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Foot Pain – What You Should Know

Proper Treatment Depends on Identifying the Cause

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Updated November 27, 2012

Written or reviewed by a board-certified physician. See About.com's Medical Review Board.

Foot Pain – What You Should Know
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Foot pain can be a vague symptom. People who have been diagnosed with arthritis will suspect that their known condition, arthritis, is the cause of their foot pain. But there are many conditions that can cause foot pain and it's important to distinguish between them. For example, arthritis would be treated differently than an injury. Even if the source of foot pain turns out to be a common foot condition, such as bunions or hammertoes, it's essential to treat the condition. Protecting body mechanics, joints, and your gait all have an impact on arthritis.

Made up of 28 bones, connected by a network of joints, muscles, tendons and ligaments, the foot is one of the body's most complex parts. Since the foot is so intricate, various foot conditions can cause the structure to break down, with inflammation and pain being the consequence.

Causes of Foot Pain

Physical trauma or injury is the most common cause of foot pain, often resulting in sprains (injury to the ligaments) or fractures (injury to the bones). Such injuries often occur when the ankle turns, twists or rolls over, far beyond its normal range of motion. Sports fans see plenty of these in the NFL or NBA. But it happens to common folks too, just in the course of a normal day. Sprains are painful, yes, but rest and time can be miraculous healers. We can assist the healing process by employing R.I.C.E., too - rest, ice, compression, elevate.

Rest gives your injury the necessary time to heal. Ice reduces pain and swelling. Compression (with an elastic bandage) also reduces swelling and speeds healing. Elevation prevents excess swelling caused by blood accumulation at the site of the injury. You may also consider taking pain medication, such as ibuprofen or acetaminophen. If you have a history of stomach ulcers or liver problems, check with your doctor first.

A fracture needs a bit more help, though, often requiring a visit to an orthopedic doctor. Typically, the orthopedist will order imaging studies. X-rays usually will show the fracture -- but not always. Some hairline fractures or stress fractures may require more sophisticated imaging, such as CT scan or MRI. If a bone is broken, your doctor may elect to cast the foot. Recovery time is typically 4 to 6 weeks. Depending on the severity of the fracture, you may need physical therapy to regain movement after the cast is removed.

Foot pain can develop without injury as well. Congenital deformities, aging, excessive stress load from being overweight or being on your feet too long, and something as simple and fixable as bad shoes (either too tight, too pointy, or lack of cushioning) can be factors. Even too much of a good thing may be implicated: runners or walkers who overdo can provoke foot pain.

Common Foot Conditions

Here's a list of some of the most common foot ailments:

  • Arthritis - Inflammation of the joint. This may be part of a larger condition, affecting other joints as well. If you experience persistent pain, with no apparent external explanation, consult your physician. An x-ray can show evidence of arthritis, if it exists.
  • Bunions - A pronounced bump at the base of the big toe, or sometimes smaller ones can affect the little toe, often are caused by repeated stress (e.g., wearing stylish, but narrow-toe shoes). Applying pads for cushioning or pain medication may provide relief, but sometimes, bunions only resolve with surgery.
  • Calluses and corns - Thick, rough, and yellowish skin caused by pressure or rubbing. Calluses form on the balls of the feet or the heels; corns are positioned on the top of the toes. You can trim corns and calluses by shaving off the layers of dead skin with a pumice stone. A podiatrist would have even better tools for shaving. You can add a moleskin pad to supply cushioning. Be sure your shoes fit well. Shoes with a wide toe box are best.
  • Fallen arches, flat feet - A normal foot has a gently curved arch. With flat feet, the arch of the foot is not gently curved, but actually comes in contact with the ground. Usually, no complications occur. When pain does develop, a physician may prescribe an orthotic to provide support.
  • Hammer toes - Toes that curl downward and have the appearance of a claw. Treatment usually begins with adding a toe pad over the angular bone. It is imperative to wear shoes that make room for the hammer toe. If pads and proper footwear fail to relieve pain caused by hammer toes, surgery may be a last-resort treatment option.
  • Heel spurs - Bone growths on the heel bone. When the plantar fascia gets overstretched from running, bad shoes, or overweight, it pulls on the bone where it is attached. Over time, the body responds by building extra bone. The extra bone can cause pain. Bone spurs also develop as a consequence of arthritic conditions – protrusions of bone and cartilage develop near degenerating joints. Treatments include rest, anti-inflammatory medication, steroid injections, and as a last-resort, surgery.
  • Morton’s neuroma - When two bones rub together, nerve tissue between the toes may thicken. This most often occurs between the third and fourth toes. Swelling, tenderness, and pain associated with this condition may graduate to tingling, numbness, and a burning sensation. The symptoms often worsen after a long period of standing or walking. First line of defense: rest, new shoes. Second line: cortisone injections. Third line: surgery.
  • Plantar fasciitis - A painful inflammation of the thick band of tissue under the foot, usually where it connects to the heel. Feels like you are stepping on a nail. The usual treatment: exercises to stretch the ligaments and orthotics to keep them stretched out.
  • Plantar warts - Pressure on the soles of your feet may cause these growths. There are an array of compounds to assist in their removal. Consult your doctor.

Consulting Your Doctor About Foot Pain

Consider seeking professional treatment if:

  • You have a sudden, severe pain in the foot.
  • You can’t put weight on the foot.
  • Redness or swelling persists.
  • You have an open sore or ulcer on the foot, plus a fever.
  • You have diabetes or another disease that affects blood flow.

To pinpoint your problem, your doctor will go down an elimination tree of questions. Expect your doctor to ask about the onset of pain; if both feet are affected; if the pain is constant or intermittent; if the pain is localized or moves around; if you have numbness or other symptoms; what makes the pain better or worse.

Preventing Foot Pain Conditions

It's always best to avoid problems when possible. Pampering your feet isn't a bad idea. To keep your feet in tip-top condition, doctors recommend:

  • Comfortable, well-fitting shoes, including arch support and cushioning, with plenty of room in the toe box and for the ball of the foot as well.
  • Foot health trumps being a fashionista. Choose shoes that are supportive, not merely good-looking. Leave shoes with narrow toes and high heels in the store.
  • Before exercising, warm up. After exercising, cool down. Putting your feet through a workout deserves proper attention.
  • Moderation in all things. Work up gradually to longer distances in walking and running.
  • Decreasing the load on your feet may help. Lose weight, if necessary. If you must stand at your job, take breaks and sit down when possible.
  • Replace your running or walking shoes regularly. Shoes don’t last forever, at least not their protective functionality. Even your favorite pair has a lifespan.

Sources:

Foot Pain and Problems. The Ohio State University Wexner Medical Center. Accessed 11/08/12.
http://medicalcenter.osu.edu/patientcare/healthcare_services/orthopaedics/foot/Pages/index.aspx

Foot Pain. MedlinePlus. 3/1/2012.
http://www.nlm.nih.gov/medlineplus/ency/article/003183.htm

Foot and Ankle. Orthoinfo.AAOS. Accessed 11/17/12.
http://orthoinfo.aaos.org/menus/foot.cfm

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