What is foot pain?
The human foot is comprised of 26 bones, 33 joints, and hundreds of ligaments, muscles, and nerves. This means your foot is strong enough to bear your body weight, but it can also be prone to injury and pain. Foot pain can affect any part of your foot, from your toes to your Achilles tendon at the back of your heel.
What causes foot pain?
Some of the common causes of foot pain include bone spurs, stress fractures, Achilles tendonitis, bursitis, neuropathy, osteoarthritis, neuromas, and tarsal tunnel. The causes of foot pain can be divided into two categories: structural, or neuropathic.
Structural foot pain
There are many different structures of the foot, and thus, multiple abnormalities that can occur. Some common structural abnormalities include bone spurs, Achilles tendinitis, osteoarthritis, rheumatoid arthritis, and stress fractures.
Bone spurs (or osteophytes) are bony projections that can develop along the edges of the bones in the feet. Bone spurs, which are typically the result of arthritis, can be very irritating to surrounding nerves and cause a significant amount of pain.
Achilles tendinitis is an inflammation of the Achilles tendon, which is located just above the heel. Achilles tendinitis is usually the result of participation in sports that utilize the ankles and calf muscles significantly, such as running, dancing, and playing basketball.
Osteoarthritis is caused by the breakdown and eventual loss of cartilage in the joints and typically occurs in older individuals.
Rheumatoid arthritis is a disorder in which the body’s immune system attacks normal joint tissues, resulting in severe pain and deformities. Stress fractures are tiny fractures that can occur in the bones of the feet and are typically caused by overuse or improper physical training.
Neuropathic foot pain
Foot pain can also be neuropathic. Common neuropathic causes for foot pain include Morton’s neuroma, peripheral neuropathy, RSD, and lumbar radiculitis.
A Morton’s neuroma is swelling and irritation surrounding a nerve, typically centered between the third and fourth toes.
Peripheral neuropathy is an inflammation of the peripheral nerves in the lower extremities and can stem from multiple things including diabetes mellitus, infections, and vitamin deficiencies.
RSD is an abnormal neuropathic response, usually caused by an injury to the foot, and is characterized by redness, swelling, and temperature changes.
Foot pain can also be caused by nerve root impingement at the lumbar spinal level.
Pain and tenderness are the immediate indicators that something is wrong. Swelling, redness, bruising, numbness/tingling, and shooting pains may also occur. The pain may come on suddenly or occur over time.
Treatments for foot pain vary depending on the type of issue – either structural or neuropathic – you’re experiencing.
Structural foot pain treatments
- Non-steroidal anti-inflammatories (NSAIDS)
- Opioid medications
- Physical therapy
- Surgical intervention
Neuropathic foot pain treatments
- Medications like Lyrica (pregabalin), Neurontin (gabapentin), and Cymbalta (duloxetine)
- Lumbar epidural steroid injections
- Lumbar sympathetic blockade
- Physical therapy
- Neuromodulation via TENS unit or spinal cord stimulation