Foot and ankle pain is often dismissed as a temporary problem caused by long hours of standing, uncomfortable footwear or overuse. While some episodes may settle with rest, persistent or recurring pain should not be ignored. The foot and ankle contain numerous bones, joints, muscles, tendons, ligaments and nerves, so pain in this area can have many different causes.

Ignoring pain can also affect mobility. When walking becomes uncomfortable, people may reduce their physical activity, which can have wider effects on overall health.

Here are three types of foot and ankle pain that deserve medical attention.

1. Painful Bunions Should Not Be Ignored

A bunion, medically known as hallux valgus, is a deformity in which the big toe gradually moves towards the second toe, while a bony prominence develops on the inner side of the foot.

Bunions can be associated with genetics and may become worse with constrictive footwear, including narrow or high-heeled shoes.

Signs to watch for

  • Pain or tenderness around the big toe joint
  • Swelling and redness
  • Calluses or thickened skin
  • Difficulty wearing certain shoes
  • Increasing difficulty while standing or walking
  • The big toe beginning to overlap or push against another toe

As the deformity progresses, the altered distribution of weight across the foot can cause pain in other areas. Untreated bunions may also contribute to difficulty walking and increase the risk of other foot problems.

What can help?

Early management may include wearing wider, comfortable footwear, modifying activities, using appropriate insoles or orthotics and addressing pressure points. Surgery is generally considered when symptoms remain significant despite non-surgical treatment.

The key point: A bunion does not necessarily require surgery, but a painful or progressively worsening bunion should be assessed rather than simply tolerated.

2. Pain on the Top or Sides of the Foot

Pain on the top or sides of the foot can have several causes. These may include tendon problems, stress fractures, joint inflammation, bone spurs, arthritis or an injury.

This type of pain is particularly important to assess if it started after a sudden increase in physical activity. Increasing running, walking, sports or other repetitive activities can place additional stress on the bones and soft tissues.

When should you be concerned?

Pay attention if the pain:

  • Gets worse when walking or standing
  • Is associated with swelling or bruising
  • Continues despite reducing activity
  • Makes it difficult to put weight on the foot
  • Keeps returning after exercise
  • Is accompanied by tenderness over a specific area of bone

A stress fracture, for example, can cause pain and swelling that become worse with walking or activity. Wearing shoes that are too tight or lack adequate support can also contribute to foot pain.

Don't simply walk through persistent pain

Continuing high-impact activity despite persistent pain can potentially worsen an underlying problem. If the pain is severe, recurring or affecting your ability to walk normally, an orthopaedic or foot and ankle specialist can determine whether imaging or other investigations are needed.

3. Sharp Foot Pain with the First Steps in the Morning

One of the most recognisable patterns of foot pain is sharp pain under the heel or along the arch when taking the first few steps after waking up. This is commonly associated with plantar fasciitis or plantar heel pain.

The plantar fascia is a strong band of connective tissue running along the bottom of the foot. It helps support the arch and absorbs some of the stress placed on the foot while standing and walking.

Typical symptoms include:

  • Sharp pain under the heel
  • Pain along the arch
  • Pain that is worse with the first steps in the morning
  • Pain after getting up following prolonged sitting
  • Symptoms that may ease initially with movement but worsen after prolonged standing or walking

Sudden increases in activity, prolonged standing, unsupportive footwear, tight calf muscles and excess body weight can increase the likelihood of developing plantar heel pain.

Does plantar fasciitis require surgery?

Usually, no. Most patients can be managed with non-surgical measures. These may include activity modification, stretching exercises, supportive footwear, insoles or heel pads and appropriate pain management.

However, persistent symptoms should be evaluated because heel pain can have causes other than plantar fasciitis, including tendon problems, arthritis or stress fractures.

When Should Foot and Ankle Pain Be Evaluated?

Not every episode of foot pain requires immediate medical attention. However, seek medical advice if:

  • Pain is severe or getting progressively worse
  • You cannot walk or put weight on the foot
  • There is significant swelling or bruising
  • The foot looks deformed after an injury
  • You heard a snap or popping sound during an injury
  • There is persistent numbness or loss of sensation
  • Pain keeps returning
  • Pain does not improve with appropriate self-care
  • You have diabetes and develop new foot pain

Severe pain accompanied by an inability to walk, deformity or a snapping sound after an injury can indicate a fracture or significant tendon injury and requires prompt assessment.

Simple Ways to Protect Your Feet and Ankles

Prevention starts with everyday habits. Choose footwear that fits properly, provides adequate cushioning and supports the foot. Avoid regularly wearing shoes that squeeze the toes or provide inadequate support.

Other useful measures include:

  • Increase exercise intensity gradually rather than suddenly
  • Stretch the calves and feet regularly
  • Avoid prolonged standing or high-impact activity when pain is present
  • Maintain a healthy body weight to reduce excessive load on the feet
  • Replace worn-out sports shoes
  • Do not ignore recurring pain simply because it temporarily improves with rest

Foot and ankle pain should not always be dismissed as an inevitable part of getting older or being physically active. Painful bunions, persistent pain on the top or sides of the foot, and sharp heel pain that is worse with the first steps in the morning are three common patterns that deserve attention.

Early assessment can help identify the underlying cause and guide appropriate treatment before pain begins to interfere with walking, exercise and everyday activities. As the exact cause of foot pain can vary considerably, persistent or unexplained symptoms should be evaluated by a qualified healthcare professional rather than self-diagnosed.

(By Dr. Dasaradha Rama Reddy Tetali, Senior Consultant Orthopaedic Surgeon, Yashoda Hospitals, Hyderabad)



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