9 Causes of Foot Pain at Night & How to Manage It

After a long, tiring day, there’s nothing quite like sinking into bed for a restful night’s sleep, unless that blissful peace is interrupted by nagging foot pain.

Unfortunately, many people experience foot pain just as they’re ready to relax and slip into the dream world. The good news? Understanding the causes can lead to simple solutions, whether it’s choosing the right footwear or other effective remedies.

So, we set out to explore the nine most common reasons for foot pain at night and suggest ways that can help you finally get the rest you need.

 

Introduction to pain in feet at night

When foot pain strikes at night, it doesn’t just disrupt your rest, it can also affect your overall health and daily life. Persistent lack of quality sleep can lead to decreased cognitive function, irritability, and overall fatigue, making it harder to tackle daily tasks effectively.

To help address this and learn how to prevent foot pain, here are the most common underlying causes of foot pain at night.

 

Overview of why foot pain occurs at night

Several factors contribute to foot pain at night, influenced by both physiological and psychological changes. As we wind down, changes in circulation and hormonal shifts can make nocturnal foot pain feel more intense and noticeable [1].

Certain conditions, like neuropathy—often seen in people with diabetes—can lead to burning sensations and other discomforts that seem to ramp up at night. This can be because, as distractions fade and the temperature drops, these sensations become more pronounced [2]. Plus, stress and the body’s natural cooling process can stir up more discomfort, making it even harder to get a good night’s sleep [1].

 

9 Common causes of pain in feet at night
Cause #1: Morton’s neuroma

Morton’s neuroma involves the thickening of the tissue surrounding the nerves between the toes, often leading to a burning or tingling sensation. This condition can become more painful at night, and is commonly caused by wearing tight or high-heeled shoes, which compress the nerves [1][3].

Treatment may include switching to well-fitting Morton’s neuroma shoes, using orthotic shoe inserts, and possibly steroid injections to reduce inflammation.

 

Cause #2: Plantar fasciitis

This condition occurs when the plantar fascia, the thick tissue running from the heel to the front of the foot, becomes inflamed. Common causes include high arches, flat feet, obesity, or excessive standing.

The pain from plantar fasciitis is often felt at the bottom of the heel. Although it tends to be worse in the morning after getting out of bed, pain can also be present at night, especially if you’ve spent long hours on your feet [1].

Managing this condition typically involves rest, icing, anti-inflammatory medications, stretching, and wearing supportive plantar fasciitis shoes.

 

Cause #3: Sciatica

Sciatica is caused by irritation or compression of the sciatic nerve, which runs from the lower back down to the feet. This pinched nerve can lead to a shooting or dull pain that may be felt in the feet, especially at night. Factors such as herniated discs, pregnancy, or muscle spasms can exacerbate this pain on the side of the foot.

Treatment options include physical therapy, stretching exercises for pain relief, anti-inflammatory medications, and in some cases, surgery [1].

 

Cause #4: Fibromyalgia

Fibromyalgia is a chronic medical condition that causes widespread pain, including in the feet. The pain can be exacerbated at night due to lower levels of cortisol, an anti-inflammatory hormone [3]. This condition also often includes symptoms such as fatigue and sleep disturbances.

Treatment focuses on managing symptoms with medications, physical therapy, and lifestyle changes.

 

Cause #5: Diabetes

Diabetes can affect how well blood flows to your feet, leading to less oxygen reaching your muscles. This reduced circulation can cause aching and discomfort, which might feel worse at night.

Treatment focuses on improving circulation with regular exercise, a healthy diet, and by avoiding smoking. In more serious cases, doctors may recommend treatments like angioplasty or surgery to boost blood flow and provide pain relief[1]. Diabetes can also lead to diabetic neuropathy.

 

 

 

 

Cause #6: Peripheral neuropathy

Peripheral neuropathy involves damage to the nerves outside the brain and spinal cord, affecting the feet and legs. This nerve damage can cause sensations such as tingling, burning, or sharp pain, which can worsen at night [4]. Achilles tendinitis may also develop alongside nerve damage, causing discomfort that worsens with foot movement or pressure.

Peripheral neuropathy can be caused by diabetes, physical injuries, or excessive alcohol consumption. Treatments often include medications, physical therapy, and managing underlying conditions.

 

Cause #7: Lifestyle factors

• Poorly fitting shoes. Shoes that are too tight, high heels, or those lacking proper support can lead to various foot problems, such as callouses, bunions, and general soreness. Ensuring proper shoe fit and support is essential. We will dive deeper into this point later in the article.
• Excess weight. Carrying extra pounds adds pressure on your feet, increasing the risk of chronic pain and foot injury. Managing weight through a balanced diet and regular exercise can reduce strain on the feet.
• Overuse. Engaging in activities that put excessive stress on your feet, like prolonged standing or running, can cause leg pain and overuse injuries such as a stress fracture and Achilles tendinitis.
• Neglecting foot care. Proper foot hygiene and care are crucial to meeting your foot care needs. Regularly inspect your feet, keep your nails trimmed, and ensure your feet are free of infections and fungus.

 

Cause #8: Foot structure

The structure of your feet can significantly impact nocturnal foot pain. People with high arches or flat feet often face more challenges, as high arches can cause excessive pressure on specific areas of the foot, while flat feet may result in uneven weight distribution, contributing to pain and fatigue. Achilles tendon problems, such as tendinitis, can also be more common with foot structure issues, leading to additional strain at night.

Properly fitting shoes for flat feet or shoes built with arch support can alleviate some of the discomfort related to these structural issues and reduce nighttime pain.

 

Cause #9: Pregnancy-related cramps

Pregnancy can alter calcium metabolism, leading to cramps in the feet and legs during the night. These leg cramps are due to increased demand for calcium and changes in how the body processes this mineral [3].

Gentle stretching and increasing calcium intake through diet or supplements can help ease these foot cramps.

 

How shoes can help manage nighttime foot pain

Choosing the right footwear, such as orthopedic shoes for women or men’s orthopedic shoes, can make a big difference in managing and preventing foot pain from standing all day. Here's how the right shoes can support your feet and potentially prevent pain:

 

• Prioritize comfort and support
  Comfortable shoes reduce the strain on your feet and help prevent muscle irritation that can lead to pain at night. Look for options that offer a good balance of support and softness.

Insoles and arch supports can provide additional support where your feet need it most. These additions can help distribute pressure more evenly and reduce stress on specific areas of the feet. This can be especially beneficial if you have conditions like plantar fasciitis or Morton’s neuroma.

 

• Avoid high heels and narrow shoes

High heels and narrow shoes can exacerbate foot pain by putting pressure on your toes and the balls of your feet. Opt for shoes with a wider toe box and a lower heel to prevent issues like bunions and cramps.

 

• Try impact-absorbing soles

Shoes with quality cushioning soles help absorb impact and reduce strain on your feet. This can prevent foot discomfort and pain from building up throughout the day, which might otherwise carry over into the night.

 

• Ensure proper fit

Properly fitting shoes are crucial. Shoes that are too tight can compress nerves and muscles, leading to pain and discomfort. Make sure your shoes fit well and provide enough space for your feet to move comfortably.

 

Benefits of choosing the right footwear

By paying attention to these key design features, you can choose shoes that support your feet throughout the day and help you sleep better at night.

 

• Orthotic insoles

As Dr. Steven Gershman, DPM, explains, "orthotic insoles help to transfer a substantial portion of body weight to the arch, reducing pressure on the heel and ball of the foot." This redistribution not only relieves foot pain but also minimizes stress on the knees, hips, and lower back, offering overall body alignment support.

 

These orthopedic insoles typically feature strong arch support, which is essential for countering excessive pronation, a common cause of foot and heel pain.

 

• Special soles

Lightweight soles with a mild rocker bottom design and layered structure can absorb impact and make foot motion smoother and easier. This reduces strain on your feet and minimizes muscle fatigue, alleviating pain that might persist into the night.

 

• Wide toe box

According to Dr. Gershman, a shoes with wide toe box allows for more room for your toes to move freely, helping to prevent painful foot issues such as bunions or hammertoe deformities. He also notes that this extra space can reduce the risk of cramping and discomfort, which can interfere with your ability to rest comfortably at night.

 

• Variety of widths

“Unlike standard shoes, orthopedic shoes come in various widths to accommodate different foot shapes and sizes”, says Dr. Gershman. Whether your feet are narrow or extra-wide, wearing wide-width shoes with the correct width ensures a comfortable fit and helps prevent excessive pressure and discomfort. This is one reason why orthopedic shoes are the best type of footwear for addressing foot pain.

 

• Extra depth

Footwear with extra depth is designed to accommodate custom orthotics or thicker insoles, providing a more relaxed fit. This added space is especially helpful if you have conditions like bunions or hammertoes, as it minimizes pressure points that could lead to aching feet or irritation.

 

• Protective interior

Shoes with soft, smooth interiors prevent pressure points and irritation, especially for those with sensitive feet. Seam-free designs can protect against rubbing, which is particularly helpful for conditions like diabetes or neuropathy.

 

• Stretch uppers

Shoes with stretchable uppers adapt to the shape and contours of your feet, reducing pressure on common problem areas like bunions and hammertoes. According to Dr. Gershman, this flexibility is particularly useful if your feet tend to swell during the day, as "the stretch adjusts itself, giving you the feeling of a perfect fit at any time of day."

 

Finding relief from foot pain with the right footwear

Understanding the causes of foot pain at night is the first step toward finding relief. Whether you're dealing with common foot problems in your 50s or experiencing discomfort after a long day, choosing the right footwear can make a significant difference. Investing in shoes for foot pain, like our women's shoes for foot pain or men's shoes for foot pain, can provide the support and comfort needed to alleviate pain. By taking proactive steps like selecting proper footwear and practicing good foot care, you can learn how to prevent foot pain and enjoy more restful nights.

 

Sources:

[1] Lois Zoppi, medically reviewed by Angela M. Bell, MD, FACP. Why do my Feet Ache at Night?. MedicalNewsToday. December 21, 2020. Accessed September 19, 2024.

https://www.medicalnewstoday.com/articles/aching-feet-at-night

 

[2] Angelica Bottaro (medically reviewed by Sarah Richards, DPM). Burning Feet Syndrome. Very Well Health. June 04, 2024. Accessed September 19, 2024.

https://www.verywellhealth.com/burning-feet-5214915

 

[3] Kimberly Holland, medically reviewed by Angela M. Bell, MD, FACP. 8 Causes of Foot Pain at Night and How to Treat Them. Healthline. April 7, 2021. Accessed September 19, 2024.

https://www.healthline.com/health/foot-pain-at-night

 

[4] Luigi Ferini-Strambi. Neuropathic Pain and Sleep: A Review. Springer Link. 4 November 2017. Accessed September 19, 2024.

https://link.springer.com/article/10.1007/s40122-017-0089-y