (possible infection or gout)
- Have numbness or tingling
- Have diabetes and new foot pain
- Have pain after trauma with suspected fracture
- Feel that the pain affects quality of life
Emergency care for:
- Inability to put weight on the foot after trauma
- Signs of infection (redness, heat, fever)
- Sudden intense pain and swelling
Investigation
- Clinical examination – gait, mobility, palpation
- X-ray for trauma or suspected osteoarthritis
- Ultrasound for plantar fasciitis, Achilles problems, Morton's neuroma
- MRI when the diagnosis is unclear
- Blood tests for suspected gout or rheumatism
- Neurography for suspected nerve entrapment
Treatment – general
Self-care
- Rest from provocative activities
- Ice for acute pain
- NSAIDs (short term)
- Supportive shoes – no flat "soft" sneakers for too long
- Foot insoles for flat feet
- Stretching of calf muscles
Physiotherapy
- Specific training for the foot
- Gait assessment
- Home exercises
Injections
- Steroid injection for local inflammation
- Local anaesthetic as a diagnostic tool
- PRP (blood platelets) in some cases
Surgery
Rarely necessary for foot pain, but relevant for:
- Pronounced hallux valgus
- Non-responsive Morton's neuroma
- Prolonged plantar fasciitis that has not improved
- Clear structural damage
Self-help
- Good shoes – supportive, the right size and not worn out
- Foot insoles if needed
- Daily stretching of calves and soles of feet
- Gradual training – no sudden increase
- Weight control – significantly reduces the load
- Avoid walking barefoot on hard surfaces with plantar fasciitis
- Roll the foot over a tennis ball or frozen water bottle
Frequently asked questions (FAQ)
What exactly is a heel spur?
A small bony growth on the heel bone visible on X-ray. It is rarely the cause of the pain – it is a consequence of prolonged strain. It is the plantar fasciitis that causes the pain.
Why does it hurt most in the morning?
During the night, the plantar fascia contracts. The first steps stretch it abruptly - that's when the pain is worst. After a few minutes, the fascia "warms up" and the pain is temporarily relieved.
Can I run with plantar fasciitis?
During the acute phase – no. Switch to cycling or swimming. Return gradually when the pain is relieved.
Does cortisone injection help?
Yes, often, but the effect is usually short-lived. It is most often used for severe pain that does not respond to other treatments. Repeated injections increase the risk of fascial rupture.
What is the difference between heel spur and plantar fasciitis?
A heel spur is the bony growth seen on X-rays. Plantar fasciitis is the inflammation of the fascia. Plantar fasciitis can be present without heel spurs, and heel spurs can be present without pain.
Do I need a referral to see an orthopedist?
No. At Scandinavian Health Clinic you book directly without a referral.
Do foot insoles really help?
Yes, for flat feet or high arches. Individually adapted foot insoles are better than standard ones, but over-the-counter support insoles also help many people with plantar fasciitis and heel spurs.
Why do my feet only hurt in the morning?
This is classic for plantar fasciitis. During the night, the plantar fascia contracts – the first steps stretch it abruptly and trigger pain. After a few minutes, the fascia "warms up" and the pain is temporarily relieved.
Summary
Foot pain is common but has many possible causes – the correct diagnosis is crucial. Most people recover fully with the right combination of self-care, physiotherapy and, in some cases, medical treatment.
Book an appointment with a specialist at the Scandinavian Health Clinic in Mölndal - without a referral, with a short waiting time and just minutes from central Gothenburg.
📞 +46 (0) 10-147 77 40 ✉️ [email protected]
Book an appointment - contact us → Pain & Orthopedics → Read about osteoarthritis → Read about knee pain → Read about hip pain → Read about nerve pain → Read about chronic pain →
