Walking is a commonly recommended activity — it's low-impact and can provide relief from arthritis and back pain. Walking also has proven benefits for your heart and mental health.
But walking is not without its risks. The American Podiatric Medical Association reports that more adults in the United States experience pain and problems with their feet than with their skin, teeth or heart.
The foot pain that many walkers feel often has nothing to do with an acute injury. It's typically caused by a condition that developed over time due to overuse or improper footwear.
To figure out what's causing your pain, start with where it hurts. The affected area of your foot may indicate possible underlying issues — or at least help you narrow it down.
Achilles pain
Your Achilles tendon is the band of strong, flexible tissue connecting your calf to your heel. Any time you move your foot — especially when walking — your Achilles tendon gets activated. If the tendon becomes swollen and painful — particularly in the morning and when walking — it's often a sign of Achilles tendinitis, an inflammation of the tendon.
Overuse is the most common cause of Achilles tendinitis. Walkers are more likely to develop tendinitis in connection with:
- Age-related arthritis
- Sudden increase in walking amount or intensity
- Tight calf muscles
- Unsupportive footwear
- Walking on concrete
A health care provider can examine the area and recommend imaging if they suspect a torn tendon. Achilles tendinitis rarely requires surgery, but it can take at least two to three months for the pain to go away.
During that time, regular icing and nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen or acetaminophen can help reduce the swelling. Follow your provider's recommendations for footwear changes — using a boot or heel lifts can take pressure off the Achilles tendon while it heals.
Ball-of-foot pain
The ball of your foot — the area on the bottom of your foot just below your big toe — contains:
- Bones
- Ligaments
- Muscles
- Nerves
- Tendons
It plays a critical role in helping you push off when walking. The ball of your foot takes a lot of stress, which can worsen with weight gain, overuse or shoes without enough cushion.
If you feel sharp pain in the ball of your foot, especially when you place pressure on it, the conditions that could be to blame include:
- Metatarsalgia: Inflammation in the ball of your foot can cause aching, sharp pain or the feeling of having a pebble in your shoe.
- Morton's neuroma: Thickened tissue surrounding a nerve in the ball of your foot can cause sharp pain and the pebble-in-your-shoe sensation.
A foot specialist (podiatrist) can pinpoint the exact cause of your pain and offer guidance for at-home remedies and new footwear, which usually resolve the symptoms. For ongoing or severe pain, your physician may recommend physical therapy, a cortisone shot (to reduce inflammation) or, in rare cases, surgery.
Heel pain
Heel pain can be associated with Achilles tendinitis. But it can also be a sign of another condition, such as:
- Flat feet: People born with feet that press flat on the ground — without an arch — can experience heel pain that worsens with activity.
- Heel pad atrophy: The protective pad of your heel can atrophy (shrink). As a result, your heel bone may hit the ground, causing pain and callus formation.
- Heel spurs: A heel spur is an abnormal bone growth that can cause pain and swelling.
- Plantar fasciitis: When the thick band of tissue on the bottom of your foot (fascia) becomes overstretched or overused, it can cause pain and stiffness in the bottom of your heel.
- Thick calluses: Areas of friction — such as your heel — can form thick layers of skin that become painful when they build up.
A podiatrist can evaluate your pain to identify the underlying issue. An X-ray helps to diagnose a heel spur. Supportive shoes and wearing condition-specific orthotic inserts can help alleviate heel pain for most conditions.
Side-of-foot pain
Pain on the side of your foot is often caused by tendinitis — inflammation of the tendons that wrap and support your foot. The location of the pain can indicate which tendon is inflamed:
- Inside of your foot: There are two tendons that support the inside of your ankle and wrap under your foot. A strained anterior tibial tendon — which controls the front of your foot — will be painful when going down stairs or walking on hills. Tendinitis of the posterior tibial tendon will be painful when your heel shifts side to side.
- Outside of your foot: Tendonitis in the peroneal tendons that run along the outside of your ankle can cause pain when pushing off or walking on uneven surfaces.
Toe pain
Your toes provide strength and help you balance when you walk. However, toe pain can often be a symptom of an underlying condition completely unrelated to walking, such as:
- Arthritis: Osteoarthritis, gout and rheumatoid arthritis can all affect the big toe, causing intense pain, swelling and redness.
- Structural issues: Bunions (bony bumps that form at the base of the big toe) and hammertoes (toes permanently bent at the joint) can cause misalignment and lead to pain.
- Toe sprain: A sprain of your big toe (called turf toe) can cause swelling and pain that worsens when you push off with your toe.
Each of these underlying conditions is treated differently. Discuss the best course of treatment with your primary care physician or podiatrist.
