5 Common Causes of Pain on the Outside of Foot When Walking

Are you experiencing sharp, aching, or throbbing pain along the outside of your foot? This type of discomfort, often felt along the fifth toe, the edge of the foot, or near the ankle, can be incredibly frustrating. Like many people, you might assume the pain is a simple issue with your shoe, or a localized problem with a bone or a callus.

While external factors can certainly aggravate the issue, they are rarely the root cause. The single biggest reason for pain on the outside of the foot is an underlying mechanical issue: your foot is twisting out or rolling inward too much when you walk. This is a condition known as pronation.

We will go through the five most common causes of pain on the outside of the foot, and most importantly, show you a reliable, in many cases, guaranteed way to alleviate it. We'll start at the front of the foot and work our way back, demystifying the pain and revealing the true mechanical problem.

What is Outside of Foot Pain?

The outside of your foot, or lateral aspect, includes structures like the fifth toe, fifth metatarsal bone, cuboid bone, peroneal tendons, and ankle ligaments. Pain in this area often arises from overuse, improper footwear, or underlying conditions that cause uneven weight distribution. When walking, your foot naturally pronates (rolls inward slightly) for shock absorption, but excessive pronation or supination (rolling outward) can lead to strain on the outer edge.

Common symptoms include:

Sharp pain during weight-bearing activities, such as walking or running.

Swelling, redness, or tenderness along the fifth metatarsal or ankle.

Numbness in the fifth toe indicates nerve involvement.

Increased discomfort after prolonged standing or on uneven surfaces.

If left untreated, this pain can radiate to the ankle, knee, or even lower back, as your body compensates by altering your gait. Now, let's start from the front and work our way back to identify the top causes.

5 Common Causes of Pain on the Outside of Foot When Walking

To understand the solution, you first need to understand the problem. The pain you feel is often a symptom of an underlying biomechanical issue, not the problem itself.

1. The Fifth Toe: Ingrown Nails, Calluses, and Fissures

Starting at the front of the foot, it is very common to experience issues with the fifth (pinky) toe. These can include:

Ingrown Toenails and Calluses: If your toenail is pressing into the skin or a hard callus is forming on the side or bottom of your toe, it's a direct sign of excessive friction. This isn't just about a poorly trimmed nail; it means your foot is twisting outward too much as you walk, causing the toe to constantly rub against your shoe.

Fissures: In the space between the fourth and fifth toes, many people develop painful fissures—cracks in the skin—due to constant sweating and a lack of proper airflow. This is a common issue for athletes and those with hyperhidrosis. Using a bit of tissue paper or cotton between the toes can absorb moisture and help the skin heal, while an antifungal powder can prevent infection.

The key takeaway here is that the problems with your fifth toe are a symptom. The real issue is the abnormal motion of your foot, which forces this tiny toe to bear pressure it was never meant to handle.

2. The Tailor’s Bunion

Just behind the fifth toe, at the head of the fifth metatarsal bone, a prominent bony bump can form. This is known as a Tailor's Bunion. It's similar to a regular bunion on the big toe, but it occurs on the opposite side of the foot.

A Tailor's Bunion is not just an abnormal bone growth. It’s caused by the foot flattening out, which widens the forefoot and pushes the head of the fifth metatarsal outward. When your foot twists out as you walk, this prominent bone constantly rubs against the inside of your shoe. While surgery is an option, a far better and less invasive solution is to use orthotics and proper footwear to correct the foot's mechanics.

3. Pain in the Fifth Metatarsal Bone

The fifth metatarsal is the long bone that connects your pinky toe to your mid-foot. Pain along this bone is a serious concern and can be caused by a variety of conditions:

Fractures: This is a common site for various types of fractures. An avulsion fracture occurs when an ankle sprain causes the peroneus brevis tendon (which attaches to the base of this bone) to rip a small chunk of bone away. A Jones fracture is a break in a specific area near the base of the bone, and stress fractures are hairline cracks that can develop from repetitive strain. These injuries require proper diagnosis and a significant amount of time to heal, often with casting and rest.

Peroneus Brevis Tendon Pain: Even without a fracture, the tendon itself can become inflamed and painful where it inserts into the base of the bone. This tendon, which runs along the outside of your ankle and leg, can be overused and strained if your foot is constantly twisting outward.

If you are experiencing sharp, localized pain in this area, especially after a specific event or with increased activity, it is crucial to consult a podiatrist for an accurate diagnosis.

4. The Cuboid Bone: A Misaligned Mid-Foot

Moving back to the mid-foot, you’ll find a small, square-shaped bone called the cuboid. If you feel pain directly on the bottom or top of this bone, especially when walking, you might have what's known as cuboid subluxation syndrome.

The cuboid bone is a key component of your foot's structure, but if your ligaments are weak or loose, this bone can easily shift out of place. When your heel is in motion, the cuboid can get "stuck" or misaligned, leading to localized pain. A skilled podiatrist can often perform a simple maneuver to "pop" the bone back into place, providing immediate relief.

5. Ankle and Peroneal Tendon Pain

At the very back of the foot, near the ankle, pain can stem from several issues:

Flat Foot (Pronation): The Number One Culprit. This is arguably the most common cause of pain on the outside of the foot. Your ankle has a joint called the subtalar joint. When your foot is in a neutral position, this joint is stable. However, when your foot pronates (flattens and rolls inward), it causes the bones on the outside of your ankle to jam and grind against each other. This grinding, caused by the foot's inward roll, creates immense pressure and pain on the outside of the ankle and heel.

Ankle Sprains: A sprain damages the ligaments on the outside of your ankle (ATFL, CFL, and PTFL). While the injury itself is painful, the chronic instability left behind can lead to long-term pain.

Peroneal Tendonitis: This is an inflammation of the peroneal tendons that run up the outside of your lower leg. These tendons work to stabilize your ankle. When your foot is constantly twisting outward due to pronation, these tendons are chronically over-strained, leading to significant pain and inflammation along the leg.

The Real Culprit: The Foot Twisting Out (Pronation)

As you can see, almost every common cause of pain on the outside of the foot—from calluses to fractures—is a direct result of an underlying biomechanical issue. The root cause is a foot that twists out or rolls inward excessively when you walk.

Let's break down the mechanics:

A healthy foot has a natural arch that provides stability.

When a foot pronates, the arch collapses and flattens out.

This collapse causes the heel to roll inward and the forefoot to widen.

This widening and outward twisting of the foot’s front end forces the fifth toe and the metatarsal bone to bump and rub against the side of your shoe.

At the same time, the subtalar joint at the ankle is forced to grind and jam, causing pain in the heel and ankle area.

This abnormal motion also overworks the peroneal tendons, leading to pain and inflammation all the way up the leg.

The solution, therefore, is not to simply treat the symptoms (the calluses or the ankle pain) but to correct the motion that is causing the pain.

The Guaranteed Way to Get Rid of Outside Foot Pain

So, how do you stop your foot from twisting out and correct your gait? The answer lies in a combination of three key solutions.

1. Ditch the Bad Stuff: Avoid Gel Pads

While gel pads and small cushions for your fifth toe might seem like a quick fix, they are often a waste of money. They can get sweaty and disgusting, and they do nothing to address the root cause of the problem. You might find temporary relief, but the rubbing and twisting will continue, and the pain will return.

2. Get the Right Gear: A Great Shoe and a Great Orthotic

The most effective way to address pronation and pain on the outside of the foot is to use a great shoe paired with a great orthotic.

A Great Shoe: Look for a shoe that provides excellent support and stability. The sole should be stiff in the bottom and in the back, but flexible in the front, where your toes bend. This rigidity prevents the foot from twisting out, while the forefoot flexibility allows for a natural, healthy stride.

A Great Orthotic: An orthotic (insole) is a game-changer. It works by providing the support that your foot's collapsed arch lacks. By lifting and supporting the arch, a good orthotic prevents the inward roll and the subsequent twisting of the foot. As a result, the pressure on your fifth toe, metatarsal, cuboid, and ankle is instantly relieved.

3. PCSsole Insoles: Your Path to a Pain-Free Stride

When it comes to choosing the right orthotic, the PCSsole insole can be the perfect solution. PCSsole insoles are designed with features that directly combat the mechanical issues causing pain on the outside of the foot.

Robust Arch Support: The core of a PCSsole Universal Arch Support insole is its strong arch support. Lifting your arch prevents the foot from flattening and rolling inward, which is the root cause of the problem. This instantly takes pressure off the outer edge of your foot.

Deep Heel Cup: A deep, U-shaped heel cup in a PCSsole insole helps to stabilize your heel and ankle. This feature prevents excessive inward rolling of the subtalar joint, stopping the painful bone-on-bone grinding.

Firm Structure: Unlike soft, flimsy insoles, a PCSsole insole is built with a firmer structure that provides a stable foundation. This rigidity works in tandem with a good shoe to keep your foot in a neutral, healthy position, preventing the twisting motion that causes so much pain and discomfort.

By using a PCSsole insole in a supportive shoe, you are not just cushioning your foot; you are actively correcting its alignment. This is the difference between a temporary fix and a permanent solution.

When to Seek Professional Help?

While a great shoe and a high-quality orthotic like PCSsole can solve most cases of outside foot pain, sometimes professional intervention is necessary. If your pain persists, or if you suspect a fracture, nerve issue, or a misaligned cuboid bone, it's time to visit a podiatrist. A podiatrist can provide a definitive diagnosis through an examination and imaging, and may recommend treatments such as physical therapy, custom orthotics, or bracing.

Ultimately, understanding the true cause of your pain is the first step toward getting rid of it. By focusing on correcting the underlying biomechanics of your foot with the right tools—a great shoe and a supportive insole like PCSsole—you can finally walk without pain and get back to living your life to the fullest.