Written By: Chloe Wilson BSc(Hons) Physiotherapy
Reviewed By: FPE Medical Review Board
Pain on the inside of the foot is a common problem that can occur anywhere between the inner heel and the big toe, along the medial arch.
In most cases, inside foot pain develops gradually from overuse, repetitive strain or tight footwear, but it can also develop suddenly with an injury.
Inner arch foot pain may make those first few steps in the morning pretty unbearable, or may get worse the longer you are on your feet. There may be tingling, stiffness, inflammation or difficulty standing on your tiptoes.
But the good news is, there is lots that you can do to help reduce pain on the inside of the foot, aka medial foot pain.
There are a number of possible causes of pain on the inside of the foot. Here we will start by looking at the six most common causes of inside foot pain and how they present. Then we’ll go on to look at some of the other possible causes, and finish by looking at the best treatment options for inner side of foot pain.
If your pain is more on the outer side of the foot, check out the Lateral Foot Pain article.
Inflammation of tibialis posterior tendon, most common cause of pain on inside of foot
Causes: ankle sprain, high impact sports e.g. football & basketball, flat feet
Symptoms: inner side of foot pain ankle to midfoot, difficulty standing on tiptoes and walking
Full Article: Posterior Tibial Tendonitis
Hairline crack in one of the medial foot bones e.g. 1st metatarsal or navicular
Causes: Repetitive overloading e.g. running and jumping, suddenly increasing activity levels
Symptoms: Mild pain on inside of foot that gradually gets more intense & comes on quicker with activity, swelling & bruising
Full Article: Stress Fractures
Small extra bone at top of inner foot arch
Cause: Genetics, injury, overuse, flat feet
Symptoms: pain, inflammation and hard lump in inner foot arch that rubs on shoes
Full Article: Accessory Navicular Syndrome
Lump at the base of the big toe that pushes the toe across leaving a bulge
Cause: Tight footwear, high heels and genetics
Symptoms: gradually increasing deviation of big toe, redness, swelling, pain and toe stiffness
Full Article: Foot Bunions
Inflammation & tearing of thick band of tissue running under the foot, supporting the arch
Causes: sudden increases in activity levels, poor foot biomechanics, muscle tightness, repetitive overloading, unsupportive footwear
Symptoms: pain on inside of foot near heel, worse in the morning, lump in arch of foot
Full Article: Plantar Fasciitis
Strong, sudden, involuntary muscle contractions
Causes: diet, medical conditions, nerve damage, muscle imbalance, fatigue
Symptoms: sharp, intense inner arch foot pain, muscle spasms, toe curling, tightness
Full Article: Foot Cramps
Compression of the posterior tibial nerve at the inner ankle
Causes: ankle swelling, cysts, bone spurs, altered foot biomechanics, jumping
Symptoms: shooting/burning medial foot pain, tingling and numbness, heel to toes
Full Article: Tarsal Tunnel Syndrome
There are a number of other possible causes of inner arch foot pain.
Another possible cause of pain on the inside of the foot is abductor hallucis strain where there is micro-tearing or inflammation of the abductor hallucis tendon. The tendon runs underneath the foot from the inner heel to the big toe, and is responsible for bending and moving the big toe outwards.
Inadequate warm ups, sudden increases in activity levels, heavy lifting or sports requiring quick pivoting movements can cause abductor hallucis inner foot pain. The pain tends to be focused around the inner foot arch and the base of the big toe. Symptoms typically worsen with activity, particularly when pushing off through the foot.
Compression of the medial calcaneal nerve can also cause inside foot pain. With medial calcaneal nerve entrapment, the nerve which supplies the sensation to the inner side of the heel and arch of the foot becomes compressed or entrapped. This can happen due to anatomical abnormalities, injuries e.g. ankle sprain, overuse or ill-fitting footwear.
Common symptoms of medial calcaneal nerve entrapment includes persistent or intermittent inner heel pain and medial arch pain which may be sharp, shooting or burning. There may be some tingling and numbness in the same area and the inner foot may become very sensitive to touch. You can find out more in the foot nerve pain section.
Problems with the big toe can also cause inner side of foot pain such as:
Repetitive or excess friction or pressure through the foot can lead to thick, raised, hardened areas of skin that cause pain on inside of foot. Corns tend to be small, pale, yellowy, pea-sized areas of thick, raised skin. Calluses tend to be larger but flatter areas of thickened skin.
There are various different creams, chemicals and orthotics that can help relieve inner foot pain from corns and calluses, or you may need to get them professional removed if they keep causing pain on the inside of the foot. Find out more about Corns & Calluses.
If the arches of the feet are lower than normal, or completely absent, it can cause pain on the inside of the foot.
In individuals with flat feet, the lack of proper arch support can cause the feet to roll inwards excessively when walking or running.
This can cause the inner side of the foot to bear more weight and pressure than it is designed to, leading to strain and discomfort in that area.
Some people are born with flat feet, other people develop them due to muscle imbalance, foot injuries, aging or certain medical conditions. Strengthening exercises, stretches and orthotics can help to support foot arches and reduce inner arch foot pain.
One of the more rare causes of pain on the inside of the foot is tarsal coalition. With tarsal coalition, a bony bridge develops between two of the foot bones so they become partially fused together. Tarsal coalition is typically a congenital problem, i.e. you are born with it, but it may not start causing inner foot pain until teenage years or later, if at all.
A bony bridge can develop between any of the foot bones but often occurs between the heel bone and the navicular, the small bone on the inner side of the ankle. Rest, corticosteroid injections and physical therapy can help to relieve inner foot pain from tarsal coalition, but if the bridge is particularly large, it may need to be surgically removed. Find out more about Tarsal Coalition.
Treatment for pain on the inside of the foot will depending on the underlying cause of the medial foot pain but will usually involve a combination of:
In most cases, pain on the inside of the foot will settle down within 6-12 weeks with correct rest and treatment.
You can find out more about specific treatment for the different causes of pain in the inside of the foot in the following articles:
So as you can see there are lots of possible causes of inner side of foot pain, each of which present with slightly different symptoms:
If your side of foot pain is more on the outer side of the foot rather than the inner side, check out the Pain On Outside Of Foot article.
You may also be interested in the following articles:
Foot & Ankle Exercises
December 9th, 2023
Diagnosis Chart
December 9, 2024
Swollen Feet
November 21, 2024
Page Last Updated: 7th October, 2024
Next Review Due: 7th October, 2026