Medically reviewed by Dr. Tom Biernacki, DPM · Board-Certified Podiatric Surgeon · Last reviewed: April 2026 · Editorial Policy
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Foot Pain During Pregnancy: Causes, Changes, and Safe Manage relates to foot pain — typically caused by overuse, footwear, or biomechanics. Most patients improve in 6-12 weeks with conservative care. Same-week appointments in Howell + Bloomfield Twp: (810) 206-1402.
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Medically Reviewed by Dr. Tom Biernacki, DPM — Board-Certified Podiatrist, Balance Foot & Ankle Specialists, Michigan. Last updated April 2026.
Foot pain is among the most common musculoskeletal complaints during pregnancy, yet it is frequently dismissed as an inevitable part of gestation. Understanding the specific anatomic changes of pregnancy that affect the foot and ankle allows targeted, safe treatment that can significantly improve quality of life during this important time.
Why Pregnancy Changes the Feet
Pregnancy produces several physiological changes that specifically affect foot mechanics. Relaxin — a hormone produced by the corpus luteum and placenta — softens ligamentous tissue throughout the body to prepare the pelvis for childbirth. This systemic ligamentous laxity also affects foot and ankle ligaments, reducing arch support and increasing subtalar and midfoot mobility. Combined with the progressive weight gain of pregnancy (25–35 lb on average), this laxity allows measurable arch collapse and foot lengthening.
Studies demonstrate that pregnant women develop measurable increases in foot length (0.5–1 cm on average), arch flattening, and increased foot width by the third trimester. Crucially, much of this structural change persists after delivery — particularly after a first pregnancy. Many women require a larger shoe size permanently after their first pregnancy.
Common Foot Conditions During Pregnancy
Plantar Fasciitis
Arch collapse and weight gain increase tension on the plantar fascia, making plantar fasciitis the most common pregnancy-related foot complaint. Morning heel pain, arch aching during prolonged standing, and inner heel tenderness are characteristic. Treatment must be safe for pregnancy: arch-supportive footwear, prefabricated or custom orthotics, plantar fascia stretching, calf stretching, and supportive lace-up shoes provide significant relief. Corticosteroid injections are generally avoided in the first trimester; low-dose corticosteroid at the plantar fascia in the second or third trimester is considered acceptable when conservative measures fail.
Edema and Ankle Swelling
Physiologic ankle and foot edema is nearly universal in the third trimester — reduced venous return from uterine compression of the inferior vena cava, hypoalbuminemia, and increased capillary filtration all contribute. Concerning features requiring medical evaluation: unilateral leg swelling with calf pain (DVT risk is significantly elevated in pregnancy), sudden severe edema after 20 weeks (preeclampsia sign), or edema accompanied by severe headache or visual changes.
Management of physiologic pregnancy edema: elevation, compression socks (15–20 mmHg), avoiding prolonged standing, cool foot baths, and moderate exercise. Diuretics are generally avoided during pregnancy as they can reduce placental perfusion.
Metatarsalgia and Forefoot Pain
Increased body weight combined with forefoot widening concentrates plantar pressure on the metatarsal heads. Metatarsal pads placed proximal to the metatarsal heads significantly reduce forefoot pressure. Morton’s neuroma symptoms can worsen during pregnancy from increased forefoot width and soft tissue edema compressing the interdigital nerve. Wide-toe-box shoes with adequate forefoot room are essential.
Ingrown Toenails
Nail growth accelerates during pregnancy due to increased circulatory demands. Combined with foot widening that increases pressure on nail edges, ingrown toenails are common. Conservative treatment — proper nail trimming, cotton wicking — is first-line. Professional nail avulsion under local anesthesia is safe during pregnancy when conservative measures fail; phenol matrixectomy is deferred until after delivery.
Safe Footwear During Pregnancy
Footwear recommendations during pregnancy: supportive lace-up shoes with heel counters to control arch collapse, low to moderate heel height (1–2 cm is acceptable; flat and very high heels increase arch and Achilles strain respectively), wide toe box to accommodate forefoot widening, non-slip soles (balance changes with advancing pregnancy), and new shoes purchased in the third trimester to accommodate foot size changes.
At Balance Foot & Ankle, Dr. Biernacki evaluates foot pain in pregnant patients at both Bloomfield Hills and Howell offices, providing treatment strategies tailored to be safe during pregnancy. Custom orthotics fabricated during pregnancy should account for expected foot size changes — this is discussed at the time of evaluation. Call (810) 206-1402 for a pregnancy foot care consultation.
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When to See a Podiatrist
If foot or ankle pain has been bothering you for more than a few weeks, home care alone may not be enough. Balance Foot & Ankle offers same-week appointments at our Howell and Bloomfield Hills clinics — no referral needed in most cases. Bring your current shoes and a short list of symptoms and we’ll build you a treatment plan in one visit.
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Pros & Cons of Conservative Care for foot care
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Considerations
- ✗ Self-treatment can mask issues
- ✗ See a podiatrist if pain >2 weeks
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About Your Care Team at Balance Foot & Ankle
Dr. Tom Biernacki, DPM · Board-Certified Foot & Ankle Surgeon. Specializes in conservative-first care, minimally invasive bunion surgery, and complex reconstruction.
Dr. Carl Jay, DPM · Accepting new patients. Specializes in sports medicine, athletic injuries, and routine podiatric care.
Dr. Daria Gutkin, DPM, AACFAS · Accepting new patients. Specializes in surgical reconstruction and pediatric podiatry.
Locations: 4330 E Grand River Ave, Howell, MI 48843 · 43494 Woodward Ave Suite 208, Bloomfield Twp, MI 48302
Hours: Mon–Fri 8:00 AM – 5:00 PM · (810) 206-1402
Dr. Tom Biernacki, DPM is a double board-certified podiatrist and foot & ankle surgeon at Balance Foot & Ankle Specialists in Southeast Michigan. With over a decade of clinical experience, he specializes in heel pain, bunions, diabetic foot care, sports injuries, and minimally invasive surgery. Dr. Biernacki is a member of the APMA and ACFAS, and his patient education content on MichiganFootDoctors.com and YouTube has reached over one million views.
- Plantar Fasciitis: Diagnosis and Conservative Management (PubMed)
- Plantar Fasciitis (APMA)
- Diagnosis and Treatment of Plantar Fasciitis (PubMed / AAFP)
- Heel Pain (APMA)
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