Your feet carry you everywhere every day. But you may not think of your feet until they hurt and when they do, you are desperate for relief. To seek appropriate treatment, you need to know the underlying problem that is causing pain in your foot.

 

Understand Thy Feet

Our foot is the cornerstone of your lower extremity. It is a complex structure that comprises an intricate anatomical web of 26 bones, 33 joints, ligaments, tendons, muscles, nerves, blood vessels, soft tissues, and lymphatics. It provides efficient shock absorption and propulsion for us to walk and run.

The bones of the foot form two crossing arches. The longitudinal arch courses along the length of the foot, and the transverse arch courses along the width. Arches fo the foot controls the amount of ground force transmitted into the body.

Joints and ligaments connect the bones of the foot. The muscles of the foot as well as the plantar fascia (a hard, sinewy tissue), provide secondary support to the foot. The fat pads in the foot absorb impact and support weight-bearing. Tendons are fibrous, cord-like bands of connective tissue that anchor muscles to the bone to provide synchronized alignment.

Thy Feet

Structure

Description

MetatarsalsThe long bones located at the ball of the foot.

Stress fractures commonly occur here.

CalcaneusA heel bone that lies at the back of the foot, beneath the ankle.

It provides balance and side-to-side movement of the back of the foot.

Plantar FasciaA band of the fibrous ligament at the sole that runs from the heel to the forefoot.

It acts like a shock-absorbing bowstring.

It supports the arch in the foot.

Achilles TendonAlso called the calcaneal tendon.

It connects the heel bone (calcaneus) to calf muscles (gastrocnemius and soleus).

Bursae (small sacs of fluid) cushions the Achilles tendon.

When the calf muscles flex, the Achilles tendon pulls on the heel to allow movement.

Despite its strength, it is also vulnerable to injury due to the limited blood supply and the high tensions placed on it.

Posterior Tibial TendonCourses down your inner ankle (medial) and attaches to the bottom of your foot near the medial arch.

It supports your foot’s natural arch and gives stability when walking.

Tarsal TunnelA narrow space on the inner side of the ankle next to the ankle bones.

Its encased with the flexor retinaculum (a thick ligament) that protects and maintains it.

Peroneal TendonIt runs down the outer side of the ankle across the bottom of the foot.

There are two peroneal tendons in each leg, which run:

(i)                  Side by side down the fibula (lower leg bone)

(ii)                Behind the lateral malleolus (bony lump on the outside of the ankle)

Assists with weight-bearing and stability.

Extensor TendonIt joins the muscles on the front of the lower leg to the toes.

It pulls the toes up, away from the ground.

SesamoidThe bones near your big toe, connected by tendons
BursaA fluid-filled sac that lines many joints.

Helps tendons and muscles to move in alignment with the joint

 

Disease or injury to these foot structures can cause pain. In return, the foot reacts by changing the way it functions to reduce the pain. These biochemical compensations may prevent the normal movement of the foot and cause further injury.

 

What’s Causing the Foot Pain

Foot pain can result from injuries, inappropriate footwear, and tendonitis. Identifying the cause can help you prevent the pain and treat it accordingly.

Injuries

Injuries such as ligament sprains, bruises, fractures, and muscle strains may result from acute or repetitive stresses to the foot.

Sprain. A sprain occurs when the ligament of the foot is overstretched. Tenderness and looseness of a joint are symptoms of a sprain. Sprains may lead to chronic pain, joint instability, and deformity.

Stress fracture is linked to repetitive stress, strenuous exercise, or heavy manual labor. It usually occurs in the metatarsal bones or the rear foot. They are also called “march fractures” because a minor often causes it (but chronic) stress from excessive walking, running or marching.

Strain. A strain occurs when muscles are stressed to the point where there is a tearing of the muscle fibers. It may result from overstretching, overuse, overloading, or even being lacerated. Swelling, tenderness, loss of function, and discoloration are common symptoms of strain.

Trauma. Trauma to the foot can ensue from acute or repetitive injury. Microtrauma can be used by running on uneven surfaces or by wearing shoes with poor force absorption. Repeated trauma can result in other bony overgrowths (spurs). Blunt-force injury to the foot can cause bruising, breaking of the skin, or even bone fracture. Trauma to the toenail can cause blood pooling and eventual loss of the toenail.

Bruises (Contusions). Bruises are most commonly the result of a direct impact injury. You may experience pain, swelling, and discoloration in the affected area.

Wrong Footwear

Poorly-fitting shoes can cause injuries such as bunions, corns, calluses, blisters, and bruises in the forefoot or the heel. Avoid shoes that are too high-heeled or tight. Improper, non-sport-specific shoes can also lead to foot pain.

Tendonitis

Tendonitis is inflammation around a tendon. Symptoms include pain, swelling, and stiffness. You might feel pain with activity, which usually dissipates with rest, only to return when you resume movement.

Foot tendonitis is most commonly due to overuse – such as vigorous activity. If a tendon is made to overwork, damage and micro-tears may develop in the tendon.

Furthermore, abnormal foot structure – high arches or flat foot – can exert stress on the foot tendons, resulting in tendonitis. Trauma – e.g., ligament strain – can also cause tendonitis.

Tendonitis can occur in several places around the foot. Achilles tendonitis – inflammation of the Achilles tendons – is one of the most common forms of foot tendonitis.

 

Heel Pain

Pain in the heel of the foot is one of the most common complaints. It has many possible causes. Although heel pain is sometimes caused by systemic illness, such as rheumatoid arthritis, it is usually a local condition that affects only the heel.

The pain is usually felt underneath the heel or behind it. Sometimes, it can occur at the side of the heel.

Symptoms

Possible Cause

A sharp pain between your arch and heel that worsens when you start walking. Pain dissipates with rest.

You may have difficulty raising your toes off the floor.

Plantar Fasciitis
Dull aching pain, redness, and swelling.

Pain in the back of the heel or at the underside.

Heel Bursitis
Overgrowth of the heel bone.

Commonly occurs in teenagers.

Heel Spur
Nerve pain that radiates from the back of the foot.Tarsal Tunnel Syndrome
Sudden sharp pain and swelling.

A popping or snapping sound upon injury.

Heel Fracture
Pain in the back of the heel and ankle.

Pain in the calf when standing on tiptoes.

Achilles Tendon Injuries
Heel pain aggravated by rigorous activity such as walking, running, or jumping.Sever’s Disease
It feels like you’re walking on pebbles.Stone Bruise

 

Plantar Fasciitis

Plantar Fasciitis

One of the most common causes of the bottom of foot pain, plantar fasciitis is the inflammation of the plantar fascia. Stabbing pain and tenderness is usually felt in the bottom of your foot near the inner side of the heel, between the heel and the base of the toes. It can affect the heel, arch, or both.

The severe, throbbing, or stabbing pain of plantar fasciitis is felt upon weight-bearing after rest. Often, the pain is worst in the morning when you’re getting out of bed or after prolonged rest. As you warm up your plantar fascia with movement, the pain gradually dissipates – but might return after long periods of standing. Pain can also be triggered by prolonged exercise or sitting. In more severe cases, pain may increase when the arch is overstressed.

Plantar fasciitis is often due to a faulty foot structure. For example, your heel arch is abnormally high or flat. Poorly-fitting shoes or high impact activities can also exert undue tension on the plantar fasciitis.

Plantar fasciitis is common in runners. Also, people who are overweight may have an increased risk of plantar fasciitis.

If left untreated and strain persists, a bony protrusion may develop where the plantar fascia connects the heel bone, forming a heel spur. Hence, it’s essential to treat the condition promptly before it worsens.

Switch to orthotic footwear or invest in shoe insoles. Gentle stretches can also help relieve pain from plantar fasciitis.

Usually, physical therapy and supervised rehabilitation are sufficient to treat severe cases of plantar fasciitis [1]. But if the pain doesn’t dissipate, your doctor may give you an injection with a combination of steroid and local anesthetic.

 

Heel Bursitis

Bursitis refers to inflammation of a bursa. In the heel, bursitis may cause pain in the back of the heel or at the underside. As the day progresses, the pain usually worsens.

Heel bursitis may be due to abnormal foot structure that causes an abnormal gait (way of walking). Wearing shoes with poorly cushioned heels can exert pressure that could also trigger heel bursitis. It can also result from landing awkwardly on the heels.

Heel Spur

Your sore heel may be due to heel spurs. Heel spurs occur when calcium deposits gradually buildup on the underside of the heel, where the plantar fascia attaches to the heel bone.

The pointed bony overgrowth may result from strains on foot muscles and ligaments, tearing of the membrane, or overstretching of the plantar fascia that encapsulates the heel bone.

Heel spurs under the sole and at the back of the heel are associated with plantar fasciitis and Achilles tendonitis, respectively.

Athletes are especially susceptible to heel spurs. Regular jumping and running are common culprits. As with plantar fasciitis, poorly-fitting footwear can aggravate the condition.

Heel spurs do not always come with symptoms. But you may feel intermittent or chronic pain – especially while walking, running, or jogging – if inflammation is present. In general, the pain is not due to the heel spur itself but the associated soft-tissue injury. People with high arches or flat feet are more likely to experience painful heel spurs.

Tarsal Tunnel Syndrome

The entrapment of the posterior tibial nerve of the foot is known as Tarsal tunnel syndrome. It is caused by anything that compresses against the posterior tibial nerve.

A person with flat feet may develop the condition because the outward tilting of the heel of the fallen arch can produce strain and compression on the nerve. An abnormal enlargement on the tarsal tunnel – such as ganglion cyst, swollen tendon, bone spur – can also compress the nerve. Systemic conditions such as arthritis and diabetes are common risk factors.

You may feel shooting or burning pain that radiates from the instep (arch) and heel areas into the soles of the feet. Sometimes the symptoms may appear suddenly. They may be aggravated by overuse of the foot, such as in prolonged walking, standing, or exercising. Symptoms might intensify at night while sleeping.

Seek treatment promptly if any of the symptoms of tarsal tunnel syndrome emerge. If left untreated, the condition may progress and culminate in permanent nerve damage.

Heel Fracture

Heel Fracture

A heel fracture typically results from high-impact injuries, such as an accident. Not only could your heel bone break – it could also shatter.

You may experience heel pain, bruising, swelling, and trouble walking. There may be a visible lump or gap at the site of the fracture. The fracture can be accompanied by dislocation of heel joints. In such circumstances, the joint ligaments are disrupted in addition to a break in the bone.

Eating fruits and vegetables rich in carotenoid may reduce the risk of fracture [2].

 

Achilles Tendon Injuries

Achilles Tendon Injuries

Achilles tendon injury causes pain in the back of the heel. Sometimes, the Achilles tendon does not function normally due to microscopic tears which cannot heal by themselves. As the Achilles tendon receives overbearing tension over time, the tendon weakens and becomes painful.

Achilles injury tends to happen when you start darting as you push off or lift your foot. For instance, a sprinter might experience Achilles pain at the start of a race as he surges off the starting block with a sudden increase in intensity. The abrupt action can be too overbearing for the Achilles tendon to handle.

Achilles Tendonitis

Achilles tendonitis causes heel and calf pain. It is an acute and inflammatory condition that most commonly affects runners. The pain may occur within the Achilles tendon itself or at the point where it attaches to the heel bone.

The tighter your calf muscles, the more tension is placed on the Achilles tendon. Exercising in footwear that is worn-out or poorly-fitted can also cause Achilles tendonitis. Achilles tendon pain may also be due to the development of bony overgrowths, such as a bone spur.

Along with swelling and pain, there may be tenderness, warmth, and morning stiffness in both the heel and calf. The symptoms ease as you warm and stretch your foot.

To prevent Achilles tendonitis, you should avoid placing excessive stress on the tendons. Gradually increase the intensity and duration of your physical activity, so that the Achilles tendon can adapt to the workload. Also, choose your footwear carefully – make sure it provides adequate cushioning for your heel.

Achilles Tendinosis

Achilles tendinosis describes a chronic degeneration of the Achilles tendon that results from untreated tendonitis. With Achilles tendinosis, the collagen fibers that make up the Achilles tendon deteriorate or break down. This deterioration causes not only pain but also the formation of scar tissue, which may lead to permanent thickening. Despite the thickening, then the tendon is weakened and vulnerable to further injury or rupture.

Achilles Tendon Tear (Rupture)

If you overstretch your Achilles tendon, it can tear or rupture. For Achilles tendon to rupture, a sudden force needs to be exerted on the tendon, as often seen during strenuous physical activity. For example, it may occur when you push off the foot with great force to jump or pivot during a basketball match. That said, even a fall or trip may be enough to tear the Achilles tendon.

Torn Achilles is not uncommon in healthy, active individuals. Its most commonly observed in middle-aged individuals between 30 to 50 years of age.

If your Achilles tendon ruptures, you might hear a pop, followed by immediate sharp pain and swelling in the back of your heel. There may be a visible gap in the area where the tendon is torn. With a complete rupture, you may only ambulate with a limp. You may not be able to run, climb stairs, or stand on your toes. Bruising and swelling around the back of the eel may occur.

Surgery or long-term immobilization is required to treat a torn Achilles. The latter option may be recommended for patients who are older, less active and have a higher risk or surgery and anesthetic. Immobilizing and maintaining the ankle in a slightly downward flexed position helps bring the ruptured tendon ends closer together to facilitate healing. After several weeks of immobilization, the cast is removed, and a small heel lift would be inserted into the shoe to prevent excessive stress on the Achilles tendon.

Sever’s Disease

Sever’s disease is the most common cause of heel pain in child and teenage athletes, especially those aged 7 to 15 years.

It is due to the overuse and repetitive microtrauma of the growth plates of the heel bone.

Stone Bruise

A stone bruise refers to a deep bruise in the fat pad or the ball of the foot. It’s often a result of impact injury but can also happen when you step on a hard object. You may feel like you’re walking on pebbles. These symptoms will gradually go away on its own.

 

Ball of Foot Pain

Symptoms

Possible Cause

Pain, swelling, bruising after intense or repetitive exercise.Metatarsalgia
Sharp, burning, or shooting pain near your toes (ball of the foot).

It feels like a lump or small pebble under your foot.

Morton’s Neuroma
Redness and swelling, dull aching pain.Bursitis or Arthritis
Hard bony lump near the big toe.Bunion

 

Metatarsalgia

Metatarsalgia is a form of stone bruise that causes pain and inflammation in the metatarsals – i.e., n the ball of your foot.

Poorly-fitting shoes are the usual culprit. But you might also get it from strenuous activity, such as jumping or running.

Morton’s Neuroma

A Morton’s neuroma refers to a benign thickening of the nerves in the ball of the foot (between the third and fourth toes). It is due to irritation, inflammation, or trauma to the affected nerve.

Morton’s neuroma occurs more frequently in women, possibly as a result of wearing high heels or narrow shoes. The poorly-fitted shoe may compress and rub against the foot, which then causes the nerve to thicken. Other potential causes are high-impact athletic activities such as running or jogging.

People with foot deformities – flat feet, high arch, bunions, hammertoes – are at higher risk of developing Morton’s neuroma.

Typical symptoms include burning or shooting pain when walking. Another common symptom is a vague feeling of pressure beneath the toes like a sock was bunched up underneath them or as though you are walking on a marble. The pain often radiates to the toes. You may also feel tingling or numbness.

The symptoms begin gradually. At first, they occur only when wearing poorly-fitted shoes or performing vigorous activities. The symptoms may dissipate temporarily by removing the shoe or by resting. Over time, the symptoms may progressively worsen and persist for several days or weeks. It becomes more intense as Morton’s neuroma enlarges and the structural deformities become permanent.

You may experience pain relief by switching to lower-heeled shoes with wider toe boxes. Other treatments include arch supports, shoe modifications, and cortisone injections to decrease nerve inflammation.

Bursitis

Bursitis refers to inflammation of a bursa. In some cases, bursitis may occur at the ball of the foot as a result of wearing high heels or narrow toe shoe. As the day progresses, the pain usually worsens.

Arthritis

Rheumatoid arthritis is a progressive and disabling autoimmune disorder. It can cause painful inflammation in the joints, accompanied by foot misalignment. The symptoms can be felt elsewhere in the body.

 

Arch Pain

Pain in the arch of the foot has multiple causes. It may be accompanied by inflammation and burning sensation. The pain may also radiate to the ball and heel, or even on the top of the foot.

Depending on the underlying cause, pain may worsen when walking or standing, or with physical activity. Pain may also intensify in the morning when you wake up.

Symptoms

Possible Cause

Pain on the inner side of the foot.Posterior Tibial Tendon Injury
No gap (arch) under feet; feet pressed flat on the floor.Flat Feet
Pain when standing, running, or walking.

Arch instability and stiffness.

High Arch
Pain on the outer side or back of the foot.Peroneal Tendonitis
Pain, swelling, redness, or bruised toe.

Hurts to walk.

Sprained Foot

 

Posterior Tibial Tendon Injury

Posterior tibial tendon injury causes pain in the inner side of the foot. It occurs when the posterior tibial tendon is torn or inflamed. As a result, the tendon may be unable to provide support and stability for the arch of the foot. Over time, the arch of the foot will gradually collapse and splay outward, resulting in flat foot.

You would usually feel pain when you start to push off through your foot. You may feel that are unable to stand on tiptoes, such as after a traumatic injury.

Posterior tibial tendon injury is more common in women and people over 40 years of age. Additional risk factors include obesity, diabetes, and hypertension.

You may need orthotics and braces to allow the inflammation to resolve. If the injury is severe, surgery may be necessary to remove the inflamed tissue or repair the tear.

Flat Foot

Flat feet is also known as fallen arches. It occurs when the arches of the feet flatten out when you are standing or walking. The outer edge of your heel touches the ground first, and then the foot rolls inward toward the arch. Pain and swelling may occur with activity.

Adult-acquired flatfoot (posterior tibial tendon dysfunction) occurs when you have a problematic posterior tibial tendon. The arch may extend along the back of the calf and inner-side of the ankle. Overpronation may also flatten your feet and lead to pain in the arch of the foot over time.

You can correct your flat feet with shoe inserts or stability shoes. Ankle brace and physical therapy may also help. If it’s severe, you may need surgery to treat the condition.

High Arch

A high arch is also known as cavus foot. The instability of the foot could be an inherited structural abnormality. It could also be caused by neurological conditions, such as Charcot-Marie-Tooth disease, stroke, or cerebral palsy.

Pain is most commonly felt when standing or walking. You may also be more prone to ankle sprains.

Orthotic shoe inserts or shoes with ankle supports may help relieve pain. Look for high-topped shoes.

Peroneal Tendonitis

Peroneal tendonitis causes pain on the back and outer side of your foot. High arched feet and a history of recurring ankle sprains may be associated with peroneal tendonitis.

Pain and swelling can come on suddenly (acute) or gradually (chronic). It happens when there is an increased load and overuse of the tendons, causing friction against the bone. The pain is usually felt when standing or pushing off through your foot. It is particularly common in runners, as their feet are more likely to roll outwards, causing friction between the tendon and bone.

Sprained Foot

A sprain occurs when the ligament of the foot is overstretched. Tenderness and looseness of a joint are symptoms of a sprain. Sprains may lead to chronic pain, joint instability, and deformity.

Toe Pain

Symptoms

Possible Cause

Hard bony lump near the big toe.Bunion
Your toe bends in the middle, creating a hammer-like appearance.Hammertoe
The toe points up or down and is unable to straighten.Claw Toe
Pain, stiffness, swelling, and popping noise.Arthritis
Sudden pain, stiffness, red or hot swollen skin around the toe joint.Gout
Difficulty strengthening or bending your big toe.Sesamoiditis
Pain and swelling due to overuse.Turf Toe
You feel pain or swelling around the toenail.

Nail curls into the toe.

Ingrown Toenail
You feel pain, tingling, and numbness when you’re cold or stressed.

Toes appear discolored.

Raynaud’s or Chilblain
Point tenderness and looseness of a joint.Toe Sprain
Pain, swelling, redness, or bruised toe.

A noticeable gap in the injured area.

Toe Fracture
Stiff big toeHallux Rigidus

 

Bunion

A bunion is a bony overgrowth that forms on the joint along the edge of the foot, next to the underside of the big toe. It forms when your big toe curves in toward the second toe, forcing the joint of the big toe to bulge. It may also form on the side of the pinky toe, too – that’s called a bunionette. The spot where bunion forms may become red, sore, and callused.

The most common cause of bunions is tight, narrow shoes. The pressure that the shoe place on the big toe can push it toward the adjacent toe. Bunions may also develop due to a foot structural abnormality, overstress, or arthritis.

Try changing to proper footwear or wear shoe inserts. The use of foam padding may help protect the bunion from irritation. A toe separator can also help create space between the toes. If the bunion causes severe pain and deformity, surgery might be necessary to realign the toes.

Hammertoe

A hammertoe occurs when your toe bends in the middle, creating a hammer-like appearance.

It happens because your toe muscles are firing in an over-intense manner through the gait cycle, causing your toes to elevate in a hammer-like orientation. This causes a toe to stick out or bulge above the others. When you run, the bulge causes friction, and corn, calluses, or blisters may develop.

Poorly-fitting shoes that are too short can cause hammertoes. You should wear shoes with a wide, deep toe bed instead. Splitting and corrective footwear may also help.

Claw Toe

Claw toe is when the toe points up or down and is unable to straighten. It may result from nerve damage from diseases such as diabetes or alcoholism, which weakens the muscles in the foot.

Without special footwear to accommodate your affected toe, you may develop irritation and calluses.

Arthritis

Arthritis may occur in joints of any part of the body – including the toes. Several types of arthritis can cause pain in the toes.

Sometimes, the protective cartilage between the bones wears away, causing the bones to rub against each other. This causes inflammation, pain, and swelling.

Toe arthritis is caused by inflammation in the toe joint. It often attacks the big toe, but the other toes may also be affected.

Prior traumatic injuries, such as a broken or sprained toe, can lead to arthritis. Rheumatoid arthritis, osteoarthritis, and gout may also be to blame. Women who wear tight, high-heeled shoes for extended periods may also be at risk for toe arthritis.

You may feel pain in the big toe or the other toes. The pain ranges from a deep, achy feeling to a sharper, stabbing sensation when you try to move. Over time, the cartilage between joints may wear off and deplete the synovial fluid, causing your joints to become stiff. With less cushioning and support, the joints become resistant to movement and make it difficult for you to walk. There may also be visible swelling and redness due to the joint inflammation.

Gout

Gout in the foot is the buildup of urate crystals in foot joint, causing intense pain and inflammation, particularly at the base of your big toe. The affected joint is hot, tender, and swollen.

Gout usually becomes symptomatic suddenly, often in the middle of the night. Sudden gout attacks can often wake you up in the middle of the night with a fiery sensation in your big toe. The pain is likely to be severe within the first few hours of onset. As the pain subsides, joint discomfort may last for a few following days.

It happens when your body has an abnormally high level of uric acid. Your body produces uric acid during the breakdown of purines – which is found in high amounts in organ meat, poultry, steak, and seafood. When your body overproduces uric acid or if your kidneys fail to excrete it, the uric acid can accumulate and form sharp needle-like urate crystals around the joint.

Men are more susceptible to gout attacks because they produce more uric acid than women. The likelihood of developing gout may also increase if you have a family history of gout or if your diet is high in purine.

You can manage gout flare-ups by moderating your diet. Avoid foods that are rich in purines or low in carbohydrate (e.g., keto diet). Low intake of carbohydrate can induce the release of ketones into the bloodstreams, which in turn can increase the level of uric acid. Also, avoid alcohol consumption because it may interfere with the removal of uric acid from the body.

Medications can address the symptoms of gout attacks, prevent future flares, and reduce the risk of gout complications such as kidney stones. Commonly used medications include non-steroidal anti-inflammatory drugs (NSAIDs), colchicine, or corticosteroids.

Sesamoiditis or Sesamoid Fracture

Sesamoiditis occurs when the tendons surrounding the sesamoids become injured and inflamed. On the other hand, a sesamoid fracture is a break in the sesamoids. Pain in and around the area of the big toe is a significant symptom. Both conditions are common with dancers and runners.

Turf Toe

Turf toe refers to an athletic injury in which the tendon and joint capsule at the base of the big toe are strained. It occurs when the big toe bends backward beyond its normal range of motion, typically as a result of a sprain or strain. Turf toe may also be a type of sesamoiditis or a sesamoid fracture.

You may experience pain or cramp in the affected toe. Physical therapy for turf toe involves managing the inflammation around the toe and gently restoring mobility of the affected toe.

Ingrown Toenail

Pain, pressure, and redness at the edge of a toenail are symptoms of an ingrown toenail. It happens when the side of the nail grows through or into the skin, which can result in infection if left untreated.

Poorly-fitted shoes are the most common cause of ingrown toenails. Other causes include improperly trimmed nails, repeated trauma to the foot, or overcrowding of the toes. To prevent ingrown toenails, you need to keep your toenails properly trimmed.

Raynaud’s or Chilblain

Raynaud’s disease causes your toes to feel numb and cold in response to cold temperatures or stress. The arteries narrow and almost completely shut down, thereby limiting blood circulation to the affected areas (vasospasm).

Chilblains, on the other hand, are the painful inflammation of narrow blood vessels in your skin. It occurs in response to repeated exposure to cold – but is unaffected by freezing air. Chilblains can cause itching, red patches, inflammation, and blistering.

Toe Sprain

You may experience a toe sprain when you jam or stub your toe. Joint looseness and tenderness can be indicators of a sprain. Ligament injury is often accompanied by a sense of instability when walking or exercising. If you don’t have a fracture, the symptoms should dissipate within days.

Toe Fracture

A fracture or break can happen in any of the toe bones. A single blow or twist can cause injury to the arch. It may also be caused by repetitive trauma that can result in a stress fracture. There may also be a distinguishable lump or gap at the site of a fracture. Fracture is a common cause of posttraumatic arthritis due to additional injury to the joint cartilage.

Hallux Rigidus

Hallux rigidus refers to a stiff big toe. It’s a type of arthritis at the base of the big toe. Symptoms of pain and stiffness may worsen over time.

 

Top of Foot Pain

Symptoms

Possible Cause

Pain, swelling, and stiffness of the tendon that run along the top of the foot.Extensor Tendonitis
Painful overgrowths that form along the joints in your feet along by the toes.Bone Spur
Pain, prickling, or numbness that can spread from the feet into the legs.Neuropathy

 

Extensor Tendonitis

Extensor tendonitis occurs on top of the foot. The pain is usually felt around the midpoint, along the tendons on the dorsal (top) of the foot responsible for pulling foot upwards.

Its usually caused by poorly-fitting shoes that rub against your foot, such as when you run uphill. The pain gradually builds as use of the injured tendon persists. The tendon may also become weaker, making it difficult to move your toes or to push off from your toes when you run, jump, or dance.

People with high-arched feet are particularly susceptible to extensor tendonitis.

Bone Spur

Foot overgrowth is termed bone spur. Bone spur commonly occurs due to the pressure placed on the toe bones. It most likely appears on top of the mid-foot.

The chances of developing a bone spur on the foot increase with age. Activities that can trigger bone spurs include running, exercise, and dancing. Other causes include foot injury, obesity, and wearing tight shoes. Osteoarthritis can sometimes cause a bone spur on top of the foot  – whereby the body produces an overgrowth to compensate for the gradual deterioration of the cartilage.

Neuropathy

Nerve pain in the foot is peripheral neuropathy – herein termed as “neuropathy.” It refers to damage of the peripheral nerves, beyond the spinal cord and brain. These damaged nerves cannot effectively transmit neural messages between the brain and other parts of the body, including your feet. It can happen anywhere in the feet.

The pain can be burning, numbing, stinging, or feel like electricity while you sleep. Symptoms may worsen gradually over the years, of you might not even notice it, thinking its just a side effect of aging.

Neuropathy is the most common cause of diabetic foot pain – termed “diabetic neuropathy.” You can reduce your risk of developing diabetic neuropathy by keeping your blood sugar levels under control.

Because the numbness may prevent you from feeling pain, heat, or cold in your feet, it’s imperative to inspect your feet regularly. Otherwise, you may not even notice when you get a cut, ulcer, or gangrene on your foot. Ignorance is especially dangerous for people with diabetes because their wound-healing capabilities are impaired.

 

Self-Care Remedies

Foot pain usually responds well to self-care measures. Restore your happy feet with the following recommendations.

Rest

Rest is crucial for healing – it prevents any further stress to the foot. Restrict activity as much as possible. Staying off the foot encourages healing and prevents further injury.

If the pain in your feet is severe, you may need to use foot or ankle supports to rest the affected area. Your doctor may prescribe a walking boot to keep your foot and ankle immobilized so that you are not exerting too much weight on foot.

You should rest for a few weeks – the exact healing rate depends on the severity of the condition. Limit walking or any other high-impact activities such as jogging, aerobic exercise, or dancing to avoid aggravating the injury. Switch to a low-impact activity (e.g., swimming) that would not strain the foot. Other examples of low-impact alternatives include biking, ski training, step exercises, and elliptical exercises.

Ice

Icing the area – either with ice wraps or ice massagers – may ease pain and inflammation.

Apply the ice for 20 minutes. Take a break for at least 40 minutes before icing again. Repeat the icing sessions 3-4 times daily.

Alternatively, you can soak your foot in cold water mixed with Epson salt.

You may alternate between cold and heat therapy for maximum therapeutic effect. Unlike ice, heat therapy can ease stiffness.

Compression and Elevation

You can reduce swelling by compressing the foot and keeping it elevated above the heart.

Apply ankle supports, wraps, or compressive elastic bandages if necessary.

Footwear

Ditch those high heels or tight shoes.

Instead, wear appropriate shoes with low heels and wide toe box. If you have a low arch, you may benefit extra paddings – such as arch supports and heel pads. An elevated shoe insert can also relieve strain on the back of the heel. These functional orthotic devices can help restore the biomechanics of your foot and relieve pressure on the nerve.

Replace your shoes every six months.

 

Pain Medication

Over-the-counter pain medications – such as acetaminophen (Tylenol), ibuprofen (Advil), or naproxen (Aleve) – can help relieve pain and swelling. Take these medications about half an hour before activity. If the symptoms of foot pain are severe and persistent, your doctor might prescribe you stronger pain killers.

 

Alternative Medicine

Ultrasound Therapy

Ultrasound therapy – or vibration therapy – is the use of sound waves to treat injuries. The basic principle is to stimulate the affected area with sound waves.

Extracorporeal Shockwave Therapy (ESWT) is an expensive and intensive cousin of conventional ultrasound therapy. It uses high-energy shock waves that can disrupt tissue, such as calcifications in foot tendons.

TENS Therapy

Transcutaneous electrical nerve stimulation (TENS) delivers tiny electrical impulses to the nerves through small electrodes placed on your skin. It can help prevent pain signals from reaching your brain.

Several forms of TENS therapy specifically targets foot pain, including conductive socks.

TENS may relieve nerve pain on foot when combined with other treatments. It can also help reduce stress on the heel. Although small and painless, TENS doesn’t work for all types of foot pain.

Cold Laser Therapy

Cold laser therapy – also known as low-level laser therapy – is a medical-grade therapeutic laser that can effectively reduce pain and inflammation.

The cold laser works by enhancing blood circulation and stimulating the injured cells to repair itself. Some pain relief may be felt immediately after treatment, but you may need to use it continuously for optimal pain relief.

Massage Therapy

Foot massage is an effective method to relieve foot pain. A foot massage can also improve blood circulation to the affected area, enhance lymphatic waste removal, and relax tense foot muscles.

Massage can be done manually or with a mechanical device, such as a foot massager. Deep tissue massage, such as neuromuscular therapy, provide precise treatment directed at specific structures in the foot to address the problem.

Before you consider a foot massage, remember to consult a doctor to rule out any broken bones or acute damage.

Hydrotherapy

Contrast foot bath, sauna, ionic baths, and hydrotherapy pools are examples of hydrotherapy treatments. You may add in Epson salt and aromatherapy oils for more relief.

Acupuncture

Acupuncture may help relieve foot pain, especially neuropathy and heel pain. Keep in mind that you may not experience immediate relief with acupuncture. You may need more than one session.

Exercise

Once the symptoms improve, incorporate exercises that strengthen the muscles and improve balance and motion. If you’re can avoid stress and overuse of the affected foot for a few days, you may be ready to start some strengthening and stretching exercises within a week. Physical therapy may also be beneficial.

Eccentric strength training involves a slow release of weight after raising it. Stretching and strengthening exercises can help regain tendon strength and flexibility, as well as a healthy range of motion.

 

Prevention

Warm-Up

One of the best ways to prevent foot pain is to do warm-up and stretching exercises before strenuous activity. Increase your time and intensity gradually when you start a new physical activity

Proper Footwear

Healthy feet rely on properly-fitted shoes that provide support and don’t irritate the top of the feet.

Use an appropriate shoe for the activity for which they are designed. In other words, if you run, invest in a good pair of running shoes. If you have flat feet, wear orthotic shoes or insoles designed to provide arch support.

Also, maintain a healthy weight to reduce pressure on the foot.

 

The Bottom Line

Foot pain is a common problem that plagues many people. Identify where the pain is felt – is it in the heel, arch, toes, or ball of the foot? Narrow down to the specific cause so that you can treat it accordingly.

Your recovery period will depend on the duration and severity of the pain. Full recovery takes, on average, six months with appropriate treatment.

Seek medical attention if the foot pain is not relieved with self-care or if it interferes with your daily activities.