Foot Pain

Causes of foot pain

1. Harmful effects on the foot:
If the muscles are fatigued and ligaments and capsules go limp, skeletal relaxation in the joints occurs. The consequences are changes and pain in the feet, which, if prolonged, especially if the harmful causes continue to be affected, not only can not be repaired, but, above all, these changes continue to increase. Even a tendinitis in the foot can be responsible for the pain. The number of harmful influences on our feet is constantly increasing. The influence that footwear has on the disease of our feet is ultimately not clear. What contrast to the influences of the environment on the foot of the mostly barefooted members of uncivilized peoples! The constant walking already in well-formed shoes and stockings already causes damage to the foot, since the normal secretions can not evaporate, but are absorbed by the footwear. This keeps the foot permanently in a moist atmosphere that softens the skin and inhibits skin respiration.

2. Inactivity Atrophy of Muscle / Muscle Atrophy:
Good footwear relieves our foot muscle cuff. This is on the one hand very pleasant on the other hand, a permanent discharge leads to a decrease in the foot muscles. Any muscle that is not exercised gradually deteriorates. Straight barefoot running on a soft surface trains the foot muscles and thus protects against the above civilization damage and foot pain.

Figure pain ankle

Emergence and prevention of foot damage and foot pain

On these, and the previously discussed considerations are based for the most part the success of a systematic sports training. The muscles specially required for a particular sport are maximally developed and trained. An anatomically completely different, but in the end quite similar process we observe in the joints. A joint that has been immobilized for a long time is then more or less stiff and must, often with great difficulty and pain, be made to move again. The reduction in the mobility of the joints arises inter alia by shrinkage of the joint capsules, which also due to the disuse, very soon adapts to the given conditions, the calm, practically immovable joint. Through the normal footwear, even if it fits very well and is well worked, the muscles of the foot and leg are "protected" to a large extent, that is condemned to inaction.
The effect is that the muscles become increasingly weaker.

But with this she is less and less able to fulfill her actual task of keeping the foot active and elastic. The effect is a completely flabby, softer, foot, which is no longer capable of active participation in walking and running and causes foot pain. This all conditions are created to deform the feet. There are then the shifts and changes of the joints and capsules added, so that after a sufficiently long development in this direction, a cure, ie restoration of the normal state, is no longer possible. Even during this development process, the discomfort and pain occur increasingly. Of course, these phenomena are not only due to the softening effect of the footwear, but are supported by them. If patients are treated in a timely manner, suitable measures, such as active foot exercises, exercise therapy etc., can prevent this danger and reduce the development to the normal.

At the same time, since the damage to the foot muscles and the foot skeleton continues, an orthopedic shoe care must be used. Thus, the already occurred in the damaged foot changes are not only mechanically offset, but it should be created by appropriate shaping of the footwear conditions that stimulate the foot to active activity. The healthy, still instinctive body defends itself against the development of the deformation of the foot by an often unconscious, increased urge to move. For example, many members of professions who are particularly threatened by these civilization losses have a pronounced urge to move in free times. They want to hike energetically in the mountains without smooth roads, or play sports or run barefoot on the hard sand of a beach. The non-connoisseur of these connections then asks probably astonished, why this, who complains throughout the year complaints in the feet, on his vacation even his feet so "strenuous", instead of "finally give them rest".

therapy

The treatment depends on what causes the pain.

In the case of foot pain, rest, cooling or warmth ( whichever is more pleasant ) can generally be improved. Even painkillers or creams such as a Voltaren ointment bandage have a decongestant, anti-inflammatory and analgesic. Especially with sprains, torn ligaments or infections, this can be helpful. When a bone fracture is often immobilized in a plaster, sometimes surgery is necessary.

For all types of foot pain care should be taken with a comfortable shoe with a matching footbed. The shoe should not push and be big enough. Occasionally, improvements can be made in the gait pattern with inserts ( eg, spread, kink, flat feet ). Socks should not wrinkle and also blister plaster and the like can counteract pressure points through shoes.

In sports ( especially running ) special sports socks should be worn to provide adequate protection from blisters. Foreign bodies in the shoes, any painful blisters, slivers or warts should be opened / removed. Warts can be frozen with cryotherapy ( cryotherapy ).

Inflamed nails can be avoided by special care and proper nail cutting. If a nail has grown, regular foot baths, cleansing of the wound and possibly the insertion of cotton between the nail and the skin can help. Occasionally, the entire nail must be pulled so that a new nail can regrow. Regular foot care often prevents warts, athlete's foot and nail changes.

Malposition of the big toe, the hallux valgus, causes pain on the outer bale. Since the malposition is often triggered by tendon shortening, can be with night rails that pull the toe out or brakes inserts Progress. However, a normal toe position can often only be achieved with one operation.
If the foot pain is caused by leg misalignments (O-legs, X-legs, pelvic obliquity), an orthopedic surgeon should be consulted to discuss the options for correction.

Rare tumors such as Ewing's sarcoma must be treated in specialized centers. Here, chemotherapy, surgery and / or radiation are used.
In the benign osteoid osteoma, surgical removal is possible, but good response rates for non-steroidal anti-inflammatory drugs are also described.

In the case of circulatory disturbances, which result in the death of bone parts (M. Köhler 1 and M. Köhler 2), conservative therapy can often provide relief by restraining in the bandage or gypsum and subsequent care with insoles. Regrettably, with the M. Köhler 2, which mainly affects girls, this is often not enough, so an operation has to be considered.

Rheumatic diseases can also occur in childhood and affect many joints, including the foot. In children with joint pain, in whose family rheumatic diseases occur, should be examined at an early stage in this regard. Most childhood rheumatic diseases disappear completely again, but in some cases the rheumatic disease becomes chronic, meaning it lasts a lifetime. The various treatment options should be weighed by a rheumatologist. Frequently, anti-inflammatory drugs and physiotherapy are used.

For bone and bone marrow infections (osteitis, osteomyelitis) rapid targeted antibiotic therapy is important because they can lead to permanent damage and can also be life-threatening.

In case of growing pains, a hot water bottle often helps on the painful area or a warm bath that relaxes the muscles. The muscles can also be massaged by the parents and rubbed with oils. In homeopathic remedies, calcium phosphoricum and manganum are said to provide relief, but these effects have not been proven. Before taking you should be advised in any case. Painkillers (acetaminophen) must be used with caution in children and adjusted to their weight and age.

Pain after getting up / tearing pain

In some patients, the pain begins when getting up.

Frequently, patients complain of foot pain after getting up.
If this is not an acute injury or its consequences, one must think of different diseases.

Even a trite footwear can be the reason for foot pain after getting up.
Osteoarthritis or arthritis ( rheumatoid arthritis ) causes a so-called pain in the ankle.

Osteoarthritis refers to a wear of the articular surfaces, that is, it is a cartilage reduction, so it comes to direct friction of the articular surfaces on each other.

The cartilage layer serves to allow the articular surfaces of the bones forming the joint to move without resistance and direct contact, slidingly and painlessly.

In addition, rheumatoid arthritis causes inflammation of the joints and nearby structures ( tendons, ligaments, muscle attachments ). These inflammations can cause foot pain after getting up.

Irritation and inflammation of the plantar fascia ( the large tendon plate on the sole of the foot ) leads to a stabbing pain, especially after rest.

However, less serious causes may cause the onset of pain, such as a change in foot arch that is common to most people as they age.

If you suffer from the described foot pain after getting up, then a presentation at the orthopedist is recommended, since only a careful diagnosis and the resulting treatment can remedy the symptoms.

Pain while walking

When walking, the feet can hurt because of too tight footwear. In general, one should pay attention to suitable footwear and straight women should not constantly run in high heels. Increased foot pain when walking through obesity, as the weight presses on the feet. This can also create a flat foot, which flattened the longitudinal vault.
Excessive stress caused by walking and standing puts a strain on the feet. Deformities such as spread / kink / flat feet can also lead to pain, but can often be corrected with insoles.

In adults, changes in the feet often occur, such as hammertoes, claw toes, and hallux valgus, in which the big toe bends to the other toes and creates a thick bale. They are often associated with spreading feet.
Likewise, corns and calluses may arise. But blistering, warts, ingrown toenails, athlete's foot and foreign bodies such as splinters can be the cause of pain. In addition, it can develop an infection that goes hand in hand with swelling, redness and overheating .
In some people, as a result of an increase in uric acid may also cause a gout attack, which may affect in particular the thumb and the big toe. This will cause swelling and overheating.
Differential diagnosis must also clarify rheumatic diseases.
An arthrosis can also develop in the foot, eg after an injury, but often the cause is unknown.

Circulatory disorders such as those associated with peripheral arterial disease (PAD) may have serious consequences on the feet. The patients report pain in the calves when walking and tingling and numbness in the feet. It is important that even the smallest wounds do not heal due to the lack of blood circulation and lead to tissue soreness ( necrosis ). If the sufferer is also diabetic, his nerves can be so affected by the high sugar levels that he hardly feels any pain and the necrosis noticed too late.
Diabetes itself leads to a circulatory disorder even without peripheral arterial disease ( PAOD ). In Germany, diabetic foot syndrome is one of the most common reasons for foot amputations.

Also a heel spur or irritation of the Achilles tendon (med. Achillodynie) cause foot pain while walking. In particular, the lower heel spur, which arises on the sole of the foot due to overloading, hurts those affected when they appear. Here it comes to calcification of the tendon attachment of the sole of the foot, the Plantarfaszie. This plantar fascia can also inflame ( plantar fasciitis ) and trigger pain during movements of the foot. This is also favored by foot deformities and obesity.
In tarsal tunnel syndrome, there is an entrapment of the nerve, which innervates the sole of the foot and the inner margin of the foot ( tibial nerve ). This runs in a channel behind the inner ankle, along the Tarsaltunnel. Compression may result from footwear, swelling, injury to the ankle, or tissue changes. The compression of the nerve results in burning pain and numbness in the treated area, similar to the hand in carpal tunnel syndrome.

Lumbar disc herniation can also cause burning pain and numbness from the herniated disc in the foot area.
Nerve pain is also caused by alcohol intake and can also cause foot pain.

How to properly treat an Achilles tendon irritation, read in the following article: Achilles tendon irritation - How to treat it properly

Foot pain in children

The wrong shoe can be to blame for the pain.

Many children complain when walking about tired legs and feet and pain in these. Almost all children do this because they take more steps than adults through the shorter legs and tire earlier. Normally, this is not bad, but if a child says after a few steps that his feet hurt, or the pain does not subside and are also available in peace, may be behind other causes.

Foot pain in children can have many reasons. First, you should check for yourself if there is a banal explanation for the pain. This could be a stone in the shoe or too tight a shoe that pushes the child's foot. Whether the shoe is too tight can also be checked by pressure points on the child's foot. Red painful spots or welts, as well as blisters, point out. Similarly, a splinter in barefoot running could be reason for pain in the foot.
Even warts can be very painful and often need treatment. Nail bed infections or ingrown toenails are common and very painful. This can be recognized by redness and possibly white purulent melts next to the nail in the nail bed. A relief of the pus is often effective, rarely has the whole nail to be pulled.

Changes in the arch of the foot, such as kink-lowering feet, are often standard variations, which usually require no therapy as it grows out again. Occasionally deposits can make sense.
A malposition of the big toe (hallux valgus) may also manifest in childhood and be accompanied by pain on the ball of the big toe. A hallux valgus can occur in childhood, for example, in a splayfoot.
Similarly, malpositions of the hip and pelvic bones, as well as X-legs ( genu valgum ) and O-legs ( genu varum ) can cause foot pain.

Seldom are worse illnesses behind foot pain in the child. Theoretically possible are bony or soft tissue tumors such as the Ewing sarcoma or an osteoid osteoma. In the context of circulatory disorders (aseptic bone necrosis) bones or bone fractions can be destroyed by the oxygen deficiency, it is said in children of Koehler disease ( M. Köhler 1: The navicular bone (os naviculare) is affected, M. Köhler 2: A metatarsal head is affected. )

Likewise, over-exertion can cause pain in the feet by a lot of running and jumping or strains and torn ligaments when bent over. If the ankles are swollen, red-blue discolored, overheated and painful, a doctor should be consulted. Often, an X-ray of the foot must be made to exclude a bone fracture.

Another common cause is the so-called growing pains in children. These should affect up to one third of all children in the growth phase, occur several times a year and last for several weeks. Why these occur is not yet clear. Unequal growth of ligaments and tendons is believed to be incompatible with bone growth and thus stretch. Mostly growing pains are observed at night when the child is at rest. The pain can be so severe that the child cries or even wakes up from the pain. The next morning, the pain is mostly gone. Above all, joint-related regions of the arms and legs are affected, such as the knee and the calf, but foot pain is also possible in the child. Pain relieving effect a hot water bottle on the region or a warm bath. Even painkillers may be needed.

Rheumatic diseases can also occur in children and cause foot pain.
An inflammation of the bone marrow, an osteomyelitis, or the whole bone ( osteitis ) is a conceivable explanation for leg / foot pain. This can occur after an open injury ( eg on the tibia ) or bacterial infections such as the respiratory tract or palatine tonsils ( tonsils ). Inflammation is usually associated with redness, swelling and fever and the suspicion can be confirmed by a blood sample. Here must be a rapid antibiotic therapy, because the disease can be life-threatening.

Foot pain heel

Foot pain in the area of ​​the heel can be caused by very different causes, such as accidents of varying severity with bone fractures, ligament ruptures, ligament strains and non-optimal healing of the heel.

This is acute pain.
In addition, a heel spur, changes in shape of the heel bone ( Haglundferse ), overloading of the foot due to long running on very hard ground or incorrect footwear lead to the discomfort.

Of course, here too, a rheumatic disease is to be considered, in addition to joint and inflammatory band participations, including the Achilles tendon leads.

bale

The ball area provides the connection between the sole of the foot and the big toe and under certain circumstances is a pain sensitive area.

Different causes can lead to the pain experience, for example stress during running, wrong footwear as well as particularly mentioned also high-heeled shoes, which lead to a shift of the body weight forward, so that on the ball area is a particularly high load.

That in itself already causes pain.
In addition, due to incorrect loading and heavy mechanical stress, increased callus or callous formation occurs in this area, which in turn can again lead to foot pain.

If there is a fracture of a tarsal bone in the midfoot area, it also causes pain.

A well-worn transverse arch of the foot resulting in contact with the ground also leads to pain in the area of ​​the bale.

Finally, the splayfoot with a hallux valgus formation is to be mentioned.
In this malposition, it comes to a tilting of the big toe outwards, ie in the direction of the other toes. The hallux valgus is favored by a wrong shoe choice, but it also occurs frequently in a family.

Foot pain on the inside

Irritation or inflammation of the plantar fascia or heel spur can cause severe pain on the inside of the foot.

This pain can be alleviated by appropriate physiotherapy exercises, which can be performed at home, but must also be done regularly.

Another cause may be the so-called " tarsal tunnel syndrome " in individual cases.
In the area of ​​the wrist we know it better than carpal tunnel syndrome. Through the tarsal tunnel, which lies behind the inner ankle, nerves and vessels run from the upper part of the foot towards the sole of the foot.
This tunnel tends to constrict by proliferation of connective tissue.

As a result, especially the N. tibialis is pressed and it comes as a result to foot pain in the area of ​​the inside.

In addition, it can also lead to discomfort and emotional disorders.
Of course, also leg deformities lead to a changed statics of the foot arch and thus to pain, here are mainly X and O legs to mention.

Hallux valgus can also cause foot pain in the inner area, as well as arthritis in the toe joint ( hallux rigidus ).

When foot pain on the inside of the sinking / flat foot plays an important role.
It is caused by a weakness of the muscles and ligaments in the area of ​​the longitudinal arch, which flattened as a result.

The resulting pain can be corrected by targeted training of the muscles and the wearing of insoles.

Foot pain outside

The pain can hinder the unwinding.

There are different causes for the occurrence of foot pain in the outer area of ​​the foot.

Thus, for example, the small toe bale (" tailor's bale "), a malposition of the little toe as a result of a splayfoot, leads to such pain.

Here, the little toe is pushed in the direction of the big toe, so that it comes as in the hallux valgus to an overload of the base joint, which can then swell.

Furthermore, misalignment of the legs as well as an unnatural rolling movement of the foot cause pain.

Not to be neglected are irritations or strains of the entire ligaments, which can also lead to foot pain in the outdoor area.

There are different treatment options for all these diseases, such as the wearing of special insoles, physiotherapy or movement exercises that can be learned.

You may also need surgery. For clarification, a specialist should be consulted.

Read more on this subject under Pain on the instep.

Foot pain during pregnancy

During and after pregnancy, mothers repeatedly report various different pain sensations, including foot pain.

For one, the cause will be seen in the physical overload.
It comes to changed initially increased organ functions, which then have to adapt to the baseline after delivery again.

This restlessness and increased stress on the organs often leads to acidification of the organism.
The acidic metabolites then deposit in the joints, causing pain.
Second, weight gain during pregnancy is another factor.
This leads to an additional burden on the foot skeleton, possibly also to painful incorrect loads or to a well-worn transverse and longitudinal arch.

During pregnancy, women often complain of edema, that is fluid retention in the tissues due to decreased / complicated blood flow back through the venous system. It is particularly common here to water in the feet.

As a result, the tissue pressure increases, it comes to compressions of the lymph channels and also there running pain fibers.

Not to be ignored is the hormonal change in the context of a pregnancy, which can affect both the pain experience and on the entire organism.

As a result of all of the above, foot pain during pregnancy may occur.
To what extent the foot pain is a condition requiring treatment requires a medical examination.

To counteract the pain in the foot a little, it is advisable to rest a few times to relieve the feet.

Common foot diseases that can lead to foot pain

hallux valgus

vvHallux valgus is the most common and significant toe deformity in humans. It is characterized by a deviation of the big toe in the base joint to the outside and a rotation of the toe inwards (internal rotation). Foot pain often occurs due to osteoarthritis (hallux rigidus) in the metatarsophalangeal joint.

For more information, see our topic: Hallux valgus

Hallux rigidus

Hallux rigidus is a wear-related disease of the metatarsophalangeal joint (arthritis). The result is restricted mobility and foot pain. If left untreated, this leads to stiffening of the metatarsophalangeal joint.
For more information, see: Hallux rigidus

Claw toe / hammer toe

In the hammer toe malposition comes to a fixed maximum diffraction in the end member.
In the claw toes deformity, there is a maximum flexion in the toe center joint and hyperextension in the metacarpophalangeal joint.

splayfeet

The splayfoot is the most common acquired foot deformity. It arises almost always due to the plant.
It comes in the course by lowering the Fußquergewölbes to foot complaints with widening of the forefoot.

ligament strain

An injury to the upper ankle joint (OSG) often occurs in the context of sports activities, but also in everyday life. Most events do not lead to serious structural damage, ie foot pain and long-term consequences. Nevertheless, it can lead to a torn ligament especially in the area of ​​the lateral malleolus. When examining the ankle by the doctor, they are unlikely to be distinguished from ligament distension or ligament tears or complete ligament tears. The transition is fluid.

ligament

The ankle ligament tear is a partial or complete rupture of one or more ligament structures. The affected joint shows swelling with pain and bruising. Tissue tears are usually treated by immobilization for 2-6 weeks or surgically by ligament suture or by fixation of torn pieces of bone. Read also our topic Ligament tear

Achilles tendon injury

The Achilles tendon (= tendo calcaneus ( Achilles )) is the supposedly strongest tendon of the human body. It attaches to the tuber calcanei (= heel bone) and unites the end tendons of the three calf muscles as the end tendon of the triceps surae muscle (calf muscle). In the case of an Achilles tendon rupture, which results from degenerative damage, it is a complete transection of the tendon, usually as a result of direct or indirect trauma and pain in the foot.

Haglundferse / Haglundexostose

It is a form variant of the heel bone body, which is prominently formed in its lateral and rear portion and thereby can lead to pressure pain in the shoe (foot pain). Often synonymous with the term Haglundexostose is used.

More information on this topic can be found at: Haglundexostose

Heel Spurs

The lower heel spur ( common ) is a painful osseous retraction on the inner heel bone under the heel.

Upper or dorsal heel spur ( uncommon ) refers to a painful osseous extension on the heel bone insertion of the Achilles tendon.

More information on this topic can be found under: heel spur

hock

The upper ankle joint (OSG) is formed by three bones. The outer malleolus ( fibula = fibula ) forms the outer ankle fork; the tibia ( tibia ) forms the inner ankle fork. The anklebone ( talus ) forms the joint - opponent as a transmission of the force on the foot. Here, the ankle fork ( Malleolengabel ) from the tibia and fibula surrounds the talus U-shaped. Calf and tibia are connected by a very strong band connection (syndesmosis).
For more information, see our topic: Ankle

Stinkfuß

The Stinkfuß ( Pes olens ) is a widespread problem in the consultation of orthopedics. Of the symptoms of Stinkfußes often the examiner suffers more than the person affected. Stinking feet occur in all age groups. In addition to the odor nuisance for the environment, it creates ideal conditions for roommates of the foot, such as athlete's foot, nail fungus and eczema.

What’s Causing your Foot Pain? (December 2019).


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