What's Causing Your Foot Pain?
Foot and ankle pain takes many forms — and the right diagnosis makes all the difference in your treatment. Browse by symptom below to identify your condition, learn what it means, and find the care that's right for you. Dr. Andrew Gunter, DPM treats the full spectrum of foot and ankle conditions in San Antonio, TX.
Call (210) 581-9800
I have heel pain!
Heel pain is the most common reason patients visit a podiatrist. The location of your pain — bottom of the heel, back of the heel, or deep inside the heel — is the key clue to which condition you have.
Sharp pain on the bottom of the heel — worst in the morning
The most common cause of heel pain. The plantar fascia — a thick band running along the bottom of the foot — becomes inflamed, producing sharp pain that is worst with the first steps after rest and typically improves after a few minutes of walking.
Pain at the back of the heel or lower calf after activity
Inflammation or degeneration of the Achilles tendon where it attaches to the heel bone. Produces pain at the back of the heel rather than the bottom — often worsening after exercise or long periods of rest. Common in runners and active adults.
A deep ache at the heel bone — worsened by prolonged standing
A calcium deposit on the underside of the heel bone, often associated with longstanding plantar fasciitis. May not cause pain independently — but when combined with soft tissue inflammation produces a persistent deep heel ache. Diagnosed on X-ray.
A bony bump at the back of the heel — aggravated by footwear
A bony enlargement at the back of the heel that irritates the soft tissue where the Achilles tendon attaches. Often called 'pump bump.' Frequently aggravated by rigid footwear pressing against the heel.
I have arch pain!
Arch pain is distinct from heel pain — it originates along the inside of the foot between the heel and the ball of the foot. The cause is usually structural, biomechanical, or related to overuse.
Aching along the inner arch that builds throughout the day
When the arch of the foot collapses partially or fully, it places abnormal stress on tendons, joints, and soft tissue. Produces fatigue or aching that worsens with prolonged standing or walking. May contribute to knee, hip, and lower back pain over time.
Progressive arch collapse with inner ankle and arch pain
The posterior tibial tendon supports the arch. When it weakens or tears, the arch progressively collapses — producing pain along the inner ankle and arch, often with visible flatfoot deformity. Most common in adults over 40.
Burning or aching along the bottom of the arch
While plantar fasciitis most commonly presents as heel pain, some patients experience the inflammation further along the fascia — producing arch burning or aching rather than focal heel pain. The cause and treatment are the same.
Pain across the arch and ball of foot from a high rigid arch
A foot with an excessively high arch places disproportionate pressure on the heel and ball of the foot. Can cause arch pain, frequent ankle sprains, and hammertoe development. Custom orthotics provide significant relief.
I have bunion pain!
Bunions are among the most common foot conditions in adults — and one of the most commonly undertreated. Many patients manage discomfort for years before seeking care. Conservative and surgical options are both available.
A painful bony bump at the base of the big toe
A bunion forms when the big toe drifts toward the second toe, forcing the metatarsal head to protrude on the inside of the foot. Progressive over time. Causes pain with footwear, difficulty walking, and worsening deformity. Conservative management, Lapiplasty and minimally invasive surgery are available.
A painful bump on the outside of the foot at the little toe
A bunionette is the same structural deformity as a bunion but occurring at the base of the fifth (pinky) toe rather than the first. Produces a painful prominence on the outer edge of the foot that is aggravated by narrow footwear.
Stiffness and pain at the big toe joint — especially with push-off
A progressive reduction in the upward range of motion of the big toe joint. When the joint cannot bend adequately during walking, it compensates by transferring load to other areas of the foot — causing pain at the big toe joint, the ball of the foot, and sometimes the knee and hip. Left untreated, hallux limitus can progress to hallux rigidus — complete rigid joint stiffness.
A stiff, painful big toe joint — very limited or no movement remaining
The end stage of big toe joint arthritis, where cartilage loss causes bone-on-bone contact and severely restricted or absent joint motion. Produces chronic deep aching, swelling, and a noticeable bony prominence on top of the joint. Can lead to large painful calluses and ulcers. Conservative management can reduce symptoms significantly — surgical options are available when quality of life is meaningfully affected.
I have toe pain or toenails problems!
Toe and toenail conditions are among the most common — and most treatable — podiatric complaints. Many are resolved in a single in-office visit.
A nail edge digging into skin — painful, red, or swollen
The corner or edge of a toenail grows into the surrounding skin, causing pain, redness, and sometimes infection. Most commonly affects the big toe. Usually resolved in one in-office visit. Permanent correction available for recurring cases.
A toe that bends abnormally downward at the middle joint
A progressive deformity where one or more smaller toes bend at the middle joint. Causes pain, corns on top of the bent joint, and difficulty with footwear. Conservative options, in-office correction, and surgical correction options available depending on severity.
Burning or numbness between the toes — like walking on a pebble
A thickening of nerve tissue between the toes — most commonly between the third and fourth — causing burning, tingling, or numbness. Often worsens in narrow footwear or with prolonged standing.
Thickened, discolored, brittle, or crumbling nails
A fungal infection of the nail bed causing progressive thickening and discoloration. Common, persistent, and progressive without treatment. Oral and topical treatment options available. Often coexists with athlete's foot.
Sharp pain, swelling, and bruising after an injury to the toe — or gradual midfoot pain from repetitive activity
A break in one or more of the small bones of the toes, from an acute injury like a stubbed or crushed toe, or from repetitive stress over time. Not every broken toe is the same — great toe fractures and displaced fractures often need more than buddy taping.
I have ankle pain!
Ankle pain ranges from acute injuries to chronic conditions that develop gradually. The distinction matters — acute fractures or sprains and chronic instability require different treatment approaches.
Severe ankle pain, swelling, and inability to bear weight after an injury
Fractures of the ankle involve one or more of the bones that form the ankle joint — most commonly the fibula, tibia, or both. Ankle fractures range from stable single-bone injuries that can be managed without surgery to complex multi-bone fractures requiring surgical fixation. Prompt evaluation is essential — an injury that appears to be a severe sprain may be a fracture, and the two require very different treatment approaches.
Sudden ankle pain and swelling after a twisting injury
A sprain occurs when the ankle ligaments are stretched or torn during an inward roll or twist. Most common sports and activity injury. When not fully rehabilitated or injured multiple times, the ligaments may not regain full tension — leading to recurrent sprains and chronic instability.
Pain and swelling along the inner ankle and lower leg — worse with activity
Inflammation of the posterior tibial tendon along its course behind the inner ankle bone. Produces aching or sharp pain on the inside of the ankle that worsens with walking, running, or prolonged standing. Early treatment prevents progression to tendon degeneration and arch collapse.
Pain along the outer ankle — especially with activity
The peroneal tendons run along the outer side of the ankle and are commonly overused in runners, hikers, and athletes. Produces aching or sharp pain on the outer ankle that worsens with activity and improves with rest.
A recurring feeling that the ankle gives way or rolls easily
Repeated ankle sprains that were not fully treated can lead to permanent ligament laxity — where the ankle feels loose, rolls easily on uneven ground, and re-sprains with minimal provocation. Rehabilitation and surgical stabilization options are available.
Stiffness, swelling, and deep aching in the ankle joint
Degeneration of the ankle joint cartilage — often from prior injury, inflammatory conditions, or age-related wear. Produces stiffness after rest, swelling with activity, and progressive loss of range of motion.
Recurrent pain at the medial ankle shooting into the foot
Compression of the posterior tibial nerve at the medial ankle — producing burning, tingling, and numbness along the inner ankle and into the sole of the foot. Often called the carpal tunnel syndrome of the foot.
I have a sports or activity injury!
Sports-related foot and ankle injuries range from acute trauma to gradual overuse conditions. Early evaluation prevents acute injuries from becoming chronic problems.
Deep, localized bone pain that worsens with activity and improves with rest
Stress fractures are small cracks in bone caused by repetitive loading — common in runners, military personnel, and anyone who has recently increased activity volume. They frequently do not appear on standard X-rays in early stages. Prompt diagnosis prevents progression to a complete fracture.
Pain, stiffness, or a sudden snap at the back of the ankle
Achilles tendinitis develops gradually from overuse. Achilles tendon rupture — a sudden, severe injury — produces an audible pop and immediate inability to push off the foot. Both conditions require prompt evaluation.
Pain and stiffness at the base of the big toe after athletic activity
A sprain of the ligaments at the base of the big toe, typically from hyperextension during running or jumping. Common in athletes on artificial turf or hard surfaces. Can limit push-off and athletic performance significantly.
Pain under the ball of the foot near the big toe — worse with push-off
Inflammation of the sesamoid bones beneath the big toe joint. Common in dancers, runners, and athletes. Produces a dull ache or sharp pain under the big toe joint that worsens with barefoot walking or athletic activity.
Pain and swelling at the lateral foot after injury, often with foot inversion
An acute or chronic fracture at the outside of the foot. Often happens after a quick and forceful inversion injury of the foot. Pain on inversion and eversion present, with noticeable swelling and bruising of the outside of the foot.
Midfoot pain and swelling after a fall, direct blow, or twisting injury — or gradual pain from increasing activity
A break in one or more of the five long bones of the midfoot. Often mistaken for a sprain when X-rays are taken non-weight-bearing. Fracture location and displacement determine whether a walking boot or surgical fixation is the right treatment.
Learn about metatarsal fractures →
Midfoot pain, swelling, and bruising after a twisting or crushing injury — sometimes mistaken for a sprain
A fracture-dislocation of the tarsometatarsal joint complex — the architectural keystone of the foot's arch. Frequently missed on initial evaluation when non-weight-bearing X-rays appear normal. Plantar bruising after a midfoot injury is a classic warning sign that something more than a sprain may be present.
I have a skin or surface issue on my foot!
Skin conditions of the foot are common at every age and are often left unmanaged longer than necessary. Most respond well to in-office treatment — and for diabetic patients, prompt attention is particularly important.
A rough, painful growth on the sole — with small black dots
Caused by HPV infecting the skin of the sole. Presents as thickened, rough skin with pinpoint black dots (clotted blood vessels). Can be painful underfoot with walking. Rarely resolves without treatment, often unsuccessful with OTC treatment. In-office removal available.
Hardened, thickened skin from repeated pressure or friction
Calluses form on the ball of the foot or heel from repeated pressure. Corns are smaller concentrated areas of hard skin on or between the toes. Both indicate abnormal pressure distribution that may benefit from orthotic correction to prevent recurrence.
Itching, burning, peeling, or cracked skin between the toes or on the sole
A fungal skin infection causing itching, burning, and skin breakdown. Persistent without proper antifungal treatment. Can spread to the toenails. Topical and oral treatment options available.
Routine foot care — especially important for older adults and diabetic patients
Routine nail care, callus reduction, and skin assessment become increasingly important with age and are critical for patients with diabetes, peripheral vascular disease, or neuropathy. Medicare covers routine nail and callus care when a qualifying condition is present and documented.
I have pain on the ball of my foot!
Pain under the forefoot — the area behind the toes — is called metatarsalgia in general terms. Several distinct conditions produce this symptom, each with different causes and treatment approaches.
Aching or burning across the ball of the foot with prolonged standing
A general term for forefoot pain caused by excessive pressure on the metatarsal heads — the bones behind the toes. Contributing factors include high arches, improper footwear, and activities that repeatedly load the forefoot. Often accompanied by callus formation directly below the affected area.
Burning or shooting pain between the toes — worse in narrow shoes
Morton's neuroma — a thickening of the nerve between the third and fourth metatarsals — produces burning, shooting pain or numbness in the ball of the foot that radiates into the toes. Often dramatically worsened by narrow or pointed footwear.
Localized sharp pain in the forefoot — worsening with each step
A stress fracture of one of the metatarsal bones produces focal, sharp forefoot pain that worsens progressively with activity. Common in runners, military personnel, and anyone who has recently increased walking or running volume. Requires imaging for diagnosis.
Pain and swelling at the base of the second or third toe — feels like a dislocated toe
Inflammation of the joint capsule at the base of the second toe causes pain, swelling, and a feeling of instability — as though the toe might cross over the big toe. Common in adults with bunions or abnormal foot mechanics. This can be progressive and lead to a rupture of the plantar plate.
I have pain on the top of my foot!
Pain on the top of the foot — the dorsum — can result from tendon issues, bone spurs, nerve compression, or stress injuries. The specific location and pattern of pain are important diagnostic clues.
Pain and tenderness across the top of the foot — worse with activity
Inflammation of the tendons that run across the top of the foot and lift the toes. Often caused by lacing footwear too tightly, a sudden increase in activity, or biomechanical stress. Produces a diffuse aching across the dorsum that worsens with walking or running.
A soft, moveable lump on the top of the foot
A benign fluid-filled cyst that develops from a joint or tendon sheath. May be painless or produce pressure-related discomfort depending on its location and size. Can be monitored, aspirated, or surgically removed.
Sharp, localized pain on top of the foot — worsening over days or weeks
Stress fractures of the dorsal metatarsals or tarsal bones produce progressive pain on the top of the foot that worsens with activity and improves with rest. Frequently missed on initial X-ray — MRI or bone scan may be required for definitive diagnosis.
Burning, tingling, or numbness across the top of the foot
The deep peroneal nerve runs across the top of the foot and can become compressed by tight footwear, bone spurs, or swelling — producing burning, tingling, or numbness across the dorsum or into the toes.
I'm managing diabetes, neuropathy, or a circulation condition!
Foot care is one of the most important — and most commonly delayed — components of diabetes management. Annual exams allow early detection of changes that, caught promptly, are manageable. Left undetected, they can become serious.
Annual exams, wound prevention & ongoing monitoring
A comprehensive diabetic foot exam evaluates circulation, nerve function, skin integrity, and nail health — providing early detection of changes that could progress to ulceration or worse if missed. Annual exams are covered by Medicare for diabetic patients. Dr. Gunter coordinates findings with your primary care and specialist teams.
Numbness, tingling, burning, or loss of sensation in the feet
Nerve damage causing reduced or altered sensation is a common complication of diabetes and other systemic conditions. Loss of protective sensation significantly increases the risk of undetected injury, infection, and amputation— making regular podiatric monitoring essential.
Cold feet, leg cramping with walking, skin color change, or slow-healing wounds on the feet or legs
Peripheral vascular disease occurs when narrowed arteries reduce blood flow to the lower extremities. Poor circulation impairs wound healing, increases infection risk, and can make minor foot injuries potentially serious — particularly in diabetic patients. Severe PVD often leads to gangrene and amputations if not addressed in a timely fashion. Early podiatric evaluation, coordinated with vascular care, is essential for protecting long-term foot health and limb viability.
Leg swelling, skin discoloration, or wounds near the ankle that are slow to heal
When the veins in the legs fail to return blood efficiently to the heart, fluid accumulates in the lower legs and feet — causing swelling, skin changes, and in advanced cases, venous ulcers near the ankle. Podiatric management focuses on wound care, compression guidance, and coordination with vascular specialists to address the underlying circulatory cause.
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Not Sure What's Causing Your Pain? Come In — That's What We're Here For.
You don't need a diagnosis before scheduling. Dr. Andrew Gunter, DPM will evaluate your symptoms, identify the cause, and explain your options in plain language. Whatever is affecting your feet or ankles — same-day appointments are available across San Antonio and surrounding communities. Most insurance plans accepted, including Medicare.
Call (210) 581-9800