The foot is the foundation of our entire body. Pain in the foot indicates that there is something wrong with either the structures or functioning of the foot. Foot pain should not be ignored. In fact, it is said that when your feet hurt, you hurt all over your body. How, when and where the pain occurs depends on what's causing the pain. When there is pain, the body reacts by changing the way it functions; it walks and stands differently, in an effort to decrease the pain. This change may prevent the normal movement and cause more injury to that foot or the other foot.
Causes of foot pain
Foot pain may be caused by many different diseases, biomechanical conditions or injuries. Acute trauma, disease, or combinations of these problems are the most common causes of foot pain, seen in sports and workplace environments that require a lot of physical activity. Poor biomechanical alignment and wearing tight shoes or very high heels may lead to foot pain.
Sprains, injuries to the ligaments of the foot, occur when ligaments are overstretched. Acute Injuries such as sprains, muscle strains, bruises, fractures and loosening of ligaments in the joints of the foot may also lead to foot pain. The foot muscles' bursa and fascia can be strained by over-stretching, overusing, overloading, or bruising; a cut may also cause foot pain. Achilles tendonitis is also a common and painful injury. Fractures or broken bones are painful and are caused by a single blow or twist to the foot, or by repeated trauma in the case of a stress fracture. The long term effects of foot deformities like bunions, and hammer toes, irritation of nerves and joints, damage to the skin and swelling can also lead to foot pain. Disease caused by viruses, fungi, and bacteria may also be the sources of foot pain.
Symptoms
Pain and tenderness are the immediate indicators that something is wrong in a part of the foot. The onset of pain, whether suddenly or over time, is an important indicator of the cause of the problem. The following questions are also important to answer for a doctor to treat the pain correctly: Where is the pain? When did it start? Is there pain with movement of the affected area? Does walking or standing on the foot make it worse? Does it change the way you walk? Is the pain there all the time or does it come and go? Is it better or worse at any particular time of the day or during any particular activity? For example, sharp sudden pain to the foot after twisting may indicate a sprain or fracture, whereas pain and redness at the edge of a toenail may indicate an ingrown toenail or numbness and burning pain may indicate neuropathy.
Diagnosis
Proper evaluation and diagnosis of foot pain is essential in planning a treatment. A good general guideline is to compare the injured side to the uninjured side. The doctor will ask you several questions to determine how the problem began. It can be helpful to tell the physician about how and when it started, how it affects you, when it bothers you and what you may or may not have done to make the pain better or worse. A physical exam will be conducted to determine the cause of the pain, and if there are any other injuries. Depending on the pain, the feet will be physically and visually examined at rest, with weight, and non-weight-bearing movement. The foot and arch will be touched and manipulated and inspected to identify obvious deformities, tender spots, or any differences in the bones and shape of the foot and arch. Then the muscles and joints of your foot will be tested. The nerves in the foot will be tested to make sure no injury has occurred there. An X-ray, MRI, or bone scan of the foot and arch may be taken to determine if there are injuries or abnormalities of the bone and/or soft tissues.
Home treatment
When you first notice discomfort or pain in the area, you can try to treat yourself at home with rest, ice, compression, and elevation (RICE) to relieve the symptoms. Rest will allow the tissues to heal by preventing any further stress to the affected area. Crutches should be used if you have difficulty putting weight on the foot. Using ankle and foot supports may also provide rest, comfort, and support to the affected area. Ice should be applied to the area for no longer than 20 minutes. The ice may be put in a plastic bag or wrapped in a towel but not directly on the skin. If more discomfort occurs, stop icing immediately. Compression and elevation will help prevent any swelling of the affected tissues.
Over-the-counter medications can also be used to reduce discomfort and pain. There are two types of over-the-counter medications that may help with the pain and swelling of foot pain. Acetaminophen (Tylenol) will help reduce the pain, while a non-steroidal anti-inflammatory such as aspirin, ibuprofen (Motrin), or naproxen (Naprosyn) can help lessen the pain as well as reduce the inflammatory response. Caution should be taken when using these drugs; dosage should not exceed the labeled directions, and medications may need to be taken with food.
When to seek help for foot pain
When the pain begins to interfere with your daily activities, or if you cannot perform your activities without pain, you should consider seeking medical attention. Other signs that you should seek medical care are if the area looks deformed, you have loss of function, change of sensation, a large amount of swelling with the pain, prolonged change of skin or toenail, the affected area becomes warmer than the
surrounding area or if symptoms increase or worsen.
Medical treatment
Treatments are directed toward the specific cause of the pain. Once the severity and cause of foot pain is determined treatment can begin to correct and or treat the cause.
Therapies may be used to treat foot pain, including electrical medical devices such as ultrasound, various forms of electrical stimulation, LED light therapy (laser), and/or manual therapies to reduce pain and increase circulation to the area to promote healing.
Relative rest
The podiatrist may order rest or modification of your exercise routine to maintain your fitness level, such as doing alternate activities that can be performed so the injured area is not made worse. For example, instead of running, he or she may suggest that you cycle, use elliptical trainers, step machines, swim or use ski machines to minimize impact and allow you to maintain and improve your fitness.
Corrective prophylactic measures
New shoes or the replacement of shoe insoles or orthotics can help prevent and treat foot pain. Proper footwear fitting, including lacing and socks are important when purchasing shoes. Additional supports can be added to the shoes such as heel pads or cushions, arch supports, and various wedges to help maintain the foot in a proper position. Remember, athletic shoes wear out after a while. A good rule of thumb is to replace your shoes every six months or more often if you wear them a lot.
Muscle strengthening and flexibility
You may be given exercises to increase the strength, flexibility and stability of the affected area, and to correct muscles that may not be balanced. Flexibility helps to make muscles stronger and less likely to be injured.
The podiatrist will also order medications to control inflammation or symptoms. In some cases, based on the cause of the pain, surgery may be necessary.
Prevention
To prevent injuries and pain, a general physical exam and a foot exam may be recommended before starting any exercise program. If you have conditions such as gout, diabetes, certain types of arthritis, and neuropathies, they should be treated before beginning any exercise program. If you have had an injury to your foot or ankle, it is best to have the area evaluated by the podiatrist to get the okay to resume exercise. Proper technique and a gradual increase in activity can help you develop good biomechanics that can prevent foot injury and pain. Properly fitting shoes and proper foot hygiene can also prevent foot pain.
Remember, if you feel pain when working out or walking, try decreasing the intensity of the workout or walking less. If the pain persists, stop immediately and see a podiatrist to discover the source of the pain. Pushing through pain often results in injury. Foot pain is not normal and is there to tell you something is wrong. Get help.
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