The foot is an important anatomical structure in the human body that carries your entire weight and facilitates your movement. Pain in the foot can make even walking a difficult task. There are various reasons why your bottom of foot hurts when walking. The pain can be due to injuries and strain on your foot or it can be due to an underlying chronic disease. If the pain in your foot interferes with your daily routine, it is recommended that you consult your doctor for the right diagnosis and treatment.

Causes of Pain in the Bottom of Foot

1. Plantar Fasciitis

Plantar fascia is a ligament that connects the heel to the front of your foot. It acts as a support for your foot arch and helps you in walking. Plantar fasciitis is a condition that affects this ligament which leads to pain at bottom of your heel. Plantar fasciitis develops in people who perform activities that places a lot of pressure on their feet. Plantar fasciitis is common in obese individuals, people who have suddenly gained weight such as pregnant women, athletes who run long distances, restaurant workers and factory workers who stand for long periods of time. Your doctor will diagnose plantar fasciitis through a physical exam, X-ray and MRI.

Management

The initial management of plantar fasciitis involves resting and applying ice for 15 – 20 minutes to reduce the swelling and over-the-counter painkillers to reduce the pain. You should initially try avoiding the activities that cause pressure on your foot. If the pain is not relieved than you should see your doctor. You doctor may recommend physical therapy and corticosteroid injections initially. Your doctor may also suggest braces and splints to hold your heel in place to reduce the pain.

2. Bunions

A bunion is a bulging bump that develops at the joint which connects the big toe to your feet. Bunions are present as a birth defect in some people. It is also common in people suffering from arthritis. Bunions are characterized by thickened, inflamed skin with blisters. It is a painful condition and over time the pain can worsen making it difficult to walk. Hence, your bottom of foot hurts when walking with bunions.

Management

• Wear shoes that are larger than your normal size to avoid pressure on your bunion.
• Apply cold and hot compress on the affected area to reduce pain and inflammation.
• Do massage with olive, castor or coconut oil to improve circulation on the affected area to provide symptom relief.
• Use bunion splints and braces. They may not provide immediate relief; however, they are beneficial for long term relief from pain.

3. Foot Stress Fracture

Foot stress fracture occurs due to prolonged pressure on the heels and foot. It is either a small crack in the bone or it can be due to severe bruising of your bone. It is common in athletes and people who run long distances. It also occurs in people who are suddenly trying new activities such as starting a new exercise regime or increasing the intensity of their workouts. Stress fractures on the foot can cause pain when the foot is exerted. Exercising, running and even walking can become painful. The fractured area becomes tender and swollen. The bottom of foot hurts when you have foot stress fracture.

Management

For immediate management of foot stress fracture follow the RICE protocol. Rest your foot, apply ice on the affected area, apply compress using a bandage to control the swelling and elevate your foot above your heart while resting. Foot stress fractures should be diagnosed and treated immediately as they can aggravate over time. They are diagnosed by means of physical exam and x-rays. Your doctor may recommend rest, medications and advise you to wear a cast or a specially designed shoe to avoid stress on your fractured foot. It normally takes 6-8 weeks for your fracture to heal.

4. Osteoarthritis

Osteoarthritis can cause pain in your feet when it affects the joints of your feet. Primary osteoarthritis occurs due to wear and tear in the joints as part of natural aging. It occurs in people above 40 years of age. Secondary osteoarthritis occurs as a result of injury, obesity and abnormal joints at birth. In osteoarthritis there is pain in the joints due to constant use and the pain appears at the end of the day. 

Management

The first line treatment for osteoarthritis is over-the-counter pain medications like NSAIDS and acetaminophen. If they are not effective your doctor may recommend narcotics, corticosteroids and stronger NSAID pain killers. You can also apply heat and cold compress to reduce the pain and swelling. Reduce your weight if you are obese. After consulting a physical therapist perform low impact exercises. You can also use arch support, braces and custom shoes to reduce the strain on your joints.  

5. Diabetic Neuropathy

Diabetic peripheral neuropathy that affects the feet can cause pain in the feet. The bottom of foot hurts when walking if you have diabetic neuropathy. It is a condition that occurs due to prolonged high blood sugar levels in the body which damage the nerves. You may develop numbness, tingling or burning and sudden sharp shooting pain in your feet. You may also develop deformities in your feet like hammer toe.

Management

You can manage diabetic neuropathy by monitoring your blood sugar levels, medications and lifestyle changes. If you notice signs of pain or injury on your feet you should consult your doctor immediately. If you have injuries on your feet it should immediately be treated as it can aggravate and lead to amputations of your toes and feet.

6. Gout

Gout is the condition where in there is accumulation of uric acid crystals in the joints. Accumulation of uric acid crystals in the toe joints leads to pain and swelling in the toes.

Management

Gout is managed by rest, ice compress on the affected area and medications like colchicine, NSAIDS, prednisone, etc. To prevent frequent gout attacks it is recommended that you avoid foods rich in purines like dried beans, anchovies, asparagus, peas, mushrooms, meats from liver and kidney and sea foods.

7. Corns and Calluses

Corns occur due to pressure exerted on the skin by bones of the feet. Calluses are hard, thickened skin on the foot that occurs due to friction on the foot. Corns and calluses are a common cause of pain in the foot.

Management

Corns and calluses can be managed by using medications that can remove the thickened and dead skin. Most medications for removal of corns and calluses contain salicylic acid. You should also take precautions to avoid conditions that lead to pressure on the corns and calluses leading to pain and inflammation.

8. Morton’s Neuroma

This condition results from chronic injury to the nerves in between the toes, leading to thickening of the nerves. Morton’s neuroma causes cramping in the toes, tingling sensation in the toes and sharp, shooting and burning pain in the ball of the foot. Hence, your bottom of foot hurts when walking when you have Morton’s neuroma. 

Management

The condition is treated by supporting the toe area by padding it and taking anti-inflammatory medications and nerve blockers.  In some instances, surgery is recommended to remove the thickened tissues.