Foot Pain Location Chart: A Better Understanding of Your Foot Pain

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If you’ve ever had foot pain, then you know how incredibly annoying it can be!

This is especially true if you don’t understand why your foot is hurting to begin with.

Wouldn’t it be nice if there was a chart to tell us what could be causing foot pain??

We thought so too!

A foot pain chart is an easy way to break down all the possible causes of foot pain.

Let’s get to it!

Possible Causes of Foot Pain Based on Location

Since the foot is so complex, that means there are MANY reasons why your foot could be hurting.

To help keep ourselves on track here, we’re going to break down the foot into different locations. Then we can talk about the possible reasons why you might be having foot pain in those areas.

A. Top of Foot Pain

1. Extensor Tendonitis

foot extensor
foot extensor 1
foot extensor 2

Extensor tendonitis is an overuse injury that affects the muscles and tendons on the top of the feet.

These muscles and tendons are responsible for lifting your foot and toes up off the ground.

The extensor muscles in the foot and ankle include extensor hallucis longus, extensor hallucis brevis, extensor digitorum longus, and tibialis anterior.

Too much stress and strain to any or all of these muscles and tendons will lead to tendonitis. Extensor tendonitis commonly causes pain and inflammation in the top of the foot. This worsens when the affected muscles contract.

This repetitive overuse injury could occur from too much walking (especially uphill), running, sports, etc.

There may also be postural or structural problems in the feet and ankles that could be causing your pain. An example of this is flat feet.

SYMPTOMS:

  • Pain worsens with foot and ankle movement, especially toe extension or ankle dorsiflexion
  • Top of foot and ankle pain and stiffness
  • Swelling
  • Warmth
  • Pain with walking or running, especially uphill

2. Toe Deformity

toe deformity

The primary toe deformities we’ll talk about here are mallet toe, hammer toe, claw toe, and retracted toe.

Mallet toe occurs when the furthest, or most distal, toe joint (distal interphalangeal joint) is hyper flexed. This may be the way your bones are set (fixed) or it may be positional (flexible).

Hammer toe occurs when the middle joint of the toe (proximal interphalangeal joint) becomes hyper flexed.

Claw toe happens when both the distal and middle toe joints become hyper flexed. The toes literally will look like a claw.

Retracted toe is when both the distal and middle toe joints become hyper flexed AND there is too much extension at the metatarsophalangeal joint.

Toe deformities can be something you’re born with, or they could be something that you develop. It’s possible to develop toe deformities from another medical condition, poor fitting shoes, or muscle imbalances.

SYMPTOMS:

  • Calluses from your shoes rubbing on the toes
  • Toe swelling and inflammation
  • Toe stiffness
  • Pain with walking and standing

3. Navicular Stress Fracture

navicular bone

The navicular bone is one of the tarsal bones located on the dorsum or top of the foot but also spans towards the inside of the foot.

This bone doesn’t have the best blood supply, so it can be more susceptible to an injury, such as a fracture.

Repetitive stress or trauma to this part of the foot can cause a bone fracture. This may be from too much running and jumping.

You could even cause a stress fracture to this bone if you do too much walking after having been inactive for a while.

A specific trauma, like a fall, may be another possible cause.

Underlying bone density issues can increase your chances of a navicular fracture.

An X-ray would be able to confirm if you’ve experienced a navicular fracture.

SYMPTOMS:

  • Broad ache and pain along the top of the midfoot
  • Pain may spread to the inner foot and arch
  • Tenderness to touch
  • Swelling on the top and inside of the foot
  • Unable to weight bear or take steps
  • Decreased foot and ankle range of motion
  • Bruising

B. Bottom of Foot Pain

1. Plantar Fasciitis

Plantar fasciitis is one of the most common foot pain issues on the bottom of the foot, or more specifically at the center of the heel or calcaneus.

The ultimate cause of plantar fascia pain isn’t well understood.

Common risk factors with developing it include having tight plantar fascia, flat feet, being overweight, having a job that requires prolonged standing and walking, decreased ankle range of motion, and structural issues like heel spurs.

Plantar Fasciitis anatomy

SYMPTOMS:

  • Heel pain and foot stiffness
  • Possible foot arch pain
  • Pain is worse in the morning or after standing and walking for too long
  • Tenderness on the heel
  • Pain improves with rest

2. Morton’s Neuroma

Mortons Neuroma

Morton’s neuroma causes pain on the bottom of the ball of the foot.

It’s thought to be caused by pressure from thickened tissue in this area, which puts pressure on the nerves in the ball of the foot.

Wearing high heels or tight shoes can cause Morton’s neuroma

SYMPTOMS:

  • It may feel like your ball of foot is standing on a pebble or small rock
  • Burning pain in the ball of the foot
  • Numbness or tingling in the toes
  • Pain with prolonged walking or standing
  • Radiating pain into the toes

3. Flat Feet

flat feet

Flat feet are noticed if your foot and ankle roll inward excessively, creating overpronation.

Some people are born with collapsed or flat arches, while others develop them over their lifetime.

Flat feet don’t offer much support to the arches, and as mentioned above, cause the ankle to roll excessively inward. This creates weakness in the arches and inner ankle.

Not everyone with flat feet will automatically have pain, BUT because of the abnormal foot and ankle alignment with flat feet, some will develop pain.

SYMPTOMS:

  • Foot pain in the inner arch or heel pain
  • Increased pain with standing, walking or running
  • Possible inner ankle swelling due to inner ankle pressure from over-pronation

4. Achilles Tendonitis

While Achilles tendonitis typically will cause pain at the back of the heel, this can still translate at times towards the bottom of the heel as well.

The Achilles tendon connects your calf muscles to the heel bone.

Overuse of the calf muscles, such as with too much running, jumping, climbing too many stairs and a lot of walking, can cause tendonitis or inflammation around the tendon.

When Achilles tendonitis happens, stressful forces will take place where the tendon attaches at the heel bone.

Achilles Tendonitis Anatomy

SYMPTOMS:

  • Heel and/or calf pain
  • Stiffness in the heel: worse in the mornings, but may improve with light activity
  • Worse pain with extended walking, stairs, running, jumping or pushing up onto the toes
  • Warmth and swelling where the Achilles tendon inserts on the heel bone
  • Pain improves with rest
  • Tenderness over the tendon or heel

5. Metatarsalgia

metatarsal

Metatarsalgia is pain on the bottom of the foot on one or more heads of the metatarsal bones near the toes, otherwise known as the forefoot.

The exact cause of pain can vary from person to person.

Some are born with abnormal structural positioning of the metatarsal bones in relation to the rest of the foot. Having a naturally high arch is an example of a foot structure that could increase your odds of getting metatarsalgia.

Others will experience metatarsalgia from repetitive pressure and stress on the ball of the foot where the metatarsal heads are (e.g., if you wear tight shoes, running, jumping, walking on uneven surfaces).

Even previous foot surgeries can increase your chances of developing this foot pain.

SYMPTOMS:

  • Forefoot pain on the bottom of the foot (may be dull ache, sharp pain or burning)
  • Increased pain with weight bearing (e.g., standing, walking, running, jumping, stairs)
  • Tenderness along the ball of foot
  • Pain is worse when barefoot
  • Possible numbness and/or tingling in the ball of foot into the toes
  • Possible sensation of a pebble in your shoe on the ball of foot

6. Heel Spurs

Heel spurs are bony growths that develop on the calcaneus, or heel bone.

Many times, a heel spur can be tough to distinguish from plantar fasciitis. Believe it or not, sometimes plantar fasciitis itself can cause a heel spur!

An X-ray is one of the best ways to confirm if a heel spur is the source of your heel pain.

Heel spurs will commonly develop as a result of repetitive stress and inflammation to the heel and plantar fascia. This may happen with sports that involve running and jumping, too much walking, or if you’re prone to wear high heels often.

When this stress and inflammation occurs, the body will try to heal itself by releasing osteoblasts to the area, which then in turn will form bony growths known as heel spurs.

Heel spurs don’t always cause pain, but when they do… Ouch!

Heel Spurs anatomy

SYMPTOMS:

  • If you have pain from a heel spur, it will be felt on the heel
  • Sometimes pain may move into the arch
  • Pain is worse when you first get up after sleeping or sitting
  • Pain likely will improve with light movement, but too much activity can make it feel worse
  • Tenderness at the bottom of the heel
  • Swelling in the heel

7. Plantar Fibromatosis

Plantar fibromatosis isn’t very common.

It happens when a benign growth or growths develop on the bottom of the foot.

These growths will develop in the plantar fascia creating fibrotic or scar tissue.

Plantar fibromatosis can develop as a result of a medical condition, medication side effect, or from previous damage to the plantar fascia.

Similar to heel spurs, not everyone with this foot condition will have foot pain if the growths are small and don’t bother the foot.

If they continue to grow then it can make walking and standing uncomfortable, causing pain.

SYMPTOMS:

  • Pain with weight bearing (e.g., standing, walking, running, jumping)
  • Visible or palpable lump or lumps in the bottom of the foot
  • Pain with or without shoes

8. Achilles Bursitis

Achilles Bursitis

There is an Achilles bursa located between the Achilles tendon and the heel. This bursa is a fluid-filled sac meant to help cushion and support movement of the tendon over the bone.

When this sac becomes irritated and inflamed, it leads to bursitis.

Achilles bursitis can happen from too much pressure or friction on the back of the heel, like if your shoes are too tight.

It can also happen if your calf muscles are too tight, having a flat foot, or repetitive motions like with too much walking, running or jumping.

SYMPTOMS:

  • Pain in the back of the heel
  • Tenderness and swelling in the back of the heel
  • Increased pain with wearing tight fitting shoes
  • Pain worsens with walking or running, especially uphill
  • Pain worsens with jumping

C. Outer Foot Pain

1. Peroneal Tendonitis

There are 3 peroneal muscles located on the outside of the lower leg: peroneus brevis, peroneus longus, and peroneus tertius.

These muscles help to perform ankle plantarflexion and eversion. They also help support the arch of the foot.

The peroneal tendons run underneath the outside ankle bone, attaching to certain tarsal and metatarsal bones on the outside and bottom of the foot.

Like any muscle and tendon that gets overused, the peroneals can suffer from tendonitis.

Peroneal tendonitis is most common in those with high arches, those who have current or previous outer or lateral ankle sprains, weakness or tightness in these muscles, or those who participate in repetitive, stressful activities (e.g., running and jumping sports).

Peroneal Tendonitis

SYMPTOMS:

  • Pain along the outside of the heel and foot
  • Tenderness in the peroneal muscles along the outside of the lower leg
  • Pain with ankle plantarflexion and eversion
  • Swelling and warmth around the tendons
  • Tenderness along the tendons
  • Pain worsens with activity and improves with rest

2. Sinus Tarsi Syndrome

The sinus tarsi is a small tunnel formed between the talus and heel bones on the outside of the foot and ankle.

When pain and inflammation develop in this space, it creates sinus tarsi syndrome.

It seems to be that the true cause of this condition might be related to subtalar joint instability. The subtalar joint is formed by the joining of the talus and calcaneus, or heel, bones.

Any joint can become unstable if the surrounding ligaments have been injured, like with ligament sprains, and aren’t able to support the joint as they used to. An inversion ankle sprain is a common injury to eventually cause sinus tarsi syndrome.

The sprain doesn’t have to only happen around the subtalar joint. The ankle itself could have had one or more sprains, and eventually created a problem at the subtalar joint.

Other possible causes may include repetitive stress, like with walking and running, or having an over-pronated or flat foot.

Whatever the case may be, these triggers will cause compression and pain in the area of the sinus tarsi.

SYMPTOMS:

  • Pain on the outside of the foot and ankle
  • Foot and ankle instability, especially at the hindfoot
  • Tenderness
  • Increased pain with walking on uneven surfaces, jumping or running
  • Increased pain with ankle plantarflexion and inversion range of motion
  • Possible swelling

3. Outer Foot or Ankle Sprain

sprained ankle

An outer or lateral ankle sprain is also known as an inversion ankle sprain. This is one of the most common ankle injuries due to over-supination of the foot and ankle.

An inversion ankle sprain can affect any of the ligaments on the outside of the foot and ankle.

When a sprain occurs, the ligaments are overstretched or can be torn if it’s a severe sprain. When overstretched, they won’t be able to support your outer foot and ankle as they normally would, causing instability and pain.

Weak outer feet and ankles or having a naturally high arched foot can increase your chances of getting an outer foot or ankle sprain.

SYMPTOMS:

  • Outer foot and ankle pain
  • Pain worsens with standing and walking
  • Feeling that the outer ankle is unstable or may try to outwardly roll
  • Outer foot and ankle swelling and warmth
  • Outer foot and ankle tenderness

4. Cuboid Syndrome

The cuboid bone is the outermost tarsal bone.Cuboid syndrome occurs when the cuboid bone regularly subluxes, or moves in and out of its normal alignment.

Athletes, especially dancers, will commonly experience cuboid syndrome.

It also can happen due to foot abnormalities like flat feet, poor fitting shoes, being overweight, sudden increase in your exercise routine intensity, a current or previous outer sprained foot or ankle, and regularly moving on uneven surfaces.

cuboid syndrome

SYMPTOMS:

  • Outer midfoot foot pain over the cuboid bone
  • Increased pain with weight bearing
  • Pain may be a gradual dull ache or a sudden, sharp pain
  • Swelling on the outside of the foot
  • Decreased foot and ankle range of motion
  • Increased pain with walking, running or jumping
  • Pain may radiate further down the foot or up into the outer ankle
  • Sitting may relieve pain

5. Outer Foot Muscle Strain

muscle strain

A muscle strain involves an overstretching or tear in a tendon. When it comes to an outer foot muscle strain, the peroneal muscles are commonly involved.

A muscle strain is usually considered more severe compared to a tendonitis. The cause of the strain can be similar to that of tendonitis, but more intense.

An outer foot muscle strain may occur from repetitive stress over time, or it could be from a one-time injury.

SYMPTOMS:

  • Pain in the outer foot or ankle
  • Pain may also be in the affected muscle on the outside of the lower leg
  • Pain worsens with activity
  • Outer foot and ankle swelling and tenderness
  • Possible outer foot and ankle bruising
  • Decreased ankle range of motion
  • Decreased ankle strength

D. Inner Foot Pain

1. Inner Foot or Ankle Sprain

foot sprain

Just like the outer foot and ankle, the inner foot and ankle ligaments can experience a sprain.

Remember, a sprain is an overstretching or tearing of the ligaments due to some type of stressful force or trauma.

Inner foot and ankle sprains usually occur from inward rolling of the ankle into too much ankle eversion. This positions the foot and ankle into an over-pronated position.

You could also sprain the inner foot and ankle from jumping and landing the wrong way or running, especially on uneven surfaces.

Those with naturally flat feet are prone to everted foot and ankle sprains.

SYMPTOMS:

  • Inside foot and ankle pain
  • Inner foot and ankle swelling and warmth
  • Inner foot and ankle stiffness
  • Tenderness over the sprained inner ligament
  • Difficulty weight bearing
  • Increased pain with standing and walking

2. Posterior Tibialis Tendonitis

The posterior tibialis muscle is a calf muscle. Its tendon passes through the tarsal tunnel on the inside of the foot and ankle.

This muscle is responsible for ankle plantarflexion, inversion and helping to support the arch of the foot.

Overuse of this muscle, like with too much walking, will lead to posterior tibialis tendonitis.

SYMPTOMS:

  • Pain on the inside of the foot and ankle
  • Frequent inward rolling of the ankle
  • Pain with walking or climbing stairs
  • Pain when rising up on the toes
  • The inside of the sole of your shoe is more worn than the outside of it
tibalis posterior

3. Tarsal Tunnel Syndrome

tarsal syndrome

The tarsal tunnel is located on the inside of the ankle. This tunnel is shaped by surrounding bones and ligaments.

Important structures pass through here, including posterior tibial nerve.

When the posterior tibial nerve becomes compressed within the tarsal tunnel, tarsal tunnel syndrome develops.

Possible causes of this nerve compression may involve pressure on the tunnel from flat feet, swelling from an inner foot and ankle sprain, inner foot and ankle tendonitis, bone spurs, etc.

SYMPTOMS:

  • Inner foot, including on the medial plantar surface of the foot
  • Numbness and/or tingling on the inside of the foot
  • Increased sensitivity on the inside of the foot
  • Increased pain with excessive ankle dorsiflexion and eversion
  • Pain behind the inner ankle bone, or medial malleolus
  • Burning sensation

4. Inner Foot Muscle Strain

foot strain

Any of the inner foot muscles and tendons can experience a muscle strain. Remember from what we mentioned before that a muscle strain is an overstretching or tearing of a muscle’s tendon.

An example of an inner foot muscle strain would be from the posterior tibialis.

Similar to sprains, inner foot muscle strains can occur from repetitive stress or a single traumatic event. That single trauma may, in fact, be an inner foot and ankle sprain!

Regardless of the cause, intense pain can develop.

SYMPTOMS:

  • Inner foot pain
  • Inner foot tenderness and swelling
  • Possible bruising
  • Pain with increased walking, running or jumping
  • Foot and ankle stiffness

E. General Foot Pain

Sometimes pain may not be in one specific location, or the symptoms are too general to place in one location category.

1. Arthritis

Arthritis can occur in any joint in the body, including the foot.

Arthritis may be osteoarthritis, which occurs from natural wear and tear in the joint surface.

Arthritis could also be related to an inflammatory condition, such as with rheumatoid arthritis.

No matter which type of arthritis is affecting the foot, the symptoms can be pretty common and similar.

Arthritis foot

SYMPTOMS:

  • Aching pain in the foot
  • Foot stiffness
  • Pain and stiffness are worse in the morning and when getting up after having been inactive for a while
  • Decreased foot and ankle range of motion
  • Increased pain with standing and walking
  • Pain improves with rest

2. Gout

gout foot

Gout is actually a form of inflammatory arthritis, but because of its common occurrence in the big toe joint, it’s worth mentioning more specifically.

While gout symptoms can occur in more than one joint in the body, as mentioned, it most often develops in the big toe joint.

Gout is formed from a build-up of uric acid crystals in the joint.

Gout symptoms tend to come and go, but when they’re around, they can create very strong and intense toe pain.

SYMPTOMS:

  • Sudden, intense big toe pain
  • Flares of pain may suddenly start in the middle of the night
  • Swollen, warm, stiff joint
  • Decreased joint range of motion
  • Increased pain with walking

3. Fracture

While we did talk about a navicular fracture specifically, realistically, a fracture can happen in any bone of the foot.

Repetitive stress over time may lead to the development of a stress fracture.

There may be a one-time incident that causes a fracture, such as from twisting the foot and ankle, falling, or jumping and landing the wrong way.

Your pain location will very much depend on which bone has been broken, but it’s usually more of an intense pain.

fracture

SYMPTOMS:

  • Difficulty or unable to weight bear
  • Increased pain with standing and walking
  • Tenderness over the area of the fracture
  • Swelling and bruising
  • Decreased foot and ankle range of motion
  • Foot weakness

While using this foot pain location chart can be helpful for pinpointing your foot pain, if you’re having ongoing foot pain, it’s important to see a foot and ankle specialist.

Don’t let your pain continue! As you can see, there are A LOT of foot problems that can cause foot pain.

Get the help you need and start working on the road to recovery!

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