Stabbing foot pain on top of foot

Overview

Plantar fasciitis (PLAN-tur fas-e-I-tis) is one of the most common causes of heel pain. It involves inflammation of a thick band of tissue that runs across the bottom of each foot and connects the heel bone to the toes (plantar fascia).

Plantar fasciitis commonly causes stabbing pain that usually occurs with your first steps in the morning. As you get up and move, the pain normally decreases, but it might return after long periods of standing or when you stand up after sitting.

The cause of plantar fasciitis is poorly understood. It is more common in runners and in people who are overweight.

Symptoms

Plantar fasciitis typically causes a stabbing pain in the bottom of your foot near the heel. The pain is usually the worst with the first few steps after awakening, although it can also be triggered by long periods of standing or when you get up from sitting.

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Causes

The plantar fascia is a band of tissue (fascia) that connects your heel bone to the base of your toes. It supports the arch of the foot and absorbs shock when walking.

Tension and stress on the fascia can cause small tears. Repeated stretching and tearing of the facia can irritate or inflame it, although the cause remains unclear in many cases of plantar fasciitis.

Risk factors

Even though plantar fasciitis can develop without an obvious cause, some factors can increase your risk of developing this condition. They include:

  • Age. Plantar fasciitis is most common in people between the ages of 40 and 60.
  • Certain types of exercise. Activities that place a lot of stress on your heel and attached tissue — such as long-distance running, ballet dancing and aerobic dance — can contribute to the onset of plantar fasciitis.
  • Foot mechanics. Flat feet, a high arch or even an atypical pattern of walking can affect the way weight is distributed when you're standing and can put added stress on the plantar fascia.
  • Obesity. Excess pounds put extra stress on your plantar fascia.
  • Occupations that keep you on your feet. Factory workers, teachers and others who spend most of their work hours walking or standing on hard surfaces can be at increased risk of plantar fasciitis.

Complications

Ignoring plantar fasciitis can result in chronic heel pain that hinders your regular activities. You're likely to change your walk to try to avoid plantar fasciitis pain, which might lead to foot, knee, hip or back problems.

Jan. 20, 2022

  1. Buchbinder R. Plantar fasciitis. https://www.uptodate.com/contents/search. Accessed Oct. 2, 2021.
  2. Plantar fasciitis. American Orthopaedic Foot & Ankle Society. https://www.footcaremd.org/conditions-treatments/heel/plantar-fasciitis. Accessed Oct. 2, 2021.
  3. Plantar fasciitis and bone spurs. American Academy of Orthopaedic Surgeons. https://orthoinfo.aaos.org/en/diseases--conditions/plantar-fasciitis-and-bone-spurs. Accessed Oct. 2, 2021.
  4. AskMayoExpert. Plantar fasciitis. Mayo Clinic; 2020.

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Experts share foot care advice to help you diagnose common problems in the heel, arch, and top of the foot, plus how to find relief and prevent future injuries.

If you’ve ever had a blister from, say, breaking in new shoes, you know firsthand how uncomfortable and frustrating it can feel to walk around or exercise with a nagging ouch. While that tenderness will eventually subside as the shoe molds to your foot, some other issues, such a sharp pain in your heel or arch, could worsen over time if untreated. Unfortunately, that’s what the majority of us do, hoping it just, poof, goes away.

According to a 2014 survey from the American Podiatric Medical Association, 77 percent of U.S. adults over age 18 have experienced foot pain. Of those people, only a third have visited a podiatrist for help. If the pain is fleeting, it’s understandable why you might not seek assistance. But if it’s reoccurring, it’s important to break the cycle of hurt before it develops into one of two types of foot injuries: traumatic (single-time injuries like a sprained ankle or broken bone) or microtrauma (those that occur over time usually from overuse).

“Repetitive stress injuries that occur over time are caused by extrinsic factors such as training errors or intrinsic factors, such as biomechanics deficits in flexibility, mobility, and stability,” says chiropractic physician Josh Sandell, D.C., the chief clinical officer of Orthology, a nationwide patient-focused facility for orthopedic care, and sports medicine specialist to the Minnesota Vikings. This causes abnormal strains and stressors throughout the kinetic chain and may result in an injury if you are not able to effectively adapt to these stressors or effectively compensate.

If you don’t want to end up needing crutches, don’t discount foot pain. Instead use this guide to better understand what you’re feeling and how you can ease the ache so that you can continue to make strong strides towards your life and fitness goals. After you’ve healed, consider seeing a physical therapist, trainer, or Egoscue specialist to get your balance and strength assessed as well as your running and walking gait so that you’re better fitted for proper, supportive footwear.

1. Where it hurts: Heel

Possible causes of pain: Plantar fasciitis or Achilles tendinopathy. “Plantar fasciitis is the heel pain that’s the most common athletic injury I see in general, and many people think of it as synonymous with a heel spur,” says Jason B. Morris, D.P.M., foot and ankle specialist at Beach City Orthopedics, Manhattan Beach, California. Plantar fasciitis involves pain and inflammation of the tissue called the plantar fascia that runs across the bottom of the foot and connects your toes to your heel bone. Achilles tendinopathy is a non-inflammatory heel pain that occurs in the Achilles tendon where your lower leg connects to your heel. “People implement intense heel workouts into their routine and often do the Terrible Too’s: too much, too quickly, too often, and too little rest or recovery,” Sandell says.

What it feels like: Plantar fasciitis results in a stabbing pain in the bottom of your foot, near the heel. For Achilles tendinopathy, you may experience a swelling, stiffness and weakness of the Achilles tendon.

Best remedy: A foot specialist might prescribe rest, orthotic shoe inserts, and stretching and strength training for your lower body so that your feet aren’t tasked with absorbing all of your weight. (You can also try these simple exercises to help relieve the pain.) When you run, for example, your hips and muscles around your knees should be the body’s primary shock absorbers, Sandell says. “If those muscles are weak, your foot has the responsibility of absorbing two to three times your bodyweight every time it hits the ground.” Make sure you also have a stretching routine for the soleus (calf muscles), hamstrings, hip flexors, and the adductors (groin muscles).


RELATED: The Essential 8-Minute Workout for Marathon Runners


2. Where it hurts: Arch

Possible causes of pain: Arch pain generally develops from overuse, wearing unsupportive shoes, weight gain, or an acute injury. It is often attributed to inflammation or strain from plantar fasciitis.
What it feels like: Pain that shoots into your arches, especially when you first step out of bed in the morning.

Best remedy: If pain persists for a few days straight, see a foot and ankle surgeon for treatment to prevent this condition from getting worse. “Have your shoes assessed since that’s the most important piece of equipment, especially runners,” Sandell says.

3. Where it hurts: Top of the Foot

Possible causes of pain: A stress fracture. “If you’re picking up a new activity that your foot isn’t used to, you’re putting your foot at a higher risk of stress fracture,” Morris warns. For example, quickly increasing your mileage when training for a race, switching sports that involve a change of motion (i.e., going from running to tennis), or occasionally wearing high heels during your workday. Once you’ve subjected your foot to an increased stress that it’s not used to that bone can fail, Morris says. Other folks at risk: Over-pronators and people with high arches. They may be more susceptible to stress fractures inside and outside the foot, respectively.

What it feels like: You might not notice a stress fracture at first. It could feel like general pain in one area on the top of your foot that progressively gets worse and possibly includes some swelling. But a lot of people can have a stress fracture for a few weeks or months without realizing it.

Best remedy: Ask for an MRI scan, which may better detect hairline bone fractures over an X-ray. If you have a stress fracture, you’ll need to temporarily stop exercising and may be prescribed a walking boot or crutches.

By Diana Kelly
Published on March 18, 2016


Comments (0)

What causes a shooting pain in the top of your foot?

Pain in the top of your foot is often caused by exercising, especially if it involves running, kicking or jumping. It may also be caused by wearing shoes that are too tight and some conditions, like gout. Your symptoms might give you an idea of what's causing your pain.

What does nerve pain on top of foot feel like?

Damage to the peroneal nerve can cause pain, tingling or numbness at the top of the foot. It may become difficult to raise your toes, your toes or ankle may feel weak, or your foot may feel like it is dropping when walking. In severe cases, you may be completely unable to lift your toes or foot or turn your ankle.

How do you treat a sharp pain on the top of your foot?

Ice: Applying ice to the inflamed area can help reduce pain and swelling. Medication: A doctor might recommend nonsteroidal anti-inflammatory drugs (NSAIDs) to help relieve pain and reduce swelling. Over-the-counter NSAIDs can help treat mild pain, while prescription NSAIDs can help with more severe or chronic pain.