Foot and Heel Pain: Why Do My Feet Hurt When Walking, Standing or Getting Out of Bed?

Oct 13

Foot & Heel Pain: Causes, Relief & Treatment | Osteopath Auckland

Do your first few steps in the morning feel like you're walking on something sharp?

Perhaps your heel hurts when you get out of bed, the arch of your foot aches after a long day at work, or you've started avoiding your usual walks because your feet become uncomfortable.

Maybe you've developed pain after running, your Achilles tendon feels stiff, or the ball of your foot burns when you're wearing certain shoes.

Foot and heel pain can be surprisingly frustrating. After all, we rely on our feet for almost everything we do — walking, standing, exercising, working and keeping up with everyday life.

The reassuring news is that many common causes of foot and heel pain can improve with appropriate assessment, treatment and rehabilitation.

Understanding where your pain is coming from is an important first step towards getting you moving more comfortably.

Where Does Your Foot Hurt?

The location of your pain can provide useful clues about which structures may be involved.

Your feet contain numerous bones, joints, muscles, ligaments, tendons and nerves, all working together to support your body weight and allow movement.

Different conditions can cause pain in different areas.

Pain Under Your Heel

Do you experience a sharp or stabbing pain underneath your heel, particularly when you first stand up in the morning?

Perhaps the first few steps are uncomfortable, but your pain eases once you've been walking for a while.

This pattern is commonly associated with plantar heel pain, often called plantar fasciitis or plantar fasciopathy.

You might notice:

Sharp heel pain first thing in the morning
Pain when standing after sitting
Tenderness underneath your heel
Discomfort walking barefoot on hard floors
Heel pain after prolonged standing
Pain after walking or running

Pain at the Back of Your Heel

If your pain is located at the back of your heel, around your Achilles tendon, you may be experiencing Achilles tendinopathy.

You might notice stiffness when getting out of bed, pain when walking uphill or discomfort when running.

Some people also develop pain where the Achilles tendon attaches to the heel bone.

Pain Through the Arch of Your Foot

Arch pain can develop from several causes, including plantar fascia irritation, muscle or tendon problems and changes in activity levels.

You may notice aching after walking, running or standing for long periods.

Pain in the Ball of Your Foot

Pain beneath your toes or across the front of your foot is often described as metatarsalgia.

You might experience aching, burning or the sensation of walking on a small stone.

Symptoms may become worse when wearing tight shoes, standing for long periods or walking on hard surfaces.

Pain on the Top of Your Foot

Pain across the top of your foot can sometimes be associated with tendon irritation, joint problems or footwear pressure.

However, persistent, localised pain — particularly following an increase in running or walking — may indicate a bone stress injury and should be assessed.

Pain Around Your Toes or Big Toe

Toe pain may develop from joint irritation, osteoarthritis, bunions, injuries or other conditions.

You might notice discomfort when pushing off during walking, wearing certain shoes or bending your big toe.

Common Causes of Foot and Heel Pain

Plantar Fasciitis: Why Does My Heel Hurt in the Morning?

Plantar fasciitis, also called plantar fasciopathy, is one of the most common causes of heel pain.

The plantar fascia is a strong band of connective tissue running along the bottom of your foot, helping support the arch.

When this tissue becomes painful and sensitive, you may notice a sharp pain underneath your heel.

A particularly common symptom is heel pain during the first few steps after getting out of bed.

You may also experience discomfort:

Standing after sitting for a while
Walking barefoot around the house
Standing at work
Walking longer distances
Running or exercising
After spending a busy day on your feet

Although the pain can be persistent, plantar heel pain often improves with appropriate load management, strengthening and other conservative treatments.

Achilles Tendinopathy

Your Achilles tendon connects your calf muscles to your heel bone.

It plays an important role in walking, running, jumping and pushing off your foot.

Achilles tendon pain can develop when activity demands increase faster than the tendon can adapt.

Perhaps you've recently increased your running distance, started walking more hills or returned to exercise after a break.

You might notice:

Stiffness at the back of your heel in the morning
Pain during or after running
Discomfort walking uphill
Tenderness along the Achilles tendon
Pain when standing on your toes

Progressive strengthening and appropriate management of activity are important parts of recovery.

Metatarsalgia: Pain in the Ball of Your Foot

Metatarsalgia describes pain around the ball of the foot rather than one specific diagnosis.

You might notice aching or burning beneath your toes, particularly after standing or walking.

It may feel as though you're stepping on a pebble or have something stuck inside your shoe.

Footwear, activity levels and several different foot conditions can contribute to symptoms.

Morton's Neuroma

Morton's neuroma involves irritation and thickening of tissue around a nerve in the forefoot, commonly between the third and fourth toes.

You might experience:

Burning pain in the ball of your foot
Tingling or numbness in your toes
A sensation of standing on a small stone
Pain when wearing narrow shoes
Discomfort during longer walks

An assessment can help distinguish nerve-related symptoms from other causes of forefoot pain.

Foot and Ankle Sprains

Foot and ankle sprains can happen when you twist your foot, step awkwardly or land incorrectly during sport.

You may notice pain, swelling, bruising or difficulty walking.

Some injuries require imaging to exclude fractures or more significant ligament damage.

Stress Fractures and Bone Stress Injuries

Bone stress injuries can develop when repeated loading exceeds the bone's ability to recover.

They may affect runners, dancers, active adults and people who have suddenly increased their walking or exercise.

Symptoms can include:

Localised pain over a particular bone
Pain that increases during weight-bearing activity
Tenderness when pressing on the area
Pain that gradually worsens with continued exercise

Persistent, focal foot pain during exercise shouldn't be ignored, particularly if you're developing a limp or pain at rest.

Heel Pain in Children: Sever's Disease

Children and teenagers can also develop heel pain, particularly during periods of growth and increased sporting activity.

One common cause is calcaneal apophysitis, often called Sever's disease.

This affects the growth area at the back of the heel and is more common in physically active children.

You might notice your child:

Complaining of heel pain after sport
Limping after running
Avoiding certain activities
Walking on their toes to avoid heel pressure
Experiencing tenderness around the back of the heel

Although Sever's disease is generally a self-limiting condition, an assessment can help confirm the diagnosis and guide appropriate activity modification.

Children with persistent heel pain or a limp should be assessed rather than assuming the symptoms are simply growing pains.

Why Does My Foot Hurt During Everyday Activities?

Sometimes it's the simplest activities that make foot pain so frustrating.

Getting Out of Bed in the Morning

Does your heel feel particularly painful during those first few steps?

This is a common symptom of plantar heel pain and can also occur with Achilles tendon problems.

You might find yourself hobbling towards the bathroom before your foot gradually loosens up.

Walking Around the Supermarket

Perhaps short walks are manageable, but your feet begin aching when you're walking around the shops.

Prolonged weight-bearing can aggravate sensitive tissues in the heel, arch or forefoot.

Standing at Work

If you're a teacher, nurse, retail worker, tradie or spend long periods standing, foot pain can make getting through the day uncomfortable.

You might notice aching that gradually builds as the hours go by.

Walking Barefoot

Some people find walking barefoot on hard floors particularly uncomfortable, especially when experiencing plantar heel pain.

Supportive footwear may help reduce symptoms while the area is sensitive.

Running and Exercising

Foot and heel pain can interfere with running, walking, dancing, tennis, football and gym training.

Perhaps you feel comfortable at the start of a run but develop pain afterwards, or your Achilles becomes stiff the following morning.

Walking Upstairs or Uphill

Walking uphill and climbing stairs place greater demands on your calf muscles, Achilles tendon and forefoot.

If these structures are sensitive, symptoms may become more noticeable.

Wearing Certain Shoes

Narrow shoes, high heels or footwear that doesn't suit your current needs may aggravate some types of foot pain.

You might find yourself choosing shoes based on comfort rather than appearance.

If foot or heel pain is affecting your ability to walk, work, exercise or enjoy everyday activities, getting an assessment can help you understand what may be contributing to your symptoms.

Book a Foot or Heel Pain Appointment with Sarah

What Can I Do to Relieve Foot and Heel Pain?

The most appropriate treatment depends on the cause of your symptoms, but there are several practical strategies that may help.

1. Modify Activities That Aggravate Your Pain

If long walks, running or prolonged standing are making your symptoms worse, consider temporarily reducing the duration or intensity.

You don't necessarily need to stop moving altogether.

2. Wear Comfortable, Supportive Footwear

Footwear with appropriate cushioning, support and enough room for your toes may help reduce discomfort.

Different foot conditions may benefit from different footwear features.

3. Avoid Prolonged Barefoot Walking if It's Painful

If walking barefoot on hard floors aggravates your heel pain, try wearing supportive shoes around the house while your symptoms are settling.

4. Gradually Strengthen Your Foot and Calf Muscles

Strengthening exercises can be particularly helpful for plantar heel pain and Achilles tendinopathy.

Depending on your condition, these may include calf raises, foot strengthening or other progressive loading exercises.

The exercises should be appropriate for your symptoms and stage of recovery.

5. Try Gentle Movement Before Getting Out of Bed

If your feet are stiff first thing in the morning, gently moving your ankles and toes before standing may help you feel more comfortable.

Some people with plantar heel pain also benefit from specific plantar fascia stretches.

6. Use Heat or Cold for Temporary Relief

A cold pack wrapped in a towel may help ease discomfort following activity.

Others find gentle warmth helpful for associated muscle stiffness.

7. Consider Footwear Inserts or Orthotics When Appropriate

Some people benefit from heel cups, shoe inserts or orthoses, particularly when combined with exercise and activity modification.

Not everyone with foot pain needs custom orthotics.

8. Seek Assessment if Symptoms Persist

If your foot or heel pain is worsening, affecting your walking or not improving with appropriate self-management, an assessment can help identify the cause and guide treatment.

You don't have to wait until you're struggling to walk before asking for help.

Book an Osteopathy Appointment with Sarah

How Can Osteopathic Treatment Help Foot and Heel Pain?

If foot or heel pain is affecting your everyday activities, osteopathic assessment and treatment may help you manage musculoskeletal discomfort and improve movement.

I'm Sarah Boughtwood, a structural osteopath based in Milford on Auckland's North Shore, with over 10 years of clinical experience.

I treat adults and children aged five years and older, helping patients manage musculoskeletal aches, pains and injuries.

My approach is to understand not just where your foot hurts, but how that pain is affecting your everyday life.

Perhaps you're struggling to get out of bed comfortably, walk around the shops, stand at work, exercise or return to running.

During your appointment, I'll take the time to listen to your symptoms, understand how your pain developed and assess your foot, ankle and surrounding muscles and joints as appropriate.

Depending on your assessment, treatment may include:

Gentle soft tissue techniques to help manage associated muscle discomfort
Appropriate joint mobilisation where suitable
Individualised strengthening and mobility exercises
Advice on footwear and activity modification
Guidance on managing walking, running and standing loads
Practical strategies to help you gradually return to everyday activities and exercise

For conditions such as plantar heel pain and Achilles tendinopathy, progressive strengthening and appropriate activity management are important parts of recovery.

Hands-on treatment may help with short-term symptoms for some patients, but it doesn't replace exercise-based rehabilitation or appropriate tissue loading.

My aim is to help you understand your symptoms, improve your movement and feel more confident getting back to the activities you enjoy.

Book a Foot and Heel Pain Assessment with Sarah

Is Foot or Heel Pain Something I Should Worry About?

Many common causes of foot and heel pain improve with appropriate management.

However, some symptoms require prompt medical attention.

Seek medical assessment if you experience:

Significant pain following a fall or injury
Inability to bear weight
Marked swelling, bruising or deformity
A sudden pop at the back of your ankle followed by difficulty pushing off your foot
A hot, red or swollen foot accompanied by fever
Persistent, localised bone pain that worsens with activity
New numbness, weakness or changes in foot colour

People with diabetes who develop a new foot wound, redness, swelling or signs of infection should seek prompt medical care, even if the foot isn't particularly painful.

Children with persistent heel pain, a limp or difficulty bearing weight should also be medically assessed.

Do I Need an X-ray or Ultrasound for Foot Pain?

Not everyone with foot or heel pain needs imaging.

For many common musculoskeletal conditions, your symptoms, medical history and physical examination can help guide treatment.

However, imaging may be appropriate if you've experienced significant trauma, have localised bone tenderness, or your symptoms suggest a condition requiring further investigation.

As an osteopath, I can assess whether imaging or referral to another healthcare professional may be appropriate.

Can I See an Osteopath for Foot or Heel Pain Under ACC?

Yes. If your foot or heel pain is related to an injury that qualifies for ACC cover, you may be eligible for subsidised osteopathic treatment.

For example, foot injuries following a fall, sporting accident or sudden sprain may qualify.

Not all foot or heel pain is covered by ACC, particularly when symptoms develop gradually without a qualifying injury.

I'm an ACC-registered osteopath, and you don't need a GP referral to book an appointment.

Don't Let Foot Pain Keep You Off Your Feet

Foot and heel pain can affect so many everyday activities.

Perhaps your first steps in the morning are painful, you're struggling to stand at work, or you've stopped going on your usual walks because your feet become uncomfortable.

It can be frustrating when something as simple as walking starts to feel difficult.

But foot pain doesn't automatically mean you need to stop exercising, avoid walking or simply put up with discomfort.

With an appropriate assessment and management plan, many common foot and heel conditions can improve.

If you're experiencing heel pain, arch pain, Achilles discomfort or pain when walking, standing or exercising, I'd love to help you explore your options.

I'm Sarah, a structural osteopath based in Milford, Auckland, providing individualised care for adults and children aged five years and older.

Let's work towards getting you back on your feet and moving more comfortably.