As a much used movement organ of humans, the feet are exposed to a constant load. Pain in the back of the foot is usually due to pathological changes in the tarsal and tarsometatarsal joints, which are held by numerous ligaments and vision. But also stiffening of the toe joints can cause discomfort on the back of the foot.

Urgent clarification by an orthopedic specialist is required if the symptoms persist for more than three days, in conjunction with other illnesses. If signs of inflammation such as overheating, swelling and redness are present, and cause a significant restriction of movement, it should urgently consult a specialist.

Symptoms and possible causes

Depending on the underlying cause, the severity of the pain may vary.

Pain on the back of the foot is often felt by stinging, which is often increased depending on the load.

Pain is rarely the only symptom. For example, if there is an inflammation, the foot is swollen, overheated, reddened and tender painful. Symptoms such as tingling and numbness occur when there is severe pressure or nerve injury.

Pain when rolling

Bone fractures in the metatarsal can cause severe pain when rolling or make the rolling of the foot impossible. Often a traumatic event, such as kinking or strong footing, precedes. The treatment of metatarsal breaks may require surgery in some cases.

Pain during unwinding is also a typical symptom of hallux rigidus. These are arthrotic changes in the metatarsophalangeal joint. Increasing joint stiffness causes discomfort, especially in the rolling motion of the foot. Often there are chronic wear processes in the event of incorrect or overstressing. The underlying disease of gout can also cause osteoarthritis.

In addition to pain when unrolling, the metatarsophalangeal joint often feels swollen and warm. There are increasing problems when putting on shoes. The symptoms worsen in many cases in cold temperatures.

In therapy of hallux rigidus conservative measures such as physical treatments, shoe inserts and anti-inflammatory drugs are prescribed ( see insole for a hallux rigidus). Surgical therapy involves joint-preserving and non-articular operations.

Pain while walking

Stinging pain is often seen in conjunction with swelling and redness on the back of the foot. These are inflammatory changes on the tarsal joints. Various causes come into question for this.

As a result of unusual physical exertion, a so-called bursitis may develop. The heavy pressure and high stress cause the bursa to inflame, which normally causes the surfaces between the joints to glide smoothly. In order to prevent chronic bursitis, the joints should be protected until the symptoms disappear completely. Not only the bursae are a possible place of origin for a painful event after overloading, but also the tendon sheaths.

When an outgrowth arises, one speaks of a so-called ganglion, which is colloquially called "Überbein". However, a sagging of the tendon sheath on the instep is one of the rare variants of a ganglion. In addition to the protection of the foot, cooling and anti-inflammatory drugs are used in the treatment.

Deviations in shape of the foot arch also cause pain when walking. The healthy foot is a stable construct consisting of a longitudinal and transverse arch, which distributes the body weight evenly. This construct is held in shape by ligaments and tendons. In particular, the tibialis posterior tendon contributes significantly. A kink-lowering foot often occurs in adults when the tension of this tendon decreases ( see buckling foot). The following instability of the arch of the foot causes pain when walking, which occur preferentially on the inner edge of the foot and pull to the inner ankle. Also on the outer edge of the foot back complaints occur. A kinked foot is in most cases conservatively treated with shoe inserts and physical measures.

The tarsal arthrosis is also called osteoarthritis of the Lisfranc joint and causes stress-dependent pain on the instep. One possible cause of osteoarthritis is a recent fracture of tarsal bones. Only when conservative treatment measures fail, a tarsal arthrodesis is performed. The joints are stiffened surgically.

The anterior tarsal tunnel syndrome may be associated with pain on the back of the foot. Heavy pressure on the anatomical tunnel, through which nerves and vessels run, can cause both load-dependent and load-independent pain. Important is the exact explanation of the cause. The therapy can be conservative and surgical.

Pain after kinking

Pain on the back of the foot rarely occurs in isolation after a kinking trauma. The painful symptoms usually show a greater spread. The foot swells due to tissue injury. In some cases, the ankles are also affected. Blue discolouring areas indicate bleeding from torn vessels. The traumatic event may result in ligament contraction, tearing, or even complete ligament tear on the foot. Even fractures in the metatarsals are possible and should be ruled out urgently. For severe complaints and persistent symptoms, a doctor should be consulted for further clarification. In the acute situation, it is recommended to raise the foot, to cool it and to apply pressure using a compression bandage.

Burning / stinging pain

A persistent sharp, stabbing pain is seen in conjunction with gout, rheumatism and other metabolic diseases. On the other hand, pushing off a nerve is accompanied by a burning, sometimes dull pain that is often accompanied by numbness and tingling. This is the case, for example, with tarsal tunnel syndrome.

Inflammations, such as the bursa, are primarily noticeable with stinging discomfort. The pain often occurs when the person starts walking. Tendinitis also shows a similar symptoms.

The so-called tearing pains occur not only in acute inflammations, but also in connection with arthrotic changes of the small ankles.

Sudden sharp and stabbing pain is characteristic of discomfort following bone injury resulting from a traumatic event such as kinking.

Also a Rash on the dorsum can cause pain in this area.

Gout - typical symptoms

Gout is a metabolic disease in which uric acid crystals are first deposited in the joints and subsequently lead to kidney damage. Often the big toe joint is affected. In the acute state, typical signs of inflammation, such as swelling, redness and pain on contact with the foot, appear. In the following years, a hallux rigidus, an increasing joint stiffening by arthrosis develops. Those affected complain of discomfort when rolling the foot and pain in the back of the foot.
In the treatment of chronic gout one tries to lower the elevated uric acid level by a coordinated diet. At the same time so-called uricosuric and uricostatic drugs are used for drug reduction.


Pain on the back of the foot is, in most cases, associated with pathological changes in the metatarsophrenia. In addition to traumatic events, acute inflammation of the bursa after overstressing or chronic wear of the joints in the form of osteoarthritis can cause discomfort. The pain is often stress-dependent and is often perceived as stinging and / or burning. If a chronic malposition of the foot or a nerve is affected, the pain can also be of dull quality. Depending on the cause, conservative and operative measures are used.

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