Pain in the foot


What causes pain in the foot?

Foot pain can be caused by disorders of various structures of the body: bones, ligaments, tendons, muscles, fascia, nails, nerves, blood vessels or skin.

Foot pain can be caused by numerous diseases, anatomical malformations, injuries, acute trauma or repeated microtrauma.
Foot problems often occur in sports and at work, where a lot of time is spent standing and heavy physical activities.

Trauma is the result of an external force that directly hits the foot.
A malposition of the foot bones can be responsible for pain under the sole of the foot.

Risk factors

Possible causes of foot pain:

  • Standing for a long time.
  • Overweight.
  • Congenital deformation of the foot.
  • Inappropriate or insufficiently cushioning shoes.
  • Excessive walking or running activities.

Pain in the front foot area

Metatarsalgia is an inflammation in the anterior foot region, more precisely at the level of the metatarsal heads (where the toes attach).
Foot-stressing activities, tight shoes and high heels can cause metatarsalgia in the forefoot or inflammation in this region.

If shoes are laced too tightly, pain and bruises can occur on the top of the foot.
Treatment of metatarsalgia includes:

Hallux valgus is an inclination of the big toe on the base joint, the ball of the big toe on the inner edge of the foot is clearly protruding.
In principle, this misalignment can occur in anyone, but since it is usually caused by tight shoes and high heels, women are affected more often than men.

The following treatment measures are useful for hallux valgus:

  • switching to comfortable shoes;
  • if the foot pain does not improve, insoles can be used;
  • if the use of insoles is also unsuccessful, surgery may be considered.

Arthritis, including gout, can cause pain in the big toe; of the toe has redness, swelling and numbness. Gout is an inflammatory disease characterized by the deposition of uric acid crystals in the joints, causing pain and swelling. The big toe and ankle joint are often affected by gout.
Treatment options for gout:

sprain of the big toe causes pain between the big toe and the first metatarsal bone.
The cause lies in a sporting activity that excessively stresses the foot with repeated overstretching if the running and jumping board is too large.
This injury can represent a type of inflammation or a fracture of the sesamoid bone.

Hammer toes are often seen in individuals with hallux valgus.

One speaks of hammer toes when the joint between the first two toe limbs is permanently bent and takes on a “hammer-shaped” tendon.
At the same time, the end joint remains stretched between the last two toe limbs.
The main cause of the formation of hammer toes is tight shoes.
There are ring-shaped orthopedic aids designed to stretch the joint.

Claw toes are when the last two toe joints (middle and end joints) can no longer be stretched.
It is a contraction that keeps the last two toe limbs in extreme flexion.
These deformities can irritate the feet and cause other disorders.

With claw and hammer toes, the following measures should be taken:
change to comfortable and suitable footwear;
avoid high heels and tight shoes;
perform stretching exercises for the toes and ankles;
use special shoes for claw toes;
apply orthopedic aids for toe extension.

If the treatment measures are unsuccessful, surgical intervention may be necessary.

The sprain of the forefoot can occur if you slip over the tip of your foot or trip over an obstacle and the soft tissues are injured. If there is no fracture, the pain and swelling caused by the sprain of the forefoot should subside after a few days.

sesamoid fracture is the rupture of the tiny bones embedded in the tendons of the big toe.
The main symptom is pain in and under the big toe.

Treatment of a sesamoid fracture includes:

An ingrown nail is when it penetrates the skin on the side of the toes. Ingrown nails are painful and can cause infection.
The cause is a nail cut too short or crooked, especially on the side.
As the nail grows back, it can grow laterally into the skin.
Take a warm foot bath, four times a day.
Spray an antibacterial agent on the nail.
After the skin is brought out from under the nail, bandage the toe.
Place a cotton ball between the skin and the nail so that a certain distance remains and the nail can grow back correctly.

Hallux rigidus, a stiff big toe, is a degenerative arthritis of the metatarsophalangeal joint.
The joint shows signs of osteoarthritis, because the joint space has narrowed, which means abrasion of the cartilage.
The symptoms are pain and joint stiffness, which increase over time.
The patient does not manage to pull the big toe upwards, even with the help of the doctor or physiotherapist.
Diagnosis is made by X-ray and a clinical examination.
Treatment includes medication for the pain and stretching exercises.
In some cases, surgical intervention is necessary.

Corns and calluses represent a thickening of the cornea and arise in response to friction or pressure.
Corns usually occur on the toes, in places where the body weight does not weigh directly on the foot, and they are painful.
Calluses usually form under the sole of the foot, where the foot carries the body weight; they are larger than corns and do not cause pain.
Corns and calluses are usually caused by incorrect foot placement or tight footwear.

Tips for treating calluses and corns:

  1. use well-fitting footwear;
  2. scrape the skin with a pumice stone or a special file;
  3. Use insoles that optimally support the placement of the foot.

In some sports, such as football, the tendon under the base joint of the big toe can become inflamed and cause pain there.

As a result of trauma to the toenail, a bruise can occur under the nail and it can detach temporarily or permanently, which often happens to football players.

Morton’s neuroma, which is caused by the thickening of connective tissue around a nerve between the toes, can cause pain and numbness in the foot, which can be exacerbated by incorrect footwear.

Diabetes, Hansen’s disease, arthritis and gout are common diseases that hit the big toe.


Pain in the heel

Heel pain or tallonitis often arises as a result of overuse, only rarely is it caused by injuries.
The heel may hurt and swell for the following reasons:

  • Running on hard surfaces, such as cement or asphalt;
  • excessive exercise;
  • hardened calf or Achilles tendon,
  • shoes with insufficient impact absorption,
  • abrupt internal or external rotation of the heel,
  • unfortunate touching of the heel bone after a jump.

Diseases of the heel

Heel pain can be based on the following diseases:

  • Achilles tendonitis is the inflammation of the large tendon that connects the calf and heel.
  • Bursitis calcanea is the inflammation of the bursa located at the back of the heel.
  • A heel spur is a bone outgrowth in the lower and inner area of the heel bone.
  • Plantar fasciitis consists of a series of microinjuries of the connective tissue ligament on the underside of the foot.
  • If a spot on the foot chafes and starts to burn, this is usually the first sign of one.

The tendons and bursae of the foot can be injured by overstretching, overloading, bruising or cuts (when stepping on a sharp object).
Often encountered is an inflammation of the Achilles tendon, which attaches to the back of the heel.
The pain of tendonitis or bursitis becomes noticeable after a walk, climbing stairs or running.

Haglund syndrome
Haglund’s deformity refers to a bone outgrowth in the back of the heel, which leads to inflammation of the bursa sitting here.
This can become very painful if the affected region rubs against the trailing edge of the shoe.
The cause often lies in the choice of certain shoes with heels, which many women wear and constrict the foot region above the heel.

The symptoms of Haglund’s exostosis begin with the widening of the bone protrusion at the back of the heel, where the Achilles tendon attaches to the heel bone. The pain can also occur when walking, especially when wearing tight shoes. Over time, the heel swells and reddens because the bursa has become inflamed.

Treatment includes a shoe change and laser therapy to relieve inflammation.

Pain under the sole of the foot

Usually, pain under the sole of the foot is caused by plantar fasciitis, which can affect the heel, arch or both at the same time.
The treatment of the inflamed tendon plate under the sole of the foot is always the same, regardless of where the pain occurs.
If self-treatment is unsuccessful, a cortisone injection together with an anesthetic can help.

Pain on the inside of the foot

Pain on the inside of the foot is relatively rare; if the affected person has flat feet, tendonitis of the posterior tibial muscle may be present or the pain is caused by a sprain in eversion.

Tendinitis is the inflammation and irritation of the tendons, which are connective tissue strands that connect muscles and bones.
The tendons run superficially in the foot and can cause pain in various places. Tendinitis is treated with painkillers and rest.
Only rarely does surgery have to be performed for tendonitis.

Pain on the outside of the foot

As a rule, ankle sprains, muscle tension, bruises and bone fractures occur suddenly (acute injuries).
Pain on the outside of the foot is quite common, especially after a “classic” sprain, the tendons of the fibula muscles become inflamed.
A sprain or distortion occurs when the ligaments connecting the bones become severely overstretched or rupture, but a demolition fracture (avulsion fracture) can also occur when the ligament tears off a piece of bone.
Ligament stretching in the ankle joint can cause instability and foot pain.

Another cause of pain on the outside of the foot is the fracture of the fifth metatarsal bone; usually this is a fatigue or stress fracture that mainly affects athletes who excessively strain the foot.
Typical symptoms are pain, swelling and bruising on the outside of the foot.
The doctor examines the foot and can have an X-ray taken.
The treatment is the same for all bone fractures of the foot in the first few days: painkillers, protection, ice and high position.
After 1 – 2 days, the joint must be immobilized, in rare cases the surgeon recommends surgery.
In order to accelerate the formation of the bone callus and thus shorten the healing times, magnetic therapy is recommended, which contributes to bone consolidation by attaching magnetic fields.

Neuropathy of the deep fibula nerve can also be responsible for external nerve pain in the foot; it is triggered by a state of distress of this nerve, which is probably compressed in a canal near the knee.
In this case, the pain occurs at night and may be accompanied by “houndstooth (stepper walk)”, the term refers to the inability to turn the foot outwards and raise the tip of the foot.

Pain that can occur anywhere in the foot

Shoes can cause foot pain. In the short term, shoes that are too tight lead to blisters, bruises and athlete’s foot.

In the long term, bursitis, calluses, nerve and joint irritation, as well as a malposition of the toes can occur.
Over time, the constant overload of the same foot structures can lead to fatigue fractures, tendonitis, plantar fasciitis and osteoarthritis.
Fatigue fractures usually affect the metatarsal bones, which are the long foot bones.
When standing, the exchange of forces (absorption and release) between the body and the outside world takes place via the arch of the foot.

Inflammation of the tendon plate of the sole of the foot is a common cause of foot pain.
Plantaraponeurosis is a fibrous tissue structure that extends from the heel to the toes on the underside of the foot, providing support to the arch of the foot.
If the tendon plate suffers numerous micro-injuries, the resulting inflammation can create pain under the sole of the foot.
Flat and hollow feet can cause pain due to a foot strain.

If the nerves of the lower extremity are affected, a feeling of numbness and burning may occur, it is peripheral neuropathy.
Diabetes can damage the foot nerves, which is peripheral neuropathy.
Symptoms include burning, stabbing or electric shock pain.
Foot pain caused by diabetic neuropathy can occur anywhere in the foot.
Treatment focuses on the cause of the symptoms, diabetes.
Medications that act on the nerves can relieve the pain in the foot.

Diseases, viruses, fungi and bacteria can be the cause of foot pain.

Warts are brownish, white or dark red growths of the skin; they form on the sole of the foot and are caused by viruses.
Warts can cause irritation, especially when walking or standing.

Athlete’s foot can also cause irritation of the foot. Usually its appearance is limited to the toes, but it can extend to the heel.
The symptoms of athlete’s foot are redness and desquamation of the skin in the first stage, over time the skin then takes on a whitish color, becomes moist and smells unpleasant. Sometimes vesicles and crusts form.

Arthritis is a common cause of foot pain. Discomfort of the foot nerves can cause intense pain, burning, numbness or tingling (peripheral neuropathy).

The fracture of bones and joints of the foot can result from a single trauma or excessive rotation of the foot, but also from repetition trauma that leads to a fatigue fracture.

With a bruise from a blunt object (for example, a person is stepped on the foot), inflammation may occur and muscles and ligaments may be injured.
Direct trauma can cause bruising, skin injuries, and even bone fractures.

Injuries to the skin and internal structures can also be provoked by minor, repeated trauma.
These can occur when running on uneven, too hard or too soft ground, especially if the shoes cushion insufficiently or are the wrong size.
Visible bulges on the outside of the foot are caused by bursitis, calluses and hallux valgus (crooked toe). A common cause of this is incorrect footwear.

Swollen foot

swollen foot is not always a sign of injury; fluid effusion can also be caused by a long hike or overload, especially in women over 50 years of age.
In young people, swelling often develops as a result of bruises, sprains, arthritis (especially rheumatoid or psoriatic arthritis), bone fractures, bursitis and – rarely – tendonitis.

Postoperative pain

After surgery on the foot (e.g. correction of hallux valgus, exposure of the tarsal tunnel, removal of a neuroma, etc.), pain and swelling can last for several months.
There is no need to worry about this, these are the normal recovery times; to accelerate the healing process, manual and instrumental physiotherapy can be used, especially Tecar and laser therapy support swelling and pain relief.

Read more