Common causes of foot pain
Each area of the foot “specializes” in its own problems. The heel on the bottom often hurts due to plantar fasciitis, on the back - due to Achilles tendinitis. The middle section suffers from flat feet and arthrosis, the anterior section suffers from transverse flat feet and metatarsalgia. Pain at the base of the first toe occurs with hallux valgus, and a sudden nocturnal attack with redness is classic gout. Metatarsal stress fractures occur in runners and military personnel.
- Plantar fasciitis and heel spurs
- Achilles tendonitis
- Longitudinal and transverse flatfoot
- Hallux valgus deformity of the first toe
- Morton's neuroma
- Gout
- Metatarsal stress fracture
- Diabetic polyneuropathy
How localization helps to understand the cause
Describe to the doctor not only the strength, but also the nature and time of onset of the pain. Pain that is most pronounced during the first steps after sleeping or sitting for a long time and decreases with walking almost always indicates plantar fasciitis. Burning pain with a sensation of a pebble under the ball of the foot and shooting into the toes is characteristic of Morton's neuroma. Pain that increases with each kilometer of running and does not go away with rest is suspicious for a stress fracture.
- The first steps in the morning hurt the most - plantar fasciitis
- Pain and thickening above the heel at the back - achilles tendonitis
- Burning between the third and fourth fingers - Morton's neuroma
- Night pain with redness of the first finger - gout
- Pain after increasing running loads - stress fracture
- Numbness and tingling in both feet - polyneuropathy
Surveys
The doctor examines the foot while standing and lying down, assesses the arches, the position of the heel, the condition of the skin and the pulsation of the arteries. An X-ray of the foot shows deformities, arthrosis, spurs and fractures, including old ones. Ultrasound visualizes the fascia, Achilles tendon and neuroma well. MRI is required in suspected stress fractures and in unclear cases. If the joint is inflamed, uric acid and inflammatory markers are checked, and all patients with burning and numbness have their blood glucose measured.
- Foot examination and gait assessment
- X-ray of the foot bones in two projections
- Ultrasound of soft tissues and fascia
- MRI of the foot for a stress fracture
- Uric acid for suspected gout
- Blood glucose and foot examination for diabetes
- Pulse assessment in the arteries of the foot
Shoes, insoles and home measures
The right shoes alone can relieve a significant portion of complaints. You need a stable heel, a small heel of 2-3 centimeters, a fairly wide toe and good shock absorption. Custom or ready-made orthopedic insoles redistribute the load for flat feet and metatarsalgia. For plantar fasciitis, daily stretching of the calf muscles and plantar fascia, rolling a cool bottle under the foot, and night orthoses help. Losing weight reduces the stress on your feet with each step.
- Shoes with a stable heel and wide toe
- Heel 2-3 centimeters instead of flat soles and stiletto heels
- Orthopedic insoles for flat feet
- Daily calf and plantar fascia stretches
- Rolling a cool bottle under your foot
- Weight loss
- Daily foot examination for diabetes
Treatment
Most patients benefit from conservative measures, but they take time: with plantar fasciitis, improvement occurs after several months of regular exercise. Additionally, physical therapy and shock wave therapy are used, which have proven effective for chronic heel pain. Anti-inflammatory drugs are used in a short course. For gout, you need a diet and doctor-prescribed therapy that reduces uric acid. Surgical treatment is discussed in case of severe hallux valgus, persistent neuroma and ineffectiveness of conservative methods.
- Unloading and load correction
- Therapeutic exercises and stretching
- Shockwave therapy for chronic heel pain
- Physiotherapy and taping
- Anti-inflammatory drugs as prescribed by a doctor
- Gout treatment and uric acid control
- Surgery for deformities and neuromas