Bottom Of the Foot Pain: Causes & Best Treatment 2019

Bottom Of the Foot Pain: The most common causes are heel pain, arch pain and ball of the foot pain. Find out what causes each type.



Why Do I Have Bottom of the Foot Pain?


Being on your feet all day has many pros and cons, it makes you stay healthy and it makes your body feel much better, but the more we walk can make us hurt our feet. This is especially true at the bottom of our feet.


Your feet can sometimes support 3x your body weight to each foot while walking and running, this can be over 1,000 lbs per foot for some of our patients!

back of the heel pain from achilles tendonitis
The bottom of the foot and heel pain is usually the plantar fascia. But look at all the structures down there! It could be the bone or soft tissue.


As a result, your feet are highly susceptible to injury and can be very sore at the end of the day and at night.


This is especially common to wake up in the morning and suddenly feel pain and soreness in your feet.


Why do your feet hurt so much when you first get up in the morning, why do they ache when you’re resting on the couch and in bed, there is many things you can do to fix your foot pain!



Back of the heel spur and bottom of the heel spur
This patient had both Achilles tendinitis and plantar fasciitis at the same time, for many years. You can see that there is the beginnings of an Achilles tendon heel spur in the plantar fascia heel spur at the bottom of the foot.

What causes bottom of the foot pain?


The most common causes of bottom of the foot pain are related due to overuse injury. These are usually not broken bones nor nerve conditions. although when you read other websites this is most likely what you see. This is meant to be a very practical guide where we address the most common 95% causes, not the 5% most dangerous causes.



plantar fascia pain with heel spur

The most common causes of bottom of the foot pain in order likely are:


Plantar Fascitis:


Plantar fasciitis is the single most common cause of foot pain. But what does this really mean? This is a very confusing disease because it is explained so many different ways and there’s so much misconception. The information is all out there, but yet we still see hundreds and hundreds of people every single month for this type of foot pain at our office.


The plantar fascia is a thick band of tissue that runs across the bottom of your foot connecting your heel to the area over your toes.


Stone Bruise Recovery Time Healing Time
The stone bruise on the heel can take about 5 to 7 days for the initial bruising to go away.
If you really bruise the bone underneath, it can take even up to 6 to 8 weeks. You will feel a lot better quicker if you wear good orthotics and good shoe.


People with plantar fasciitis experience pain across the bottom of their foot usually in the mornings and after strenuous exercises like going for a jog. You might even have heel pain while simply pushing at the bottom of your heel while sitting in place with your thumb.


The real key to plantar fasciitis is to decrease the swelling and inflammation. It does not make sense to start stretching exercising and beating up on an already damaged muscle.

Heel fat pad cushion atrophy and heel spur formation
This is an example of heel fat pad atrophy. There is a lack of cushion on the bottom of the heel and this spur is pushing against the ground. This can cause a large amount of heel pain while walking!


You have to think about this like a broken ankle, you wouldn’t exercise or stretch a broken ankle, it does need to rest to a certain degree. Just applying a cream or taking a medication will not make it better in one day, it can take weeks!


There is physical damage to this band of tissue, it does need time to heal and you need to do all the right types of stuff to keep pressure off. The secret is to find out how to keep moving while avoiding this type of pain. Read the end of this guide to see just how to do that.


Plantar Fibroma:

This is when your plantar fasciitis develops a thick hard lump in the middle of the ligament.






The second most common cause of bottom of the foot pain is called metatarsalgia.

This is a very painful condition used to describe pain in the ball of the foot. At the ball of the foot is the area of your toes there were and where your toes meet the front of the foot.

The condition is called metatarsalgia because the long bones in this area are called the metatarsal bones. This type of pain is most common in people with very high arched feet, running and jumping activities, long-standing during the day. These bones and joints can become very swollen.


Metatarsalgia ball of the foot pain
Metatarsalgia or ball of the foot pain is the pain the front of the foot.
This is most common in people who have very tight hamstrings calf muscles are putting much more pressure on the ball the foot. This can lead to neuroma, metatarsal or even stress fracture pain.

Seeing a podiatrist for this condition or coming to see us can definitely result in pressure being taken off of this site.


This is a condition that can frequently be taken care of without any surgery injections or medications, this is where good shoes and good orthotics can come and play. But you probably do want to get an image in terms of an ultrasound or an x-ray in the office to get this evaluated.


Big Toe Joint Pain:



Big toe joint pain can be numerous different conditions. This could be a bunion which is a dislocation of the big toe joint, it could be turf toe which is a sprain of the big toe joint, or it could be arthritis of the big toe joint.


This pain could radiate from your big toe joint down through the bottom of the foot. Try bending your big toe and see what happens is this where the pain is coming from, and your big toe up and down and see if this is what’s causing the bottom of your foot to her.


The big toe holding can deftly cause a nerve reaction through the bottom of your foot that radiates up the bottom of your foot and through your ankle.


Posterior Tibial Tendinitis:


The posterior tibial tendon goes down the inside of your leg towards the center line of your body and attaches to the bottom inside of your foot.


This is the tendon that can sometimes be associated with shin splints. This tendon helps support your foot’s natural arch, this can also cause pain and be associated with plantar fascia pain.


Just like plantar fascia pain, it does not always make sense to start working out and stretching this muscle. Just like you would not stretch or work out a broken ankle, does not make sense to stretch out damaged or tendon. This is where a lot of the advice on the Internet goes wrong.


Insertional Achilles tendonitis heel spur pain
This is the Achilles tendon inserting into the calcaneus. As you get Achilles tendonitis for many years, it gradually rips out of the bone and causes an Achilles tendon heel spur.

A true injury needs time to heal and you need to make sure you are healing correctly. This is another condition where a podiatrist can really come in handy to make sure that you don’t have a pretty significant injury.



Tarsal Tunnel Syndrome:


This is a condition similar to carpal tunnel in the wrist, if your ankle joint is putting pressure on your nerve, then you could have radiating pain at the bottom of your foot. This type of pain can be felt the most at night-time while you are laying in bed.


If you have a sharp shooting pain that goes throughout your ankle joint  and the bottom of your foot while you are sleeping, there’s a good chance that this is tarsal tunnel syndrome.




This is where podiatrist could come in handy and help you diagnosis this vs other conditions.



Home treatment for bottom of the foot pain:


The real key is identifying which one of these disorders you have. There are also many any other disorders that could be causing your bottom of the foot pain.

Calcaneus Bone Spur Bottom of the heel spur
This is a bone spur at the bottom of the heel. This is caused by a condition called plantar fasciitis.
Achilles tendon bone spur is at the back of the heel were the Achilles tendon inserts.

The main thing is, these are likely not surgical diseases, they are not permanent nerve disorders or malignant cancer like diseases, these are 95% of the time biomechanical injuries.


These are biomechanical injuries that need time to get better. There are excellent treatments that can help make all these feel better.




Home treatments to make the bottom of your foot pain feel better:


  • Make the pain feel better. This is where icing comes in handy, and excellent treatment is to freeze a bottle of water in your freezer and roll at the bottom of your foot. At this is where your tight ligaments of the plantar fascia and the posterior tibial tendon insert. By rolling this on the bottom of your foot for approximately 20 minutes and icing the bottom of your foot your plantar fascia will feel significantly better. Do this for 20 minutes on it 20 minutes off.


  • Get yourself a good pair of shoes, by avoiding walking barefoot you will notice that your foot will start to feel better. Where is supportive slipper inside the house and a good supportive shoe and a lot of your foot pain will start to get better.


  • Limiting your time on your feet. A lot of the time people think they can fix their foot problems by spending more time on their feet, this is the single biggest mistake we see people make! You will not fix your foot pain by going on longer walks will contain to walk 4 miles per day. Try switching to swimming and biking in the meantime. People think the best exercise for their feet are by walking or running, these are terrible exercise for your feet!


  • Focus on non-weightbearing exercise like riding a bike, swimming stretching and weightlifting. You can still be in great shape and lose a lot of weight while letting your feet feel better. You are exercising because you want to be in better shape, not to develop an injury that makes you stay off your feet for longer.


  • Get yourself a good pair of orthotics, a podiatrist can help you get a custom pair of orthotics, or you can get an over-the-counter pair of orthotics.
cryosphere for plantar fasciitis pain review
Icing and massaging the bottom of the foot can lead to almost instant pain relief in some people!


Is surgery needed for bottom of the foot pain?


Most the time surgery is not needed for the bottom of foot pain conditions. Most of the time it is a biomechanical condition where you simply have to find out what’s going on let it heal. Don’t get stuck in a rut where you continue living in pain and trying to get back to early and then living in more pain.


It is a tough battle because you do put on weight while you can’t walk or move, but at the same time if you’re not healed your foot pain will never get better.


This is a hard situation but it is one that you have to get through, sometimes a podiatrist can help you with this plan and get you back on your feet. If you do have specific injury, you can get imaging lab work in a diagnosis by a professional.


Only then can you know whether you need surgery or not.



Bottom Of The Heel Pain Links:

Plantar Fasciitis:

  • This is the most common source of heel and arch pain.
  • It is worse in the morning & better with massage.
  • This Includes heel spur treatment.

Foot Fat Pad Atrophy:

  • If it feels like you do not have any fat pad cushion in your heel.

Heel Stress Fracture:

  • This gradually onsets in high activity people starting a new activity.
  • It presents over days and weeks as an aching deep heel pain.

Posterior Tibial Nerve Entrapment:

  • The posterior tibial nerve runs along the back and inside of the ankle.
  • You will feel numbness, burning and tingling.

Bruised Heel:

  • This happens after long running or a big fall.

Stone Bruise:

  • This is a deep contusion after stepping on a stone.

 Bottom Of The Foot Arch Pain:

Plantar Fasciitis:

  • This is the most common source of heel and arch pain.
  • It is worse in the morning & better with massage.

Plantar Fibroma:

  • This is a bump anywhere along your arch. It could be one or multiple.
  • This feels like a pebble under your skin.

Sprained Foot Arch:

  • This can happen when you fall violently.
  • There may be swelling and bruising in the midfoot.

Posterior Tibial Nerve Entrapment:

  • The posterior tibial nerve runs along the back and inside of the ankle.
  • You will feel numbness, burning and tingling.

Plantar Fascia Strain:

  • If you have severe pain in your arch after a fall or injury.

Foot Cramps At Night:

  •  Foot cramps are the most common muscle spasm in our body.


Ball Of The Foot Pain:



 Back Of Heel Pain:

This has 4 very common causes: