Common Foot Issues: Causes, Symptoms and When to See a Podiatrist

Foot problems are more common than most people realise. An estimated one in four Australians will experience significant foot pain at some point in their life, yet many delay seeking help, assuming the pain will pass.

Sometimes it does. Often it doesn't. And the longer certain conditions are left untreated, the more complex and difficult to manage they become.

This guide walks through the most common foot issues, explains what causes them and what symptoms to look for, and helps you understand when it's time to stop managing on your own and get a professional opinion.

Quick summary

• The most common foot issues include plantar fasciitis, ingrown toenails, bunions, flat feet, Achilles tendinopathy, Morton's neuroma, hammer toes, and corns or calluses.
• Many people live with foot pain unnecessarily because they assume it will resolve on its own. Often, it won't.
• Early intervention typically means less invasive treatment and faster recovery.
• Penrith Podiatry Clinic manages complex and persistent foot conditions that other clinics refer on, including surgical cases.

Plantar fasciitis and heel pain

Plantar fasciitis is the most frequently diagnosed foot condition in Australia. It involves inflammation of the plantar fascia, the thick band of connective tissue running along the underside of the foot between the heel bone and the toes.

What it feels like:

• Sharp, stabbing pain at the base of the heel, especially with the first steps in the morning
• Pain that eases after walking but returns after long periods of standing or activity
• Tightness or aching through the arch of the foot
• Increased discomfort after sitting for extended periods

Who gets it? Plantar fasciitis is particularly common in runners, people who stand for long hours (teachers, healthcare workers, retail staff), those who are overweight, and adults aged 40 to 60. Flat feet, high arches, and tight calf muscles all increase the risk.

What actually works? The good news: the vast majority of plantar fasciitis cases resolve without surgery. Evidence-based treatment includes a structured stretching programme, custom orthotics to correct the underlying biomechanics driving the load, shockwave therapy for persistent cases, and ultrasound-guided injection therapy for stubborn presentations that haven't responded to conservative care.

At Penrith Podiatry Clinic, heel pain is assessed with a full biomechanical evaluation before any treatment is planned. We want to understand why your plantar fascia is under load, not just treat the symptom.

Ingrown toenails (onychocryptosis)

An ingrown toenail occurs when the edge of the nail grows into the surrounding skin, causing pain, swelling, redness, and in many cases, infection. The big toe is most commonly affected.

Common causes include:

• Cutting nails too short or rounding the edges
• Wearing tight or narrow footwear
• Genetic predisposition to curved nail shape
• Trauma or injury to the toe
• Excessive sweating (hyperhidrosis)

Conservative vs surgical treatment. Minor ingrown toenails can often be managed with correct nail-cutting technique and footwear changes. Where the nail is significantly ingrown, infected, or recurring, a minor surgical procedure called a partial nail avulsion (PNA) is the most effective solution. This is performed under local anaesthetic in-clinic, takes around 30 minutes, and permanently removes the offending nail edge.

Don't leave it. An infected ingrown toenail can spread to surrounding tissue and, in people with diabetes or compromised circulation, can become a serious medical issue. If the toe is red, warm, and discharging, seek assessment promptly.

Bunions (hallux valgus)

A bunion is a bony prominence that forms at the base of the big toe when the joint becomes misaligned. The big toe drifts toward the second toe, forcing the metatarsophalangeal joint outward. The condition is more common in women but affects men too.

Symptoms to watch for:

• A visible bony bump at the side of the big toe joint
• Redness, swelling, and tenderness around the joint
• Difficulty finding comfortable footwear
• Restricted movement in the big toe
• Callus formation under the second or third metatarsal

Conservative management

• Wide-fitting, supportive footwear
• Custom orthotics to offload the joint
• Padding and splinting
• Joint mobilisation and strengthening
• Anti-inflammatory injection therapy

Surgical management

• Indicated when conservative care fails
• Osteotomy to realign the metatarsal
• Managed by a Registered Specialist Podiatric Surgeon
• Detailed pre-operative planning and post-op follow-up
• Available in-house at Penrith Podiatry Clinic

Bunions are progressive. They don't resolve on their own, and delaying treatment generally means more complex management later. Early review gives you the most options.

Flat feet and high arches

The arch of the foot acts as a natural shock absorber. When it's significantly lower or higher than normal, it alters the mechanics of every step you take, creating compensatory strain in the foot, ankle, knee, hip, and lower back.

Flat feet (pes planus). Flat feet occur when the arch collapses fully to the ground when standing. This can be flexible (the arch appears when not weight-bearing) or rigid. Symptoms include aching along the inner foot and ankle, fatigue during prolonged standing or walking, and in some cases, knee or lower back pain.

High arches (pes cavus). A high arch concentrates pressure on the heel and ball of the foot rather than distributing it evenly. This leads to clawing of the toes, instability, and a heightened risk of stress fractures, lateral ankle sprains, and metatarsalgia (forefoot pain). High arches are sometimes associated with neurological conditions and warrant thorough clinical assessment.

Orthotic therapy is one of the most effective tools for managing both flat feet and high arches. Custom-prescribed orthoses correct the foot mechanics driving the symptoms, rather than simply cushioning the foot.

Achilles tendinopathy

The Achilles tendon connects the calf muscles to the heel bone and absorbs significant load with every step. Tendinopathy develops when the tendon is repeatedly loaded beyond its capacity, causing tissue degeneration and pain.

Key symptoms:

• Pain and stiffness at the back of the heel, especially in the morning
• Thickening or nodular change along the tendon
• Pain that increases with running or jumping and eases with rest
• Tenderness when pinching the tendon

There are two main types: insertional tendinopathy (where the tendon attaches to the heel bone) and mid-portion tendinopathy (a few centimetres above the heel). Treatment differs between the two, which is one reason why a clinical assessment matters rather than self-managing with generic advice from the internet.

Treatment may include a graded loading programme (heavy slow resistance training), shockwave therapy, heel lifts, orthoses, and in resistant cases, ultrasound-guided PRP injection to support tendon healing.

Morton's neuroma

Morton's neuroma involves a thickening of the tissue around one of the nerves leading to the toes, most commonly between the third and fourth metatarsal heads. It's not technically a tumour, despite the name. The result is nerve compression that produces characteristic symptoms.

What patients describe:

• A feeling of standing on a pebble or a fold in a sock
• Burning, sharp, or tingling pain in the ball of the foot
• Numbness or shooting pain into the toes
• Symptoms that worsen in narrow footwear and ease when barefoot

Conservative treatment includes footwear modification, metatarsal padding, orthotics, and ultrasound-guided corticosteroid injection. When conservative measures fail, surgical excision is an option, managed by our specialist podiatric surgical team.

Hammer toes and claw toes

A hammer toe occurs when the middle joint of a toe becomes flexed and fixed, causing the toe to resemble a hammer. Claw toes involve flexion at both the middle and end joints. Both conditions frequently develop secondary to bunions, flat feet, or ill-fitting footwear worn over many years.

Problems they cause:

• Corns and calluses on the tops of the affected joints (from shoe friction)
• Pain when wearing closed footwear
• Difficulty finding comfortable shoes
• In rigid deformities, pain even when barefoot

Flexible hammer toes (those that can still be manually straightened) respond well to splinting, padding, and footwear advice. Rigid hammer toes may require surgical correction. The earlier the condition is assessed, the more conservative the treatment options available.

Skin and nail conditions

Not all foot problems involve the joints or tendons. Skin and nail conditions are extremely common and, while often dismissed as cosmetic, can cause real discomfort and in some patients carry significant health risks.

• Corns and calluses: thickened skin from repeated pressure or friction. Corns have a hard central core and are often painful; calluses are broader and often painless initially. Managed by debridement and offloading the pressure point.
• Fungal nail infections: cause thickened, discoloured, brittle nails. Often dismissed as cosmetic but can spread and worsen. Treated with topical or oral antifungals, or laser therapy, and important to address in diabetic patients.
• Cracked heels: dry, thickened skin around the heel border that can crack deeply enough to bleed and become infected. A risk factor in diabetic patients requiring monitoring, managed with debridement and appropriate emollient use.
• Plantar warts (verruca): caused by the human papillomavirus (HPV) and often mistaken for corns due to location on the sole. They range from single lesions to mosaic clusters, and are treated with cryotherapy, caustic agents, or surgical excision.

When to see a podiatrist

A useful rule of thumb: if foot pain has lasted more than two weeks, it warrants a professional opinion. Beyond that, certain signs should prompt a same-day or next-day appointment.

Book promptly if you experience any of the following: sudden severe foot or ankle pain after an injury, an open wound on the foot that isn't healing, signs of infection (spreading redness, warmth, pus), loss of sensation or circulation in the foot, foot pain combined with diabetes or peripheral vascular disease, or symptoms that have already been assessed and treated elsewhere without improvement.

Penrith Podiatry Clinic offers same-day and next-day bookings for priority presentations. For complex or recurring cases, we welcome referrals from GPs, sports physicians, physiotherapists, and orthopaedic surgeons, and we return detailed case reports to the referring practitioner on request.