Overview

The foot is a complex and hard-working structure which can be susceptible to overload type problems involving joints, ligaments, tendons and nerves.

Sprains to the ankle or foot can be common causes for pain and usually get better reasonably quickly despite severe pain initially. Footwear and natural foot position can also influence ankle and foot problems.

There are a number of other reasons for foot and ankle pain which might need slightly different management, although understanding what is causing your pain and how you can quickly help your foot or ankle problem yourself is always the best place to start.

Find out more about your foot or ankle pain in the other sections for further help.

Types of foot and ankle pain

Plantar fasciitis or plantar heel syndrome can be due to degeneration and/or inflammation at the heel, where tendons and fascia which attach under the heel bone can cause pain.
Plantar fasciitis commonly affects people aged 40 to 50 with active occupations or who spend long hours standing and walking.
Research has shown that plantar fasciitis is often caused by the shortening of the Achilles tendon and tight calf muscles. Simple exercises can help to lengthen and strengthen the plantar fascia and surrounding areas.
Try these exercises today to get better quicker.
Losing weight and wearing heel cushions to provide cushioning in your footwear may ease symptoms. Shockwave therapy and steroid injections can help but they are not recommended as a first line of treatment. For more information, Visit our Plantar Fasciitis information leaflet.
This condition may also be called Achilles tendonitis; however, Achilles tendonitis is an older term and strictly means that there is inflammation, which may not necessarily be the case.
Achilles tendinopathy can cause pain, thickening and stiffness of the Achilles tendon at the back of the ankle.
It often occurs as an over-use injury in people who take part in excessive exercise or exercise they are not used to. It can also affect people who have certain type of inflammatory arthritis.
Symptoms of Achilles tendinopathy often get worse when standing and walking. The pain can start slowly and increase in intensity over time. It may be so severe that you have difficulty walking or getting up from sitting. It usually affects one heel, but can affect both where the affected heels can be stiff, mainly after periods of rest.
Although it can take months to get better, there are some simple exercises that can be carried out several times a day to help get better quicker and reduce the chance of the problem coming back.
For more information including specific exercises, click on our Achilles Tendinopathy information leaflet.
Osteoarthritis can affect any joint in the foot. Osteoarthritis is a degenerative and sometimes inflammatory problem that can cause episodic pain and swelling in a joint or joints and can also cause bone enlargement.
As we get older, osteoarthritis can be linked to changes in the shape of feet, which may cause pain.
Osteoarthritis often affects the big toe joint. The joint will become stiffer and the range of movement will be reduced.
Often the bones become larger and knobbly due to an overgrowth of new bone. These changes may go together with a bunion -a lump on the side of the big toe joint.
Research suggests that osteoarthritis is more common in the arch area of the foot. Osteoarthritis can also develop in the ankle, but this is usually following a previous injury or due to long-standing inflammatory arthritis.
An ankle sprain is an injury to the tough bands of tissue (ligaments) that surround and connect the bones of the lower leg to the foot.
The injury typically happens when you accidentally twist or turn your ankle in an awkward way. This can overstretch the ligaments that hold your ankle bones and joints together. When ligaments surrounding the ankle are pushed past these boundaries, it causes a sprain.
Sprained ankles most commonly involve injuries to the ligaments on the outside of the ankle. It can take several weeks or months for a sprained ankle to heal completely depending on the severity of the sprain.
Swelling and bruising can often occur as a result of these injuries. You may also feel pain or discomfort when you place weight on the affected area.
Most ankle sprains can be treated yourselfClick here for advice on what to do in the early stages to help your pain, swelling and overall recovery  and when to seek further support.

Feet with lower arches (Pes planus) tend to be more flexible. It is not necessarily a problem but could increase your chances of developing other foot problems.

If your feet are painful and flat, there may be some footwear advice and exercises that you could try to help to strengthen the foot and assist with the discomfort.

Losing weight can help ease symptoms because it reduces the stress on joints. Swimming is a good form of exercise if you find weight-bearing exercise difficult.

Some people find orthotics or arch supports in their shoes can help to support the feet more and alleviate pain or tiredness. You can find very affordable and good quality foot orthotics online so there’s no need to have them costume-made usually.

The tibialis posterior tendon serves as one of the major supporting structures of the foot, helping it to function while walking. Tibialis posterior dysfunction or posterior tibial tendon dysfunction is a condition caused by changes in the tendon, affecting its ability to support the arch. This can result in flattening of the foot.

Tibialis posterior dysfunction is often called adult acquired flatfoot because it is the most common type of flatfoot developed during adulthood. Although this condition typically occurs in only one foot, some people may develop it in both feet. It is usually progressive, which means it will often get worse, especially if it is not treated early.

Overuse of the tibialis posterior tendon is often the cause of the dysfunction and pain. Commonly the symptoms occur after activities that involve the tendon, such as running, walking, hiking or climbing stairs.

Physiotherapy can help by providing footwear advice, activity modification and specific strengthening and stretching exercises.

Having higher arches (pes cavus) may increase your chances of developing other problems such as bunions, hammer toes, calluses or corns.
Hammer toes (also known as claw toes, mallet toes or retracted toes) are toes that are permanently bent. Hammer toes occur because of problems with the tendons inside the foot or because toes are squashed by poorly fitting shoes and/or socks.
Pain from hammer toes is usually due to a build-up of hard skin over the bent joints, resulting in calluses and corns. Pain from calluses and corns may be relieved by opting for footwear with more generous fit or softer uppers, or by using a protective pad over the painful area.
The only permanent way to correct hammer toes is with surgery.
Bunions are bony lumps that develop on the inner side of the foot at the base of the big toe.
Sometimes as the bunion develops, thebig toe may be pushed over towards the smaller toes. The big toe joint can become stiff and painful.
Sometimes this happens without the bony lump – This is called hallux rigidus. This can cause the other toes to become squashed and clawed or permanently bent – known as hammer toes.
Symptoms of a bunion can be controlled by choosing footwear with a soft, wide upper to reduce pressure and rubbing on the joint. Insoles (orthotics) can help control the foot function to relieve pressure on a painful joint.
Bunion pads are available from chemists if you have a flare-up of a bunion pain.
If your symptoms persist over a long period and you have tried all of the above then the bunion may need to be surgically removed. Click here to find out more about how to access Podiatric Day Surgery if necessary.
A neuroma or Morton’s Neuroma is the thickening of a nerve that occurs when it rubs against other internal tissues. It is most common at the base of the toes, often between the third and fourth toes. The common symptoms are sudden pain and/or tingling in the toes.
A neuroma should settle down with more spacious footwear but special insoles or pads under the area may help. These may be provided by a podiatrist or orthotist.
A local steroid injection may be recommended and, if symptoms are severe, the thickened nerve may have to be surgically removed.

Is my foot or ankle pain likely to persist?

Take our one minute test

This quick questionnaire can help you identify how likely your pain is to persist over the next 6 months and whether you may need some extra support. It has been developed by a team of experts from Keele University – Click here for more information about the tool.

The tool has been shown to be very useful for people with common Musculoskeletal pain to profile individual risk of having a poor recovery and to use as a guide in conjunction with support from a healthcare professional if necessary.

Try out the questionnaire for yourself to see how you score and to get further help and advice. It will also be useful to retake the questionnaire after you have learned more key facts about your pain, either from this website or from a healthcare professional, to re-assess in time whether your foot and ankle pain problem is improving.

For question 1 – 9, think about just the last two weeks:
Pain intensity
1. On average, how intense was your pain? [where 0 is “no pain”, 10 is “pain as bad as it could be”]











Select one of the options for each question below Yes No
2. Do you often feel unsure about how to manage your pain condition?
3. Over the last 2 weeks, have you been bothered a lot by your pain?
4. Have you only been able to walk short distances because of your pain?
5. Have you had troublesome joint or muscle pain in more than one part of your body?
6. Do you think your condition will last a long time?
7. Do you have other important health problems?
8. Has a pain made you feel down or depressed in the last two weeks?
9. Do you feel it is unsafe for a person with a condition like yours to be physically active?
10. Have you had your current pain problem for 6 months or more?

 

High Risk

This test suggests you have some serious concerns about how well your foot or ankle will recover.

This may be related to feeling low and anxious generally or by being afraid that you might have done something serious to your foot or ankle.

It might help to discuss your concerns with a doctor or physiotherapist if things are still not improving over the next few weeks after following the advice and exercise in the  Self Help section.

Also, visit the section on Persistent Pain for more information and support.

Most foot and ankle problems are not related to a serious condition.  Allowing yourself to move normally, without too much worry, will help your foot or ankle to return to normal. Painkillers often help you to move normally, while your foot or ankle recovers.

If you are feeling low or anxious, whether this I related to your foot or ankle pain or not, and you would like further help and support, visit NHS website – Health in Mind.

Medium Risk

This test suggests you may have some doubts about how well your foot or ankle will recover.

This may be related to feeling low and anxious generally or by being afraid that you might have done something serious to your foot or ankle.

It might help to discuss your concerns with a doctor or physiotherapist if things are still not improving over the next few weeks after following the advice and exercise in the Self Help section.

Most foot and ankle problems are not related to a serious condition.  Allowing yourself to move normally, without too much worry, will help your foot or ankle to return to normal. Painkillers can help you to move normally, while your foot or ankle recovers.

You might also want to access the Essex Lifestyle Service for further support and help on making healthy lifestyle choices and live healthier lives as this could be contributing to.

Low Risk

Congratulations!  You most likely have the right ideas about your foot or ankle pain, and feel in control of how you manage your recovery.

We all know an episode of foot or ankle pain is very annoying, and at times extremely painful.   Carrying on as normal and continuing to move your foot or ankle allows the quickest recovery, and stops your foot or ankle stiffening up and losing strength.

Keep going as you are, although check out this link for more information and advice to get better even quicker!

You might also want to access the Essex Lifestyle Service for further support and help on making healthy lifestyle choices and live healthier lives as this could be contributing to your foot or ankle pain.

Please select all options.

Self help

Evidence has shown that people who understand their Musculoskeletal health problem and take an active involvement to help themselves have a much better outcome.

Here are some really helpful leaflets, exercises and useful links to other websites that have been approved by our physiotherapists so that you can start getting better with your foot or ankle pain today!

leaflets

Achilles Tendinopathy
Plantar Fasciitis
Source: Versus Arthritis
Source: Chartered Society Of Physiotherapy

Exercises

Source: Versus Arthritis

Useful Links

Further Support

If your foot or ankle pain is still not improving despite following the advice and guidance provided on the website for up to 6 weeks and you score a ‘Medium’ or ‘High Risk’ when completing the Is my ankle or foot likely to persist?, you may require further help and support from the Physiotherapy Outpatients Service. Please see your GP if you wish to be referred or discuss the management of your foot or ankle problem further.

Contact NHS 111 or seek urgent medical care if you think you may have broken your foot or ankle. Click for further guidance.

FAQs

Normally, flat feet disappear by the age of six as the feet become less flexible and the arches develop. Only about 1 or 2 out of every 10 children will continue to have flat feet into adulthood.
For children who do not develop an arch, treatment is not recommended unless the foot is stiff or painful. Shoe inserts won’t help your child develop an arch, and may cause more problems than the flat feet themselves.
However, certain types of flat feet may need to be treated differently. For example, a child may have tightness of the Achilles tendon or calf muscle that can limit the motion of their ankle. This tightness can result in a flat foot, but it usually can be treated with special stretching exercises to lengthen the muscle and tendon.
Rarely, a child will have truly rigid flat feet, a condition that can cause problems. These children have difficulty moving the foot up and down or side to side at the ankle. The rigid foot can cause pain and, if left untreated, can lead to arthritis. This rigid type of flat foot is seldom seen in an infant or very young child. More often, rigid flat feet develop during the teenage years should be evaluated by your child’s GP, a podiatrist or physiotherapist.
Symptoms that should be checked by a medical professional include foot pain, sores or pressure areas on the inner side of the foot, a stiff foot, limited side-to-side foot motion, or limited up-and-down ankle motion.
Click here for more information on flat feet in children for parents and carers.
 
Achilles pain is very common especially in people aged between 40 – 60 years old.
Initially, ensure that you are wearing the most comfortable and suitable footwear for the activities you are undertaking.
Stretching of the calf muscle can alleviate tightness and doing this throughout the day can help reduce muscular pain in the calf.
Strengthening exercises to load the tendon are the recommended conservative management modality for Achilles pain so practising pushing up onto your tip toes and down is a good exercise to start with.
For further advice please see the Self Help section above. See Achilles Tendinopathy, for information and exercises that you can try for Achilles pain.
Yes! Plantar fasciitis is a common foot complaint where you may have heel pain that can extend into the arch of the foot. It is often most painful when you first get out of bed in the morning or when you get up from a chair after sitting.
Treatment normally consists of calf stretching exercises, massage into the base of the foot, footwear modification and gel or soft heel cushions that can be inserted into shoes.
Wearing well cushioned footwear indoors and avoiding walking in bare feet can also help.
Please read the section on Plantar Fasciitis and check out the links for information and exercises that can help.
Yes, osteoarthritis can affect any joint in the foot.
It is a degenerative, inflammatory problem that can cause episodic pain and swelling in a joint or joints and can sometimes cause bone enlargement.
As we get older, osteoarthritis can be linked to changes in the shape of feet, which may cause pain. It is more common in people 40 years old and above, if you are overweight or obese, if you have had a previous foot or ankle injury or previous surgery in that area. It can also be genetic.
If you have pain associated with osteoarthritis in the feet the treatment and management is often around footwear advice, activity modification, strengthening any weak muscles and stretching any tight muscles.
Please see Self Help section for further information and exercises to try.
Bunions are very common and are not always a cause of pain.
They are bony lumps that develop on the inside of the foot at the base of the big toe and may affect one or both feet. Sometimes as the bunions develop, the big toes may be pushed over towards the smaller toes.
If there is pain at the base of the big toe then the advice is often around modifying your footwear for comfort, pacing your activities and ensuring there is no rubbing or skin irritation.
Please see the Bunion section for further information.