The Basics of Foot Pain

Leg PainThe foot has 26 bones and 33 joints. These components function in an intertwining web of more than 120 nerves, muscles, and ligaments. Many things can cause foot pain, such as ill-fitting shoes, high-impact exercise, and nerve root compression related to a back problem. Around 50% of people in the United States have been treated for foot pain at some point during their lives.

The feet are small when compared to the rest of the body. The force exerted on the feet is 50% greater than a person’s body weight. In a typical day, a person will spend around four hours on his/her feet and take up to 9,000 steps. This means the feet support a force of several hundred tons each day.

What are the risk factors for foot pain?

Certain situations and conditions put a person at risk for foot pain. Risk factors include:

  • 1. Female gender
  • 2. Obesity
  • 3. Arthritis
  • 4. Herniated lumbar disc
  • 5. Diabetes
  • 6. High-impact activities

What are the types of foot pain?

Foot pain occurs in one of three places: the forefoot, the hindfoot, and the toes.

  • 1. Forefoot – This is the front of the foot. Pain from this region is related to the metatarsal bones (five slender bones that extend from the front of the arch to the toe) and the sesamoid bones (two small bones at the top of the first metatarsal bone).
  • 2. Hindfoot – This is the back portion of the foot. Pain originates here and extends from the heel, across the sole, and to the ball of the foot.
  • 3. Toes – Toe problems most often occur due to pressure imposed by ill-fitting shoes.

What causes foot pain?

Foot pain is caused by:

  • 1. Ill-fitting shoes – One of the main reasons a person has foot pain is ill-fitting shoes. High heels and tight shoes put pressure on the toes and plantar region of the foot.
  • 2. Certain medical conditions – Back problems can lead to nerve compression, which causes foot pain. In addition, diabetic neuropathy and peripheral neuropathy can lead to burning nerve pain of the feet. Other diseases cause foot pain such as cerebral palsy, Parkinson’s disease, spinal problems, foot deformities, and leg deformities.
  • 3. High-impact exercise – Jogging and other strenuous activities can lead to foot pain.
  • 4. Plantar fasciitis – This condition occurs from standing on the feet.
  • 5. Corns, calluses, and blisters – These problems can cause foot pain.
  • 6. Arthritis – Arthritis can cause foot pain, such as osteoarthritis, gout, and rheumatoid arthritis.
  • 7. Obesity – Being overweight or obese.

How is foot pain treated?

The aim of foot pain treatment is to address the underlying cause. Options are:

  • 1. Orthopedic shoes – The doctor may recommend a special shoe or type of shoe with rubber heels, thick soles, and support arches.
  • 2. Night splints – These are worn at night during sleep. One splint uses an Ace bandage and L-shaped fiberglass device to keep the foot stretched.
  • 3. Orthotics – These special inserts cushion the foot and support the arch.
  • Extracorporeal shock wave therapy (ESWT) – This therapy is used as an alternative to surgery for people who do not respond to other treatments. Low-dose sound waves are emitted to the tissues of the foot, which trigger a healing response in the body. Studies show this treatment is effective for reducing heel pain.
  • 5. Botox – This injectable medicine is used to paralyze muscles to reduce pain with walking and impact activities.
  • Epidural steroid injection (ESI) – The epidural space is injected with a corticosteroid and anesthetic agent. This procedure helps alleviate foot pain related to nerve compression in the lower back.

Resources

Donley BG, Moore T, Sferra J, Gozdanovic J, Smith R. The efficacy of oral nonsteroidal anti-inflammatory medication (NSAID) in the treatment of plantar fasciitis: a randomized, prospective, placebo-controlled study. Foot Ankle Int. 2007;28:20-23.

Frey C, Zamora J.The effects of obesity on orthopaedic foot and ankle pathology.Foot Ankle Int. 2007;28:996-999.

Gollwitzer H, Diehl P, von Korff A, Rahlfs VW, Gerdesmeyer L. Extracorporeal shock wave therapy for chronic painful heel syndrome: a prospective, double blind, randomized trial assessing the efficacy of a new electromagnetic shock wave device. J Foot Ankle Surg. 2007;46:348-357.

Hawke F, Burns J, Radford JA, du Toit V. Custom-made foot orthoses for the treatment of foot pain. Cochrane Database Syst Rev. 2008;16:(3):CD006801