Foot & heel pain

Pain in the feet or heels is very common and there are lots of possible causes. Some people are more prone to it than others, for example those who have a problem in their foot structure or are overweight. 

Many conditions that cause foot pain or heel pain can be managed at home, while others may need attention from a GP. If you're unsure whether you should see your GP, you can ask your pharmacist for advice.

There are many different causes of foot and heel pain. Here are some of the most common:


Plantar fasciitis

Plantar fasciitis is the most common cause of heel pain. The main symptom is very severe pain in the first few steps after a period without moving (for example after you've been sitting down). You may also find it difficult to lift your toes off the floor.

Plantar fasciitis is caused by a swelling of the ligament that runs under the heel and along the sole of the foot. The exact cause isn't known, but some factors put you at greater risk, such as:

• Being on your feet a lot

• Changing exercise surface (for example, running on a road rather than grass)

• Having tight Achilles tendons or calf muscles

• Wearing shoes that don't properly support your arch or cushion your feet

• Being overweight or obese


Treating plantar fasciitis

• If possible, reduce the time you spend on your feet

• Do gentle foot-stretching exercises three or four times a day, as long as they don't cause you too much pain. Your GP or pharmacist will be able to advise you on specific exercises that may help you

• Use an ice pack for 20 to 30 minutes every two hours to help reduce ligament swelling

• Wear supportive footwear which cushions the heel

• You can consider a pain-relieving medicine. Ibuprofen targets inflammation, but isn’t suitable for everyone, so ask your pharmacist’s advice

• You can also try heel pads and supports


Stress fractures

Stress fractures occur when bones are put under repeated, high-impact stress (for example, when running). The main symptom is bone pain, which is relieved when you rest but comes back when you start moving again.


Treating stress fractures

• Visit your doctor for a thorough examination of the painful area

• Take a complete break from exercise until your doctor advises it's safe for you to return to it

• Consider a pain-relieving medicine – your pharmacist will be able to advise you on which is most suitable for you

• When your pain has gone, re-introduce activity gradually according to your doctor's advice – don't simply return to your previous schedule


Arthritis

Arthritis is a condition that causes pain and inflammation in the joints. If your foot is stiff, swollen and difficult to move, you may have arthritis. It’s most common in adults over 40, but can occur at any age, including in childhood.


Treating arthritis

If you think you have arthritis, you should see your GP. They can make an accurate assessment and prescribe the appropriate treatment.


Fractures, strains & sprains

The main signs of a broken or fractured bone are pain, swelling or deformity (when the injured area is an odd shape) following an injury. You may hear a crack or grinding noise, and pressing or taking weight onto the bone may be very painful. You might also feel faint, sick or dizzy.

Strains and sprains occur when the muscles or ligaments are injured. The main symptoms are pain and swelling. Putting any weight on the injury can be very painful. It's not always easy to tell the difference between a sprain or strain and a broken bone. Level of pain is helpful but not always reliable as it's possible to break a small bone without realising it, while a sprain or strain can be extremely painful.


Treating fractures, strains & sprains

If you've had an injury to your foot and you have severe pain, swelling or deformity, you should go to A&E.

If you think you may have broken a bone but you're not in significant pain you should go to a minor injuries unit.

Speak to your pharmacist about treating sprain and strains. They will advise you and can recommend products to help ease the symptoms.


Peripheral neuropathy

This condition is caused by damage to the nerves in your feet. Symptoms include:

• Numbness and tingling in the feet

• Burning, stabbing or shooting pain

• Loss of balance and coordination

• Muscle weakness

Peripheral neuropathy is more common in the over 55s. If you have diabetes, you should be regularly reviewed for this condition by your doctor or specialist, as you're at higher risk of developing it.


Treating peripheral neuropathy

If you have symptoms of peripheral neuropathy, see your GP immediately. Early diagnosis and treatment is important to help prevent the condition progressing.


Heel spur syndrome

Heel spurs are bony lumps that form underneath the heel. They're caused by stress on the heel, for example, from running or other high-impact activities. 

Heel spurs don't cause pain in themselves. In fact many of us have heel spurs and don't know it. If you have heel spurs and also experience pain, it’s likely to be caused by another condition, such as plantar fasciitis or arthritis.


Next steps

• To protect the long-term health of your feet, choose comfortable, supportive footwear

• If you're not sure whether you need to see your GP, talk to your pharmacist for advice

• If your foot pain does not improve with self treatment, if it gets worse despite treatment, or if you're worried, see your GP