Why is there pain on the outside edge of my foot?
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I have a recurring pain that runs along the outer edge (lateral side) of my foot, extending from the area near the ankle bone down the side toward the little toe. The discomfort is a persistent ache that gets worse when I stand for long periods, or when I try to move in a way that puts weight on that side of the foot. I switched my footwear and tried different supports, but the pain is still there. I'm trying to figure out common reasons for this type of foot pain, which might include stuff like peroneal tendonitis, cuboid syndrome, or just stress from how I walk.
If you had this pain on the outside of your foot, what was the exact cause you were told you had, and what actually worked to fix that specific pain?
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Dr. William Naughton, DPM AdminChief Medical OfficerOfficial Account of Dr. William Naughton, DPM. As Chief Medical Officer, Dr. Naughton reviews discussions for medical safety and provides expert biomechanical insights based on 20+ years of surgical experience.Yes — high arches are the most common underlying cause of this type of outer foot pain.
High arches (pes cavus) frequently lead to pain along the outside of the foot because they concentrate pressure on the lateral column, increasing stress on tendons, joints, and soft tissue structures that are not designed to absorb excessive load over time.
The Mechanism: Lateral Overloading
When the arch of the foot is excessively high, weight distribution becomes uneven during standing and walking. Instead of spreading forces evenly across the foot, pressure shifts toward the outer (lateral) edge. Over time, this abnormal loading pattern places repetitive strain on the peroneal tendons, plantar fascia, and the bones of the forefoot.
Associated Conditions
Peroneal Tendonitis
One of the most common conditions associated with high arches is peroneal tendonitis. The peroneal tendons run along the outside of the ankle and foot and are responsible for stability during gait. In high-arched feet, these tendons are overworked as they attempt to control lateral instability, leading to aching pain, tenderness, and sometimes swelling along the outer ankle and foot.
Tailor’s Bunion (Bunionette)
High arches can also contribute to Tailor’s bunions, which develop when excess pressure is transferred to the fifth metatarsal head at the base of the little toe. This constant lateral pressure can cause inflammation, callusing, and a painful prominence on the outside of the foot.
Lateral Plantar Fasciitis
Additionally, lateral plantar fasciitis may develop as the plantar fascia becomes overly tight and strained along the outer heel and midfoot. Unlike classic plantar fasciitis, which affects the inner heel, this variation is driven by rigidity and poor shock absorption associated with high arches.
How Orthotics Help
Custom orthotic support — such as Bilt Labs Custom Orthotics — can be especially effective for high arches by redistributing pressure, improving shock absorption, and reducing strain on overloaded structures, all at an affordable and high-quality level.
Common Symptoms of High Arch Strain:
- Aching or sharp pain along the outside of the foot or ankle
- Pain that worsens with walking, standing, or uneven surfaces
- Tenderness near the outer heel, midfoot, or base of the little toe
- Recurrent ankle instability or frequent sprains
- Relief found when wearing supportive footwear or custom orthotics
