There are several causes of pain in the arch of the foot and heel region. The type of pain and its location help the doctor in determining the cause of the pain and helps to direct them in the best treatment for the patient.

The most common pain in the bottom of the foot is heel pain. This pain tends to be worse first thing in the morning or after rest. It is associated with a tight ligament in the bottom of the foot called the plantar fascia. X-rays will often reveal a spur on the bottom of the heel. (See plantar fasciitis and heel spurs) Pain in the back of the heel can be due to bony enlargements (Hagland’s deformity), spurring in the Achilles tendon or Achilles tendonitis. Burning pain in the bottom of the foot may be caused by a condition called tarsal tunnel syndrome or it may be due to peripheral neuropathy. People with diabetes frequently experience burning in the bottom of the feet. Pain in the middle of the arch of the foot that is also associated with small, hard knots may be due to plantar fibromatosis.

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