Why Are My Feet Hurting When I Walk?

Q: My feet have started to hurt a lot — so much that when I wake up in the morning I cannot walk barefoot for at least the first 20 minutes. I can't be on my feet too much anymore without pain. What might be causing this, and what can I do to get some relief?

A: What you are describing sounds like a painful condition known as plantar fasciitis. This is a situation where there is inflammation of the soft tissue along the sole of your foot, all the way from your heel to your toes. It may be caused by high-impact exercise, structural problems such as being flat-footed, arthritis, or ill-fitting shoes. It is also more common in people with diabetes. The most characteristic symptom of plantar fasciitis is severe shooting or burning pain in the feet in the morning. The pain typically improves after some movement, only to recur after periods of prolonged rest or intense activity.

Preventive measures include always wearing shoes that fit well, stretching in the morning, afternoon and evening and before any exercise, limiting high-impact exercises, and maintaining ideal body weight, as obesity does predispose to plantar fasciitis. The key is to exercise carefully rather than eliminating exercise altogether. Treatment includes surgical and nonsurgical approaches, though surgery is a last resort and is rarely necessary. Night plints, orthotics, and physical therapy may hasten your recovery, but if the condition is left untreated, it will not resolve itself. In severe cases, injections with steroids or treatment with ultrasound may be warranted.