Foot pain can come from joints, tendons, ligaments, nerves, inflammation, gout, arthritis, hypermobility, or chronic pain patterns. MPM evaluates the source of pain before recommending treatment.
Learn how Dr. Siefferman evaluates foot pain, identifies its underlying cause, and develops personalized treatment plans to help patients get back on their feet.
Our team organizes conditions and treatments into related zones of expertise to make it easier to explore the care paths most relevant to your symptoms and goals.
Use the zone tags above to browse dedicated pages for each focus area, including services, providers, and what to expect during treatment.
Hi, I’m Dr. Jason Siefferman, medical director, 91视频 and physiatrist. As a physiatrist, I’m trained to evaluate all joints, bones, muscles, nerves, and any dysfunction they may present with anywhere in the body, including the feet. So, we work closely with a number of podiatrists, but also we treat a lot of foot pain ourselves.
Our first step is to look mechanically at the foot and identify any possible mechanical reasons for pain. For example, are there flat feet? We see this frequently with hypermobility. As a result of hypermobility, the arch of the foot can be lost. Either the medial longitudinal arch or the transverse arch. And in either of these situations, what happens is the bones end up working and rubbing in a way that they’re not meant to, which can cause pain in the bones or the nerves that run between them.
As a result of this, then the ankle starts adapting, the knee starts adapting, the biomechanical chain adapts to the foot pain, and patients will often then begin experiencing pain in other parts of their bodies. So if there is foot pain, treating that as a primary process is essential.
Now, separate from primary issues within the foot, we also must consider more proximal neurologic causes. For example, there may be a nerve pinched in the back that’s actually causing the plantar fasciitis or the Achilles tendonitis. So if a patient comes in with Achilles tendonitis, plantar fasciitis, or other foot pain that has been persisting despite physical therapy, despite podiatry treatments, we’re really looking for what was missed. Is there a more proximal cause that helps us better understand holistically how this pain came to be and why it’s persisting? So, we see foot pain.
Foot pain, it’s fun to diagnose because it’s complex and you can know that we will dive deeply into primary intrinsic issues within the foot as well as more proximal issues that may be driving and contributing to foot pain.
When we approach foot pain, know that we look not just at the foot and all the complexities that exist within the foot, but we also look more proximally in the body to understand is there anything else that may be contributing to pain in the foot.
Foot pain is common, but it is not always simple. Pain may occur in the heel, arch, ball of the foot, toes, ankle, sole, or top of the foot. It may feel sharp, aching, burning, tingling, numb, electric, swollen, stiff, or unstable. Some patients have pain when walking or standing, while others feel symptoms at rest or at night.
At 91视频 (MPM), foot pain is evaluated through a diagnosis-first approach. The goal is to identify whether symptoms are coming from a joint, tendon, ligament, nerve, fascia, inflammatory condition, gout, arthritis, hypermobility, EDS, peripheral neuropathy, tarsal tunnel syndrome, Morton鈥檚 neuroma, metatarsalgia, chronic sprain, or another pain generator.
MPM evaluates persistent, recurrent, or complex foot pain by reviewing the pain location, walking pattern, injury history, nerve symptoms, swelling, prior imaging, prior orthotics, prior injections, and response to physical therapy or other care.
For patients looking for foot pain treatment in NYC, MPM considers whether symptoms are mechanical, inflammatory, tendon-related, nerve-related, joint-related, hypermobility-related, or part of a broader chronic pain condition. Care may include diagnostic ultrasound when appropriate, ultrasound-guided injections, steroid injections in selected cases, peripheral nerve blocks, regenerative options only when clinically appropriate, sympathetic blocks for selected pain patterns, and coordination with podiatry, orthopedics, rheumatology, neurology, or other specialists when needed.
The foot contains many small joints, tendons, ligaments, nerves, and soft tissue structures. Pain in one area can come from several possible sources. Ball-of-foot pain may come from metatarsalgia, Morton鈥檚 neuroma, arthritis, joint irritation, nerve compression, or altered mechanics. Burning foot pain may come from tarsal tunnel syndrome, peripheral neuropathy, nerve entrapment, spine-related nerve pain, or inflammatory nerve irritation.
This is why MPM does not rely on location alone. The evaluation looks at the full pattern, including movement triggers, walking tolerance, nerve symptoms, swelling, joint tenderness, tendon loading, inflammatory history, hypermobility, and prior treatment response.
Foot pain fits within MPM鈥檚 Musculoskeletal issues Zone of Expertise because symptoms often involve joints, tendons, ligaments, fascia, bone, soft tissue, walking mechanics, and load tolerance. In some patients, the pain is primarily mechanical. In others, it may involve nerve irritation, inflammation, gout, arthritis, hypermobility, EDS, or complex chronic pain.
MPM鈥檚 role is to identify what is driving the patient鈥檚 symptoms, then coordinate care around that finding. The goal is not simply to treat the painful area, but to understand why the pain is occurring and what treatment path is most appropriate.
I cannot say enough good things about 91视频. From the moment I walked in, I felt truly cared for and taken seriously. Dr. Nino Mikaberidze, Director of Rheumatology, is exceptional 鈥� knowledgeable, compassionate, and incredibly thorough. She takes the time to listen, explains every...
The best care I've received as a chronic pain patient. I traveled from out of state to visit 91视频 because I could not find knowledgeable doctors in my hometown for my hypermobility, and Ehlers-Danlos syndrome symptoms and comorbidities. Let me tell you, it was worth every travel e...
I was injured in a bicycle accident over 8 years ago. I鈥檝e suffered throughout the years since my accident with nothing seeming to work. PT, Yoga, lifestyle changes, NOTHNG! I finally made an appointment with Dr Kane and I鈥檓 feeling an improvement in my life. I no longer stay up all night in pain, a...
One of the best experiences, if not the best, I have ever had at the doctor鈥檚 office. From the front desk to the nurses to the PA assisting the doctor this was a great experience. Dr.Nino actually listened to me and came up with a game plan. Would recommend this practice to as many people as I could...
I have very unique & severe nerve pain from CRPS which has no known specific cure. Dr. Siefferman has a huge tool box, far greater than the other 23 Drs. I have seen. He saved me from jumping off a bridge and continues to help me with both treatments and advice. Dr. S. is in a different league!
After two years of searching and feeling lost and let down, I finally found real help at 91视频. With Dr. Siefferman, Adam Rosenberg, Dr. Mikaberidze, and the whole team, I feel heard, supported and understood. Every symptom is being considered and I鈥檓 finally getting answers with m...
Why is Dr Dr. Tayyaba Ahmed one of the top pevic Floor specialists - 1- She wants to know a full history of what led the patient to get to this point. 2 - She listens intensley to the patient 3- She does not rush you 4- Extremely skilled at giving pelvic floor injections 5- I thank my luck stars she...
The staff was friendly and helpful. Dr. Siefferman was thoughtful, listened, asked questions and proposed simple safe ways to come to further conclusions regarding my pain and discomfort. The office staff including Dr. Siefferman is responsive even after the initial in-person visit. Very pleased.
Dr. Siefferman is a brilliant provider. While my pain is still a work in progress, Dr Siefferman always gives me options and explains his reasoning behind things. He listens to my feedback and concerns. I never feel rushed; and am grateful he works to meet me where I am. I highly recommend him.
What a great find! They listen to me, I listen to them and the diagnosis is made and a plan developed to develop an approach to treat all of my chronic pain. I wish I could have discovered this type of treatment sooner. This doctor and group give me hope.
Chronic foot pain can come from many sources, including tendon injury, ligament sprain, joint irritation, arthritis, gout, metatarsalgia, Morton鈥檚 neuroma, tarsal tunnel syndrome, peripheral neuropathy, peripheral nerve entrapment, autoimmune inflammation, hypermobility, EDS, or altered walking mechanics. MPM evaluates the pain pattern before recommending treatment.
You should consider specialist evaluation when foot pain persists, worsens, limits walking, interferes with daily activities, causes numbness or tingling, follows an injury, or does not improve with orthotics, stretching, physical therapy, medication, or prior injections. Persistent pain deserves a structured evaluation to identify the true pain generator.
Ball-of-foot pain may be caused by metatarsalgia, Morton鈥檚 neuroma, joint irritation, arthritis, inflammation, tendon overload, nerve compression, or pressure-related mechanics. Some patients describe feeling like they are stepping on a pebble or marble. A careful exam helps determine whether the pain is coming from a nerve, joint, tendon, or soft tissue structure.
Morton鈥檚 neuroma usually involves irritation or thickening around a nerve between the toes, often causing burning, tingling, numbness, or a pebble-like sensation in the ball of the foot. Metatarsalgia is a broader term for pain and inflammation in the ball of the foot. The two can feel similar, so careful evaluation is important.
Yes. Tarsal tunnel syndrome involves irritation or compression of the tibial nerve near the inside of the ankle. It may cause burning, tingling, numbness, electric pain, or pain in the sole of the foot and toes. Similar symptoms can also come from peripheral neuropathy, spine-related nerve pain, or other nerve entrapments.
Yes. Peripheral neuropathy can cause burning, tingling, numbness, sharp pain, electric pain, sensitivity to touch, or symptoms that worsen at night. Neuropathy may be related to diabetes, autoimmune disease, vitamin deficiency, medication effects, chemotherapy, infection, or other causes. MPM evaluates neuropathic foot pain in context and coordinates with neurology or other specialists when needed.
Yes. Gout can cause sudden, intense joint pain, often in the big toe, though it can affect other joints in the foot or ankle. The joint may become swollen, red, hot, and very tender. Sudden severe foot pain, especially with swelling or redness, should be evaluated to distinguish gout from infection, fracture, inflammatory arthritis, or another urgent condition.
Yes. Autoimmune and inflammatory conditions can contribute to joint pain, tendon pain, enthesitis, swelling, stiffness, neuropathic symptoms, or inflammatory arthritis in the foot. Conditions such as rheumatoid arthritis, psoriatic arthritis, gout-related inflammation, enthesitis, and other inflammatory patterns may require rheumatology coordination.
Hypermobility and EDS can contribute to foot pain in some patients by affecting joint stability, ligament support, proprioception, walking mechanics, and tendon load. This may lead to recurrent sprains, instability, tendon irritation, joint pain, or compensatory muscle guarding. MPM evaluates hypermobility as part of the full clinical picture.
Diagnosis begins with a detailed history and physical exam. MPM reviews pain location, injury history, walking tolerance, swelling, numbness, tingling, joint tenderness, tendon loading, footwear or orthotic response, prior imaging, prior injections, and medical conditions such as gout, arthritis, autoimmune disease, neuropathy, EDS, or hypermobility. Diagnostic ultrasound may be used when appropriate.
Diagnostic ultrasound may help evaluate selected soft tissue, tendon, ligament, joint, and nerve-related causes of foot pain. It can be useful when symptoms suggest tendon injury, joint fluid, soft tissue irritation, neuroma-like pain, nerve entrapment, or other structures that can be assessed dynamically. Its value depends on the suspected diagnosis and the anatomy involved.
Treatment depends on the cause. Options may include activity modification, footwear or orthotic coordination, physical therapy coordination, medication management when appropriate, diagnostic ultrasound, ultrasound-guided injections, steroid injections in selected cases, peripheral nerve blocks, regenerative options for selected musculoskeletal conditions, or referral to podiatry, orthopedics, rheumatology, or neurology.
Foot injections or nerve blocks may be considered when the evaluation suggests a specific joint, tendon, soft tissue, or nerve-related pain generator. These procedures may be diagnostic, therapeutic, or both. They are not appropriate for every case of foot pain and require diagnosis-specific evaluation, risk discussion, and clinician supervision.
Foot pain should be evaluated urgently if there is sudden inability to bear weight, severe swelling, deformity, open wound, spreading redness, fever, a hot swollen joint, sudden severe pain, new numbness or weakness, color or temperature change in the foot, loss of pulses, diabetic foot wound, suspected infection, trauma, or rapidly worsening symptoms.
Before care begins, our team helps patients understand the practical side of treatment, including insurance verification, out-of-network benefits, cost-share estimates, self-pay options, and billing questions. We believe patients should have as much clarity as possible before moving forward.
If foot pain, burning, tingling, numbness, swelling, instability, or walking-related pain is affecting your life, MPM can help evaluate what may be contributing. Our diagnosis-first approach considers joints, tendons, ligaments, nerves, inflammation, gout, arthritis, hypermobility, neuropathy, and chronic pain patterns before recommending care. Request an appointment to discuss your symptoms and treatment options.
Foot pain can affect almost every part of daily life. Walking, standing, exercising, commuting, working, and even wearing shoes may become difficult. Some patients feel sharp pain with each step. Others feel burning, tingling, numbness, pressure, swelling, stiffness, instability, or the sensation of stepping on a pebble.
Because the foot is made of many small structures, pain can come from several different sources. A joint, tendon, ligament, nerve, fascia, blood flow issue, inflammatory condition, gout flare, arthritis, or neuropathy can each create foot pain. Sometimes more than one problem is present at the same time.
MPM evaluates foot pain through a diagnosis-first model. The goal is to identify the pain generator before choosing treatment.
Foot pain may appear in the heel, arch, ball of the foot, toes, top of the foot, sole, ankle, or outer foot. The location can offer clues, but it does not provide a diagnosis by itself.
Ball-of-foot pain may be related to metatarsalgia, Morton鈥檚 neuroma, arthritis, joint irritation, tendon overload, inflammation, or nerve compression. Heel pain may involve tendon, fascia, joint, nerve, or inflammatory contributors. Burning or tingling pain may suggest neuropathic involvement, but the source may be peripheral neuropathy, tarsal tunnel syndrome, nerve entrapment, or spine-related nerve pain.
The quality of pain also matters. Sharp pain, aching pain, burning pain, electric pain, numbness, stiffness, swelling, and instability point to different possible causes.
Pain in the ball of the foot is one of the most common reasons patients seek care. Metatarsalgia refers to pain and inflammation in the ball of the foot. It may be related to pressure, overload, footwear, foot mechanics, joint irritation, or activity demands.
Morton鈥檚 neuroma is different. It usually involves irritation around a nerve between the toes, often causing burning, tingling, numbness, or a pebble-like sensation under the ball of the foot. Some patients feel pain that worsens in tight shoes or improves when removing footwear.
Because these conditions can feel similar, MPM evaluates the location, nerve symptoms, tenderness, walking pattern, and prior response to orthotics or injections before recommending treatment.
Heel and ankle-region pain may come from tendon irritation, ligament injury, chronic sprain, joint irritation, nerve entrapment, inflammatory disease, or altered foot mechanics. Tendinopathy may cause pain with loading, walking, running, stairs, or pushing off the foot.
Chronic sprains may lead to persistent pain, instability, swelling, or recurrent injury. In patients with hypermobility or EDS, ligament laxity and altered proprioception may make sprains more frequent or recovery more complex.
Diagnostic ultrasound may be considered when the clinical question involves tendon, ligament, joint, or soft tissue structures that can be evaluated with ultrasound.
Foot pain can also be inflammatory. Arthritis may cause stiffness, swelling, joint tenderness, and pain with movement or weight-bearing. Gout can cause sudden, intense pain, often in the big toe, with redness, heat, swelling, and severe tenderness.
Autoimmune and inflammatory conditions can affect the foot through joint inflammation, tendon involvement, enthesitis, or nerve-related symptoms. Psoriatic arthritis, rheumatoid arthritis, autoimmune-related pain, and enthesitis can each create foot or ankle symptoms.
When inflammation is suspected, MPM may coordinate with rheumatology or other specialists. Pain procedures may help selected pain generators, but they do not replace immune-directed evaluation or treatment when inflammatory disease is present.
Tarsal tunnel syndrome involves irritation or compression of the tibial nerve near the inside of the ankle. It can cause burning, tingling, numbness, electric pain, or pain in the sole of the foot and toes.
Nerve-related foot pain may also come from peripheral nerve entrapment, peroneal nerve entrapment, peripheral neuropathy, lumbar radiculopathy, or complex regional pain syndrome. The symptoms may overlap, so the evaluation should consider the full nerve pathway from the spine to the foot.
Diagnostic ultrasound may be used in selected cases to evaluate nerve size, surrounding structures, or possible entrapment. Peripheral nerve blocks may be considered when the pain pattern supports a targeted nerve approach.
Peripheral neuropathy can cause burning, tingling, numbness, sharp pain, electric pain, sensitivity to touch, or symptoms that worsen at night. It may affect both feet or follow a broader nerve distribution.
Neuropathy may be related to diabetes, autoimmune disease, vitamin deficiency, thyroid disease, medication effects, chemotherapy, alcohol use, infection, or other causes. Some patients have neuropathic symptoms with normal or inconclusive imaging, which can be frustrating.
MPM evaluates neuropathic foot pain in context, including symptom distribution, medical history, prior testing, medication history, autonomic symptoms, and possible inflammatory contributors. Coordination with neurology, endocrinology, rheumatology, or primary care may be appropriate.
Patients with hypermobility spectrum disorder or Ehlers-Danlos syndrome may develop foot pain because the joints and ligaments may be less stable. This can affect walking mechanics, tendon load, balance, proprioception, and injury risk.
Hypermobility-related foot pain may involve recurrent sprains, tendon irritation, joint pain, arch strain, nerve irritation, or compensatory muscle guarding. The pain may shift, flare with activity, or persist despite orthotics if the underlying stability issue is not addressed.
MPM evaluates hypermobility as one part of the full clinical picture. Treatment may involve stabilization strategies, careful rehabilitation coordination, bracing or orthotic coordination when appropriate, and selective use of procedures only when a specific pain generator supports that plan.
Orthotics, stretching, and physical therapy can be helpful for many foot pain conditions, but they may not resolve pain when the diagnosis is incomplete. Persistent symptoms may mean that the pain is not only mechanical, or that more than one pain generator is involved.
For example, ball-of-foot pain may involve both joint overload and nerve irritation. Heel pain may involve tendon pain, nerve irritation, and inflammatory features. Burning pain may be treated as a local foot issue when the source is neuropathy or nerve entrapment.
MPM reviews prior treatments to understand what helped, what did not help, and what that response suggests about the pain source.
MPM begins with a detailed history and exam. The evaluation reviews pain location, onset, activity triggers, walking tolerance, injury history, footwear response, orthotic response, swelling, stiffness, numbness, tingling, weakness, color or temperature changes, prior imaging, and prior treatments.
The exam may assess tenderness, joint movement, tendon loading, ligament stability, nerve irritation, gait, strength, sensation, and signs of inflammatory or neuropathic involvement. Diagnostic ultrasound may be considered when appropriate for selected tendon, ligament, joint, soft tissue, or nerve questions.
If symptoms suggest gout, inflammatory arthritis, diabetic complications, vascular disease, infection, fracture, or progressive neurologic involvement, MPM coordinates care with the appropriate specialist.
Treatment depends on the diagnosis. Some patients need conservative care, activity modification, footwear changes, orthotic coordination, physical therapy, or medication management. Others may need targeted procedures when a specific pain generator is identified.
Ultrasound-guided injections may be considered for selected joint, tendon, soft tissue, or nerve-related pain patterns. Steroid injections may be used in selected cases when inflammation is a likely contributor and risks are appropriate. Peripheral nerve blocks may be considered when symptoms suggest a nerve-mediated pain generator.
Regenerative options such as PRP or prolotherapy may be considered only in selected musculoskeletal pain patterns after diagnosis, anatomy, severity, goals, and evidence are reviewed. These treatments are not routine for all foot pain.
For persistent neuropathic or complex pain patterns, advanced options such as sympathetic blocks, lumbar sympathetic blocks, dorsal root ganglion stimulation, or other advanced pain strategies may be considered only in carefully selected cases.
Foot pain may require coordination with podiatry, orthopedics, rheumatology, neurology, vascular medicine, endocrinology, or primary care. Referral may be appropriate when symptoms suggest fracture, infection, severe arthritis, diabetic foot complication, vascular disease, progressive nerve damage, severe deformity, systemic inflammatory disease, or a surgical condition.
MPM鈥檚 role is to identify pain generators, provide pain-focused evaluation and treatment when appropriate, and coordinate care when another specialty is needed.
Patients should seek urgent evaluation for sudden inability to bear weight, severe swelling, deformity, open wound, spreading redness, fever, a hot swollen joint, sudden severe pain, new numbness or weakness, color or temperature change in the foot, loss of pulses, diabetic foot wound, suspected infection, trauma, or rapidly worsening symptoms.
Foot pain can overlap with fracture, infection, vascular disease, diabetic complications, inflammatory arthritis, gout, nerve entrapment, peripheral neuropathy, spine-related nerve pain, tendon injury, ligament injury, and complex regional pain syndrome. Red flags should not be ignored.
MPM approaches foot pain through a diagnosis-first process. The goal is to understand whether the pain is coming from a tendon, joint, ligament, nerve, inflammatory condition, gout, arthritis, hypermobility-related instability, neuropathy, or a broader chronic pain pattern.
For patients looking for foot pain treatment in Manhattan or NYC, MPM offers a careful pain medicine perspective focused on precise localization, diagnostic ultrasound when appropriate, targeted image-guided care, nerve-related foot pain evaluation, inflammatory disease awareness, and coordination with the right specialists. Treatment is individualized and selected only after the likely pain generator is identified.
