You recently went to your favorite cocktail spot and decided to rock your new heels. But now, what you thought was just some morning-after foot pain isn’t going away. Uh-oh, time to go to the podiatrist. From heel pain to tingling toes, there are some types of foot pain you shouldn’t ignore. Find out more below.
1. Heel pain
“There are a lot of different causes for heel pain, which is why it shouldn’t be ignored. It’s important to find out the ideology so that it can be treated appropriately,” says Dr. Chanel Perkins, DPM aka Fab Foot Doc. “The most common type of heel pain I see is plantar fasciitis—it’s essentially a type of overuse injury where plantar fascia ligament on the bottom of the foot is inflamed.”
Causes for plantar fasciitis vary—which is why if you feel pain in your sole or stabbing pain in the heel, you should go get it checked out by a professional. If you have been taking it easy during the pandemic and suddenly decide to get back to your high-impact workout routine, this can easily trigger plantar fasciitis. It can also happen if you stand for long periods of time at work.
Another common cause of plantar fasciitis? New floors. “I see a lot of patients who had to replace their carpeted floors with tiled, wood or laminate floors due to hurricanes,” explains the Houston-based doc. “They come to me after about two months complaining about heel pain because they go from having carpet—which has a lot of shock absorption—to walking or standing on hardwood floors.”
Plantar fasciitis is generally treated with stretching (check out this easy tutorial) and arch supports. Avoiding weight gain will also help prevent this condition from occurring.
2. Achilles tendinitis
If you were a high school or college athlete, then you’re probably familiar with the fragility of the Achilles tendon. But you don’t need to be a super jock to have an Achilles affliction. Achilles tendinitis is another type of heel pain, which originates at the back of the heel and not underneath, like plantar fasciitis.
“Remember, the feet are biomechanical, which means what happens in one part may affect another,” says Dr. Perkins. “So if the plantar fasciitis has gone on for so long, sometimes you can get Achilles tendinitis.”
“You’ll notice that your foot is going to want to be in a downward flex position, meaning you’ll feel relieved when you’re wearing a shoe that has some sort of a heel, like a wedge (or something like a cowboy boot for men).” However, as comfortable as your espadrilles may feel, wearing them when you have Achilles tendinitis will only add to the pain.
“If that foot is flexed in that position for too long, it’ll only add to the problem because the tendon will contract and shorten. So when you go take the shoe off, you put a lot of stress and strain on Achilles because it would prefer to be shortened and the inflammation becomes more intense.”
Achilles tendinitis can also be treated with similar stretches as plantar fasciitis. Heel lifts—when worn per doctor's orders—can help take the stress and strain off the Achilles’ tendon so that it may heal.
3. Stress fracture
Also known as an insufficiency fracture, a stress fracture can happen gradually, or as the result of a high impact activity after you’ve been inactive for a while. According to Sports Health, this type of foot pain is characterized by sharp, localized pain, tenderness and swelling, among other symptoms.
“This one can be sneaky because patients oftentimes don’t even know that they have a stress fracture,” says Dr. Perkins. “A lot of times I’ll examine a patient and who can’t even relate it to any traumatic event—they didn’t hit their foot or drop anything on it—but they have pain. The problem with stress fractures is that the pain will present before it shows up on the X-ray. If a patient comes in right at the onset, the X-ray may look totally normal. We’ll usually give them a protective boot, stiff sole shoe or advise them to limit activity level, then follow up in two to three weeks, which is when the stress fracture typically shows up.”
4. Peripheral neuropathy
Another tricky yet serious type of foot pain, peripheral neuropathy is usually a result of nerve damage. “Peripheral neuropathy has a gradual onset and is often ignored because it comes and goes,” explains Dr. Perkins. “Usually there’s tingling, burning, numbness and the foot might feel like it’s falling asleep in one area.”
Unlike Achilles tendinitis and plantar fasciitis, which have definitive causes, neuropathy is a bit more ambiguous. “There are so many reasons why a patient may have neuropathy—from injury of the nerve to alcoholism and even vitamin deficiencies,” says Dr. Perkins. “It gets progressive and it’s irreversible, that’s why it shouldn’t be ignored. It can start as a little tingle in your big toe, then a year later it’s all five toes or it’s gone up the foot.”
Treatment for peripheral neuropathy can also be tricky as doctors first need to get to the root cause of the neuropathy. "Identifying the source will allow for proper treatment," states Perkins. "For example, if the peripheral neuropathy is caused by uncontrolled diabetes, then treatments aimed at lowering blood sugar levels would directly impact the symptoms of neuropathy."
5. Morton’s neuroma
“This happens when the tissues that surround the nerve start to enlarge and swell,” Dr. Perkins says. “Patients tend to feel it on the ball of their foot, in one spot. It may feel like they’re stepping on a marble or pebble.”
While a patient who has a neuroma can have the same symptoms as someone who is suffering from peripheral neuropathy, the two conditions also have some stark differences. For one, neuromas show up on MRIs, while peripheral neuropathy diagnoses are mostly clinical because they’re caused by nerve damage. “Because of the swelling, we can identify neuromas because we can visualize not only where it is, but how large it is in the foot,” Dr. Perkins explains.
Treatment for this condition is also direct. "Morton’s neuroma can be treated by changing the biomechanics of the foot with special padding and inserts that redistribute pressure from the area of the neuroma," says Dr. Perkins. "Sometimes topical or oral anti-inflammatory medications, corticosteroid injections or surgical removal of the neuroma are also offered as treatment."
2 Tips to Avoid Foot Pain
1. Don’t forget to stretch.
You make sure to stretch your arms, your back and your neck before you work out. And while you’re stretching your legs, Dr. Perkins suggests stretching and warming up your feet.
“The single most effective way to not only prevent, but also alleviate these issues is to stretch. Most people think walking is benign, but it can be very detrimental. It’s not as impactful as running, but it’s still impactful to the foot,” she says. “The internet is filled with tons of plantar fasciitis and Achilles tendinitis exercises and the best thing about those is that you can do one stretch and knock out both areas because of the way they insert on one heel bone.”
2. Wear appropriate shoes.
We all want to be Beyonce, but let’s reserve the high heels for date night, not Zumba class. And even if you’re not going to those extremes, you want to make sure that the shoes you wear to do simple activities such as walking are supportive. (Sorry, flip-flop fans.)
“The problem is a lot of the surfaces that we walk on—concrete, asphalt—are manmade and all of them are hard surfaces with zero shock absorption,” explains Dr. Perkins. “That’s the basis of the majority of our foot conditions, because our feet our mobile adaptors. Before industrialization, we were walking on gravel and grass and our feet were meant to adapt to those types of surfaces, which are more forgiving.”