Types of foot pain – What you need to know

Life will definitely not be easy if ‘that’ part of your body which carries almost all of your body weight, is in pain. You may not realize how important it is, to have a painless body until there is some sort of discomfort, troubling you. It will definitely reduce the quality of life and keep you on bed for many days.

Foot- Yes, it is what we are talking about! Painful feet can be really disturbing even in the simplest form of severity since they are the weight carrying structures of our body. Therefore, it is very important to identify the signs and symptoms related to the foot pain you are having and the exact location, in order to identify where the problem lies.

Heel pain

The pain arising in heel can be a common feature of the condition known as Plantar Fasciitis, which is defined as an inflammation or irritation of the ligaments (plantar fascia), connecting heel bone to the toes.

Commonly seen in runners, over-weight individuals and those who wear shoes of inappropriate size and texture.

The characteristic stabbing-like pain usually gets precipitated on bearing weight after prolong hours of rest, such as stepping on the floor in the morning, after 7-8 hours of sleep. It will dramatically improve on sitting or elevating the limbs even though standing back will again initiate the pain. Your doctor will suspect Plantar Fasciitis mostly by the signs and symptoms you complain of and x ray studies will also confirm it by revealing ‘Heel spurs’ which is a common sign seen in affected individuals.

Resting the foot, engaging in heel and foot muscle stretching exercises, over the counter pain relieving drugs and wearing comfortable shoes with a good arch and cushions will help to improve Plantar Fasciitis in most of the patients.

Persistent plantar fasciitis will be treated effectively with a mixture of steroid and local anesthetic agents.

Heel Spurs

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Also seen in most of the patients suffering from plantar fasciitis, these are some abnormal bony growths found in the heel of the foot, often due to wearing uncomfortable shoes, following wrong postures in day to day activities and strenuous physical activities like running.

More importantly, most of the individuals with these spurs will not experience any symptoms unless they present with congenital high arched-feet or flat feet.

Being diagnosed by X ray studies, this condition is mostly treated by maintenance of a proper posture, wearing proper shoes which fit well with cutout heel pads, over the counter pain relievers, physiotherapy and resting the foot.

Stone bruise

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This is a type of deep bruising which affects the fat pad of the heel or ball of the foot as a result of trauma such as hitting a stone or a rough surface upon stepping the ground.

The mild-moderate pain arising after this kind of an incident will progressively reduce spontaneously, when the traumatized part of the heel, heals.

Meanwhile, the affected foot can be elevated and rested whereas keeping ice will also help to give a quick relief. If the pain is unbearable, which might occur rarely will be symptomatically treated with pain relievers.

Sesamoiditis

Defined as an inflammation of the tendons– Tendinitis which bind the Sesamoid bones located near the big toe. Mostly found in runners and ballet dancers, this condition will give a dull pain, associated with redness, warmth and swelling in the area. Severely affected individuals might find it hard to walk.

Sesamoiditis is usually treated with resting, applying ice, wearing comfortable shoes ideally with a foot pad under the toe and sometimes with steroid injections.

sesamoidbone

Bursitis

Defined as an inflammation of the bursa – a fluid-filled sac, located between a tendon and bone.

The characteristic pain of hell bursitis, will mostly occur deeply in the back of the heel as a result of the inflammation of this bursa, lying below the Achilles tendon at the place of attachment to the Achilles tendon.

In some people, the same pathophysiology will take place by a shoe, rubbing against a bony prominence on the heel bone, resulting in pain, redness, swelling, warmth and difficulty in moving.

bursitis

As a rule, Bursitis is usually seen in locations which undergo repetitive movements.

Also these will spontaneously recover over time whereas some people with moderate discomfort could be treated with pain relieving medications.

However, it is important to take advanced precautions in order to prevent from further traumatic events which might lead to relapsing episodes of this condition.

Calcaneal Apophysitis

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Also known as Sever’s disease, Calcaneal Apophysitis mostly affects the adolescent age group (8-14 years).

The characteristic pain usually initiates following stress and strain on the back of the heel bone (calcaneus) and aggravates on sports and exercises which involve the tightening of the calf muscles.

Treatment for affected individuals with this pain in the foot include rest, ice, compression and elevation of the limbs, immobilization with splints, anti-inflammatory medications, stretching exercises and avoid exercises and activities which can lead to precipitating attacks until a quick recovery is achieved.

All these conditions can be treated effectively with life style modifications, immediate first aid- Rest, Ice, Compression, Elevation (RICE) and pharmacological managements while, non-responding cases might need surgical interventions depending on the severity, location and other comorbid conditions.

Nerve Entrapment causing nerve pain in foot

This is a common condition seen in elderly people with underlying pathologies like chronic diabetes mellitus (diabetic neuropathy) where nerves in the foot and ankle sites are more prone to get compressed as a result of their close proximity to other bony structures and organs.

The pain will usually arise in the site of entrapment and will radiate along the course of the nerve. Most of the time, these compressions occurring in the lower limbs will ultimately end up, precipitating a pain in the lower heel and ankle areas. The commonest example known as Tarsal Tunnel Syndrome or posterior tibial neuralgia is a condition which occurs due to the entrapment of posterior tibial nerve as it travels through the tarsal tunnel, from inner aspect of the leg behind the medial malleolus.

Most patients will present with electric shock and tingling sensation around ankles and toes, swelling and numbness of the foot and pain along the posterior tibial nerve path way which will get aggravated on prolong hours of standing and activity.

This condition is usually treated with resting, manipulation and strengthening of muscles innervated by the affected nerves, anti-inflammatory medication, hot wax baths and physiotherapy. But in some patients surgical interventions like tarsal tunnel release surgery might be needed depending on the severity and extent of the entrapment.

(Tarsal tunnel area, where the pain will be felt)

Stress fracture

This is a small break within any of the bones of feet, arising due to chronic repetitive stress. A high incidence is seen among athletes or individuals engaging in occupations involving weight bearing activities and strenuous physical exercises. Osteoporosis, resulting in decreased bone mass can also increase the risk fracture heel bones.

Stress fractures are mostly treated with adequate pain relief, resting, immobilization and casting (splinting) of the fractured bone.

Feet, as described in the beginning of this article is one of the most important parts of our human body, so we should take every possible measure to prevent damages to it and minimize trauma to avoid giving rise to several types of foot pain described above.

Also, it is highly important to take immediate medical advice once you experience any signs or symptoms mentioned above, to make necessary interventions as soon as possible to reduce further damage, wherever required.

References

  1. https://jfootankleres.biomedcentral.com/articles/10.1186/1757-1146-2-1
  2. https://medlineplus.gov/bursitis.html
  3. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2875907/

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