Common Causes of Foot Pain
Plantar Fasciitis
A common cause of foot pain is plantar fasciitis. People that have this condition will report that they start to have pain in the heel or sole of the foot that is most severe with the first few steps that they take in the morning. As it progresses, they will start to report that they have pain throughout the day while walking, especially if they sit for a while and then start walking.
Plantar fasciitis is caused by inflammation that leads to tightness of some thick tissue at the bottom of your foot. When you sit or sleep at night, the tissue on the sole of the foot rests in a shortened position, so that when you start walking, it has to be stretched out again.
People who are overweight, age above 60, run, perform aerobic dance exercise, or do other types of high impact activity are at risk of this condition. Having flat feet or having a profession that requires standing for long periods of time, like retail or teachers, also have an increased risk of developing this especially if proper foot wear is not worn.
Diagnosis is made by your physician on physical examination and imaging studies such as MRI/X-Ray/CT are usually not necessary.
Treatment is aimed at stretching the plantar fascia at the bottom of the foot with exercise, night-time splints, orthotics in the shoe during the day and if not improved possibly a steroid injection. Surgical treatment is rarely needed.
Gout
Gout is another common cause of foot pain. A person that has this will complain of a sudden intense pain usually in the big toe that may be severe enough to awaken them from sleep. The joint will become swollen, hot, and difficult to move. Sometimes just the sheet touching it will cause unbearable pain.
It is caused by the buildup of a substance called uric acid. Uric acid is present in all of us and is formed by the breakdown of meats such as steak, liver, and seafood. Other foods also cause higher levels of uric acid, such as alcoholic beverages, especially beer, and drinks sweetened with fructose. Normally the kidneys get rid of this extra substance, but in some people either the kidneys can get rid of enough of it or they make they make too much uric acid.
The result is the uric acid builds up and accumulates in a joint, such as the big toe and causes these attacks that cause severe pain.
Gout is diagnosed with drainage of the joint and sending the fluid to a lab for evaluation. X-rays may be obtained to rule out other causes such as a stress fracture.
Treatment for gout is usually with NSAIDs (medications like ibuprofen and naproxen), a medication named colchicine, and sometimes with a steroid.
Some people will have one gout attack and never have another. Some people will have a few of these attacks per year. If you fall into the latter category, there are medications that you doctor can start you on to reduce the attacks.
Neuropathy
A common cause of foot pain is neuropathy, or nerve damage in the foot. The most common cause in this country is Diabetes. Individuals with this condition describe the pain as burning, tingling, numbness, cramping, sharp pain, and/or stinging in the feet that is often worse at night. Some people will describe a crawling sensation as well. They may also have balance problems.
It is caused by damage to the small blood vessels in the body that supply the tiny nerves of the hands and feet. Without the blood supply, these nerves start to malfunction and die. They give these odd sensations off as they do.
The diagnosis is made by physical examination by a physician as well as nerve testing performed by a specialist.
Treatment for this condition has 3 goals. Slowing the progression, treating the pain, and decreasing complications.
To this end, blood sugar should be tightly controlled with blood glucose numbers between 80-120 if you are 59 years old or younger and 100-140 I you are 60 years old or older.
The pain may be treated with some medication, but it doesn’t work for everyone.
To decrease complications, feet should be examined by a physician once per year and if you are diabetic, you should check your own feet twice per day with a mirror to look for open cuts, bruises, callouses, or other skin issues that you may not be able to feel – remember the whole reason for the pain is that the nerve are not working!
Osteoarthritis
Pain in the foot can also come from osteoarthritis of the foot. Your foot is made up of joints just like your knee, shoulder, or hip so it can develop osteoarthritis just like the rest of us. Osteoarthritis is the most common type of arthritis and it is the type that we will all most likely develop if we are able to blessed to live long enough. People who have arthritis of the feet will complain of pain, especially with walking that may be worse in the morning. The feet will fell tight, may have some crunching and cracking, and be tender when you touch the feet.
It is diagnosed with X-Rays of the feet most commonly.
The treatment consists of gentle exercise, stretching, modalities like hot packs, cold packs, or US, medications such as NSAIDs, injections, supplements such as glucosamine chondroitin, or acupuncture.
What to Do if You have Foot Pain
If you have foot pain, you should not ignore it as it can lead to more severe disease and permanent pain and/or disability. Discuss it with your primary care doctor and ask for a referral to see specialists such as ourselves if necessary to initiate treatment that is beneficial.