The foot is a complex set of small bones, ligaments, tendons, and muscles that bear the full weight of the body. We don’t think much about our feet until they hurt! When they hurt, we want relief. Pain is the body’s warning system that something is wrong. Many times, mild foot pain responds to home treatment; however, any foot pain that lingers more than a week should be evaluated by a pain management doctor.
Ignoring pain often leads to problems that can complicate the healing process, especially if the pain develops following an injury. Novus Spine and Pain Center understands foot pain, and that symptoms of foot problems may be similar to other medical conditions. Discovering how and where foot pain occurs provides pain management doctors clues to possible causes of the pain. Determining the actual cause of the pain is the only way to determine the proper treatment.
The list below is not comprehensive. It contains abbreviated information for quick reference, to help patients talk with their doctor. It may also be helpful in providing some insight into the different types of foot pain. Click on the type of pain to learn more about the pain and symptoms, the cause of a specific pain, as well as some of the treatment options available at Novus Spine and Pain Center.
What It Is
An overuse injury of the Achilles tendon. The Achilles tendon is a band of tissue that connects the calf muscle to the heel bone.
Symptoms
Typically begins as a mild ache in the back of the leg or above the heel after running or sports activities. More severe pain may occur after stair climbing, prolonged climbing or sprinting. May also experience tenderness or stiffness, especially in the morning, which usually improves with mild activity and the tendon warms up.
Cause
Common in runners who suddenly increase intensity or duration, middle-aged people who play sports such as tennis or basketball on the weekend. The Achilles tendon weakens with age, making it more susceptible to injury. People who participate in weekend sports, or have a sudden increase in intensity are more susceptible.
Treatment
Usually, responds to self-care measures. However, medications can help reduce inflammation and relieve pain. Physical therapy, stretching and strengthening exercises can help promote healing. An orthotic device in the shoe can ease the strain on the tendon and provide cushion. Surgery may be necessary if more conservative treatments don’t work, or if the tendon is torn.
What It Is
A break of any of the three bones that make up the ankle joint – shin bone (tibia), ankle bone (talus), and heel bone (calcaneus).
Symptoms
Pain and swelling.
Cause
A fall or trauma to the ankle.
Treatment
Will heal on its own with support, usually requires a cast. Surgery may be necessary if the bones are too separated or misaligned.
What It Is
An injury to any of the foot’s ankle ligaments.
Symptoms
Usually includes swelling, pain or bruising but varies depending on how severely the ligaments are stretched or torn.
Cause
When the ankle rolls, turns or twists beyond the normal range of motion. May happen during awkward foot placement, walking on irregular surfaces, weak muscles, loose ligaments, wearing shoes with spiked heels.
Treatment
Rest, wrapping the ankle with elastic bandage or tape, ice pack application (to reduce swelling), elevation, nonsteroidal anti-inflammatory drugs, gradual return to walking and exercise. Physical therapy and surgery may be necessary for more severe cases.
What It Is
Painful inflammation and stiffness of a joint.
Symptoms
Joint pain and limited joint function, stiffness, swelling, redness, and warmth.
Cause
Varies depending on the form of arthritis. Can be caused by injury, metabolic abnormalities, hereditary factors, infection, a broken bone, general wear and tear, or a bacterial or viral.
Treatment
Depending on the type of arthritis, physical therapy, cold packs, anti-inflammatory drugs, pain medications can help. Lifestyle changes are the preferred method of treatment. Low-impact exercise (walking) can help and increase range of motion for flexibility. Strength training for muscle tone. Treatment may include heat or ice, splints, or orthotic devices to support the joints, water therapy, and massage.
What It Is
A fungal infection that usually begins between the toes.
Symptoms
Scaling, burning, and blisters on the soles, fissures of the toe webs, itching. The skin may crack and peel.
Cause
Fungus that grows on the top layer of skin that can spread to other parts of the body.
Treatment
Anti-fungal medications, keep feet dry by using cotton socks and breathable shoes. Oral medication is also available.
What It Is
A small piece of bone attached to a tendon or ligament gets pulled away from the main part of the bone.
Symptoms
Intense and sudden pain where the trauma occurred; swelling; bruising; trouble moving the bone or joint; pain with movement.
Cause
An avulsion fracture occurs when a tendon or ligament that is attached to the bone pulls a piece of the fractured bone off.
Treatment
Rest and icing the affected area, followed by controlled exercises to help restore range of motion, muscle strength, and promote bone healing. Most do not require surgery.
What It Is
Sometimes called a stone bruise. A form of tendinitis common with runners and ballet dancers. An injury to the tendons in the ball of the foot.
Symptoms
Pain and inflammation behind the toes on the bottom of the foot.
Cause
Ill-fitting shoes are usually the cause, but could be from strenuous activity (running, jumping). Possible nerve or joint damage, or a non-cancerous (benign) growth like Morton’s neuroma.
Treatment
Pain relievers, ice and rest for the foot, wear comfortable shoes, shoe inserts to help relieve the pressure on the area. Corticosteroid injections and using supportive shoe inserts. Complete relief may require surgery.
What It Is
Bone spurs are bony projections that develop along the edges of bones. Bone spurs (osteophytes) often form where bones meet each other — in and along the joints of the feet by the toes.
Symptoms
Most bone spurs cause no signs or symptoms. You might not realize you have bone spurs until an X-ray for another condition reveals the growths. In some cases, though, bone spurs can cause pain and loss of motion in your joints.
Cause
Joint damage from osteoarthritis is the most common cause of bone spurs. As osteoarthritis breaks down the cartilage cushioning the ends of your bones, your body attempts to repair the loss by creating bone spurs near the damaged area.
Treatment
If your bone spurs cause pain, your doctor may recommend over-the-counter pain relievers. Physical therapy can help strengthen the muscles around the affected joint. Bone spurs that limit your range of motion or press on nerves may require surgical removal.
What It Is
An injury to the bone.
Symptoms
If you have a broken ankle, you may experience some of the following signs and symptoms: Immediate, throbbing pain; pain that increases with activity and decreases with rest; Swelling, bruising, tenderness, deformity, difficulty in walking or bearing weight.
Cause
The most common causes are car accidents that cause crushing injuries. Can also be the result of falls from heights, landing on feet or jumping, impact from a heavy object, missteps, or overuse.
Treatment
Treatment for a broken ankle depends on the exact location and severity of the fracture. A severely broken ankle may require surgery to implant plates, rods, or screws into the broken bone to maintain proper position during healing.
What It Is
More pressure than a bone can withstand will cause it to break.
Symptoms
Visibly out-of-place or misshapen limb or joint, swelling, bruising, or bleeding, intense pain, numbness and tingling, limited mobility.
Cause
Fall from a height, trauma, accidents, direct blow, repetitive forces (such as running).
Treatment
Set the bone if needed, immobilize it with a splint, apply ice packs to reduce pain and swelling. Surgery may be required in severe cases.
What It Is
An injury to the bone.
Symptoms
If you have a broken foot, you may experience some of the following signs and symptoms: Immediate, throbbing pain; Pain that increases with activity and decreases with rest; Swelling; Bruising; Tenderness; Deformity; Difficulty in walking or bearing weight.
Cause
The most common causes are car accidents that cause crushing injuries. Can also be the result of falls from heights, landing on feet or jumping, impact from a heavy object, missteps, or overuse.
Treatment
Treatment for a broken foot depends on the exact site and severity of the fracture. A severely broken foot may require surgery to implant plates, rods, or screws into the broken bone to maintain proper position during healing.
What It Is
A broken toe is a common injury that most often occurs when you drop something on your foot or stub your toe.
Symptoms
Pain, swelling, and discoloration.
Cause
In most instances, a broken toe occurs when you drop something heavy on your foot, or you stub your toe against something hard.
Treatment
In most cases, a broken toe can be immobilized by taping it to a neighboring toe. But if the fracture is severe — particularly if it involves your big toe — you may need a cast or even surgery to ensure that your toe heals properly.
What It Is
Medically, a contusion. The breaking or damage of tiny blood vessels as a result of trauma to the skin.
Symptoms
Purplish discoloration under the skin that may be tender or painful.
Cause
Trauma to the skin that is the result of an impact injury such as having the foot stepped on or stepping on a rock.
Treatment
Cold compress, elevation (above the level of the heart if possible). If bleeding, apply pressure to the area to reduce bleeding.
What It Is
A bunion is a bony bump that forms on the joint at the base of your big toe. It develops when the big toe pushes against the next toe, forcing the joint of the big toe to get bigger and stick out. The skin over the bunion might be red and sore.
Symptoms
A bulging bump on the outside of the base of your big toe; Swelling, redness or soreness around your big toe joint; Corns or calluses often develop where the first and second toes overlap. Persistent or intermittent pain, restricted movement of the big toe if arthritis affects the toe.
Cause
Wearing tight, narrow shoes might cause bunions or make them worse. Bunions also can develop as a result of an inherited structural defect, stress on your foot or a medical condition, such as arthritis. They can also be the result of trauma (sprain, fracture, and nerve damage).
Treatment
Treatment options vary depending on the severity of your bunion and the amount of pain it causes. Conservative treatment ranges from wearing roomy shoes; padding, taping, or splinting to reduce stress on the bunion and alleviate pain; medications to control pain; shoe inserts to help distribute pressure; ice. Surgery to realign the toe may be necessary if conservative treatments do not provide relief.
What It Is
Bursitis is a painful condition that affects the small, fluid-filled sacs — called bursae — that cushion the bones, tendons, and muscles near your joints. Bursitis occurs when bursae become inflamed. Most often at the base of the big toe.
Symptoms
Feel achy or stiff; Hurt more when you move it or press on it; Look swollen and red.
Cause
Repetitive motions or positions that put pressure on the bursae around the joint.
Treatment
Generally, improves on its own. However, conservative treatment such as rest, ice, and pain medication can help relieve the discomfort. Physical therapy, exercise, and injections are helpful. Surgery may be necessary.
What It Is
A hard patch of skin that is rarely painful. They usually develop on the soles of your feet, especially under the heels or balls, on your palms, or on your knees. Calluses vary in size and shape and are often larger than corns.
Symptoms
Thick, rough area of skin; hardened, raised bump, tenderness, or pain under skin; flaky, dry, or waxy skin.
Cause
Pressure and friction from repetitive actions cause calluses to develop. This pressure and friction may include wearing ill-fitting shoes, and tight shoes and high heels that compress areas of your feet. When footwear is too loose, your foot may repeatedly slide and rub against the shoe. Your foot may also rub against a seam or stitch inside the shoe. Wearing shoes and sandals without socks can cause friction on your feet. Socks that don’t fit properly also can be a problem.
Treatment
To relieve discomfort, most find relief by eliminating the source of friction or pressure. Callus-removing medications and patches are available, with and without a prescription. A pumice stone, nail file or emery board is useful for removing dead skin.
What It Is
The first joint of a toe is cocked upward, and both the middle joint and the tiny joint at the end of the toe are curled downward like a claw.
Symptoms
The toe is unable to straighten out. Calluses may form as a result of irritation.
Cause
The cause can be from a nerve-damaging disease like diabetes or alcoholism which weakens the muscles in the foot.
Treatment
Avoid high heels and tight-fitting shoes, do stretches for the toes and toe joints, wear shoe inserts. Stiff-soled shoes or foot pads may help relieve pressure. Surgery may be an option in some cases.
What It Is
The medical term for a bruise. The breaking or damage of tiny blood vessels as a result of trauma to the skin.
Symptoms
Purplish discoloration under the skin that may be tender or painful.
Cause
Trauma to the skin that is the result of an impact injury such as having the foot stepped on or stepping on a rock.
Treatment
Cold compress, elevation (above the level of the heart if possible). If bleeding, apply pressure to the area to reduce bleeding.
What It Is
Thickened skin on the top of the toes, smaller than calluses, and have a hard center surrounded by inflamed skin. Corns tend to develop on parts of your feet that don’t bear weight (such as the tops), sides of your toes, and even between your toes. They can also be found in weight-bearing areas. Corns can be painful when pressed.
Symptoms
Thick, rough area of skin; hardened, raised bump, discomfort, tenderness, or pain under skin; flaky, dry, or waxy skin.
Cause
The thickening is a natural defense mechanism to strengthen the skin in areas of friction or excessive pressure. Pressure and friction from repetitive actions cause corns to develop and grow. Some sources of this pressure and friction include wearing ill-fitting shoes, and tight shoes and high heels that compress areas of your feet. When footwear is too loose, your foot may repeatedly slide and rub against the shoe. Your foot may also rub against a seam or stitch inside the shoe. Wearing shoes and sandals without socks can cause friction on your feet. Socks that don’t fit properly also can be a problem.
Treatment
Treatment is necessary to relieve discomfort. Most find relief by eliminating the source of friction or pressure. Treatment for corns usually involves avoiding the repetitive actions that caused them to develop. You can help resolve them by wearing shoes that fit correctly, using protective pads, and taking other self-care measures. Shoe inserts may help if there is an underlying foot deformity. In rare instances, surgery may be necessary.
What It Is
Diabetic neuropathy is a type of nerve damage that can occur if you have diabetes which affects nerves, blood vessels, and blood flow. High blood sugar (glucose) can injure nerve fibers throughout your body, but most often damages nerves in your legs and feet.
Symptoms
Depending on the affected nerves, symptoms of diabetic neuropathy can range from pain and numbness in your extremities to problems with your digestive system, urinary tract, blood vessels and heart. For some people, these symptoms are mild; for others, diabetic neuropathy can be painful, disabling, and even fatal.
Cause
Prolonged exposure to high blood sugar can damage delicate nerve fibers, causing diabetic neuropathy. Other factors that may contribute to diabetic neuropathy include inflammation in the nerves, genetic factors, smoking, and alcohol abuse.
Treatment
Diabetic neuropathy has no known cure. Treatment for diabetic neuropathy focuses on slowing progression of the disease, relieving pain. managing complications, and restoring function. The use of anti-seizure medication and antidepressants can help relieve pain.
What It Is
The arches on the inside of your feet are flattened, allowing the entire soles of your feet to touch the floor when you stand. Also called “Fallen Arches.”
Symptoms
A common and usually painless condition, flat feet can occur when the arches don’t develop during childhood. Flat feet can sometimes contribute to problems in your ankles and knees, because the condition can alter the alignment of your legs. Most people have no signs or symptoms associated with flat feet. But some people with flat feet experience foot pain, particularly in the heel or arch area. Pain may worsen with activity. Swelling along the inside of the ankle can also occur.
Cause
A flat foot is normal in infants and toddlers because the foot’s arch hasn’t yet developed. Most people’s arches develop throughout childhood, but some people never develop arches. It is a normal variation in foot type, and people without arches may or may not have problems. Arches can also fall over time. Years of wear and tear can weaken the tendon that runs along the inside of your ankle and helps support your arch.
Treatment
No treatment is necessary for flat fee if they do not cause pain. If painful, treatment options include arch support (orthotic devices), stretching exercises, supportive shoes, and physical therapy. Surgery isn’t done solely to correct flat feet. However, surgery may be necessary for an associated problem, such as a tendon tear or rupture.
What It Is
Foot heaviness or weakness.
Symptoms
A weak or heavy feeling that makes it impossible to flex the ankle and bring the front of the foot up. Pain that radiates down the outside of the calf and over the top of the foot to the big toe.
Cause
Due to an L5 nerve root problem.
Treatment
Various treatments to relieve pressure on the nerve in the back.
What It Is
Gout is a complex form of arthritis, characterized by sudden, severe attacks of pain, redness, and tenderness in joints, often the joint at the base of the big toe.
Symptoms
An attack of gout can occur suddenly, often at night and without warning. The sensation is that the big toe is on fire. The affected joint is hot, swollen, red, and so tender that even the weight of the sheet on it may seem intolerable. Gout is most common in the big toe, but it can also occur in the feet and ankles. Pain is most severe within the first 4 to 12 hours of an attack. There is lingering discomfort for a few days or weeks; inflammation and redness, tender, warm and red. Limited range of motion.
Cause
Gout occurs when urate crystals accumulate in your joint, causing the inflammation and intense pain of a gout attack. Urate crystals can form when you have high levels of uric acid in your blood. Your body produces uric acid when it breaks down purines — substances that are found naturally in your body, as well as in certain foods like steak, organ meats, seafood, and drinks sweetened with fruit sugar (fructose). Normally, uric acid dissolves in the blood and is eliminated through the kidneys via urine. But sometimes your body either produces too much uric acid or the kidneys excrete too little uric acid. When this happens, uric acid can build up, forming sharp, needle-like urate crystals in a joint or surrounding tissue that cause pain, inflammation, and swelling.
Treatment
Early stages of gout can be treated with diet and lifestyle changes. Treatment usually involves medications including NSAIDs and corticosteroids for inflammation and pain. Other drugs may be used to help block the production of uric acid.
What It Is
A bony enlargement on the back of the heel.
Symptoms
The symptoms include a noticeable bump on the back of the heel, pain in the area where the Achilles tendon attaches to the heel, swelling in the back of the heel, and redness near the inflamed tissue.
Cause
The soft tissue near the Achilles tendon becomes irritated when the bony enlargement rubs against shoes leading to bursitis (an inflammation of the bursa). Often called “pump bump” because the rigid backs of pump-style shoes can create pressure that aggravates the enlargement when walking. In fact, any shoes with a stiff back, such as ice skates, men’s dress shoes, or women’s pumps, can cause this irritation. To some extent, heredity plays a role in Haglund’s deformity. Inherited foot structures that can make one prone to developing this condition include a high-arched foot, a tight Achilles tendon, or a tendency to walk on the outside of the heel.
Treatment
Non-surgical treatment of Haglund’s deformity is aimed at reducing the inflammation of the bursa. While these approaches can resolve the pain and inflammation, they will not shrink the bony protrusion. Non-surgical treatment can include one or more of the following: medication, ice, exercises, heel lifts, heel pads, or other shoe modifications to help avoid or minimize irritation. Physical therapy. Custom orthotic devices to control the motion of the foot are helpful, and immobilization. In some cases, casting may be necessary. Surgery may be required if more conservative measures do not relieve the pain.
What It Is
A type of arthritis.
Symptoms
Pain and stiffness of the joint that worsens over time.
Cause
Arthritis.
Treatment
Pain relievers and stretching exercises. In some cases, surgery may be necessary.
What It Is
A deformity in which a toe bends downward, or buckles, at the middle joint. The second toe is most often affected; however, other toes (and more than one) can be affected.
Symptoms
An abnormal bend in the joints of one or more of your toes. Moving the affected toe may be difficult or painful. Problems walking may lead to blisters, corns, and calluses as a result of the toe rubbing against the inside of the shoes.
Cause
The type of shoes you wear, foot structure, trauma, an abnormal balance of the toe muscles, and certain disease processes can contribute to the development of these deformities. Also, a weakened muscle makes the tendons shorter forcing the toe to curl under the foot.
Treatment
If your toe is still flexible, roomier, more comfortable footwear and shoe inserts (orthotics) or pads may help. Exercise (like pickup up marbles or crumpling a towel with the toes) will help stretch and strengthen the toes. If conservative treatment does not help, surgery can release the tendon that prevents the toe from lying flat, or removing a piece of bone to straighten the toe.
What It Is
A fracture of the heel bone. In some cases, the heel bone may shatter.
Symptoms
Heel pain, bruising, swelling, or trouble walking are the main symptoms.
Cause
A heel fracture is often the result of a high-impact injury, as from a fall or an accident.
Treatment
Avoid putting pressure on the heel, often by using crutches. Protect the heel with pads, wear a splint or cast, over-the-counter pain relievers, physical therapy may also be an option. In some cases, surgery may be necessary to repair.
What It Is
A bone growth on the heel bone, usually located on the underside of the heel where it attaches to the plantar fascia.
Symptoms
Pain when pressure is placed on the heel along with inflammation and tenderness.
Cause
Wearing the wrong shoes, abnormal walk or posture, running. Over time, the body builds extra bone tissue in response to stress and inflammation.
Treatment
Includes: rest, cold packs, anti-inflammatory medication, proper stretching before activity, correct footwear, shoe inserts, well-fitting shoes with shock-absorbing soles, and corticosteroid injections. Surgery may be necessary for more severe or prolonged conditions.
What It Is
The inability, or limited ability to bring the foot up.
Symptoms
Unable to bring foot upward, may be accompanied by numbness in the middle lower leg and foot.
Cause
One or more spinal nerve roots in the lower back that stimulate the sciatic nerve are affected.
Treatment
Various treatments to relieve pressure on the nerve in the back.
What It Is
A common condition in which the corner or side of a toenail grows into the soft flesh of the toe, usually the big toe.
Symptoms
Pain, redness, swelling, and sometimes, an infection.
Cause
Wearing shoes that crowd your toenails, cutting your toenails too short or not straight across, injuring your toenail, having unusually curved toenails.
Treatment
Lifting the nail to separate the nail from the skin, partially remove the nail, remove the nail and tissue. Soak the feet, elevate the foot, proper nail cutting, and good general foot hygiene. Oral antibiotics are sometimes required as a treatment if infection is present.
What It Is
Mallet toe affects the joint nearest the toenail. A foot deformity that occurs due to an imbalance in the muscles, tendons or ligaments that normally hold the toe straight. Usually occurs in the second, third, and fourth toes.
Symptoms
An abnormal bend in the joints of one or more of your toes. Moving the affected toe may be difficult or painful. Corns and calluses can result from the toe rubbing against the inside of your shoes.
Cause
The type of shoes you wear, foot structure, trauma, an abnormal balance of the toe muscles, and certain disease processes can contribute to the development of these deformities.
Treatment
If your toe is still flexible, roomier, more comfortable footwear and shoe inserts (orthotics) or pads may help. Inserts or pads can reposition your toe and relieve pressure and pain. Exercise (like pickup up marbles or crumpling a towel with the toes) will help stretch and strengthen the toes. If conservative treatment does not help, surgery can release the tendon that prevents the toe from lying flat, or removing a piece of bone to straighten the toe.
What It Is
Fracture in a small area of the fifth metatarsal that receives less blood and is more prone to difficulties in healing.
Symptoms
Intense and sudden pain where the trauma occurred, swelling; bruising, trouble moving the bone or joint, pain when trying to move.
Cause
Overuse, repetitive stress, or trauma. Less common and more difficult to treat than Avulsion fractures.
Treatment
Often do not require a cast, a stiff-soled shoe may be all that’s needed for support as the foot heals. Sometimes surgery is necessary to correct misaligned bones or fractured segments.
What It Is
A condition in which the ball of the foot becomes painful and inflamed.
Symptoms
Sharp, aching or burning pain in the ball of your foot — the part of the sole just behind your toes. Pain that worsens when standing, running, flexing the feet, or walking — especially barefoot on a hard surface that improves when resting. Sharp or shooting pain, numbness, or tingling in the toes. A feeling of having a pebble in your shoe.
Cause
Can develop if you participate in activities that involve running and jumping. Intense training or activity in running and jumping sports. Certain foot shapes (high arch), foot deformities (hammertoe and bunions), excess weight, poorly fitting shoes (too tight or loose), stress fracture, Morton’s neuroma.
Treatment
Conservative measures — such as resting, changing shoes, or using a metatarsal pad — might be all you need to relieve signs and symptoms. In rare cases, surgery may be necessary to realign the metatarsal bones.
What It Is
A buildup of non-cancerous (benign) tissue in the nerves running between the long bones of the foot, usually the bones leading to the third and fourth toes or the second and third toes. Usually occurs after standing or walking for extended periods.
Symptoms
Swelling, tenderness, and pain in the ball of the foot. May lead to tingling, numbness, and burning that radiates to the toes. An odd feeling, as if standing on a pebble in the shoe. The pain may force a person to limp or stop walking.
Cause
Two metatarsal bones in the foot rub together, squeezing the nerve between them at the base of the toes. Women suffer from it more often due to wearing high heels or tight shoes.
Treatment
Treatment depends on the severity of the symptoms. Arch support and foot pads help reduce pressure on the nerve, along with rest and footwear that does not restrict the foot. Cortisone injections or surgery may be an option if the problem persists.
What It Is
Nerve damage in the feet.
Symptoms
Pain anywhere in the foot that might feel like a burning, stinging, or might feel like electricity.
Cause
Nerve damage caused by diabetes.
Treatment
Treatment goals are to manage the condition causing the neuropathy and to relieve symptoms. Pain medications, such as nonsteroidal anti-inflammatory drugs, can reduce mild symptoms; Anti-seizure medications developed to treat epilepsy, may relieve the pain. Topical treatments like capsaicin cream may help. Certain tricyclic antidepressants may help ease the pain by interfering with chemical processes that cause you to feel pain.
What It Is
A common form of arthritis that damages joints by wearing down the protective cartilage on the ends of bones over time.
Symptoms
Pain, tenderness, stiffness, and a loss of flexibility. There may be the sound or feeling of a grating sensation when using the joint. Bone spurs.
Cause
Age, obesity, joint injury, occupations that place repetitive stress on the feet and ankles, genetics, and bone deformities.
Treatment
Osteoarthritis cannot be reversed, but symptoms can usually be managed efficiently with lifestyle changes, physical and other therapies, medications, and surgery. Exercising and achieving a healthy weight are the best ways to treat osteoarthritis. Nonsteroidal anti-inflammatory drugs (NSAIDs) may help reduce inflammation and pain. If conservative measures don’t help, cortisone injections, realigning bones or ankle replacement surgery may be necessary.
What It Is
A bone infection. People who have diabetes may develop osteomyelitis in their feet if they have foot ulcers.
Symptoms
Fever or chills, irritability or lethargy in young children, pain in the area of the infection, swelling, warmth and redness over the area of the infection. Sometimes osteomyelitis causes no signs and symptoms, or has signs and symptoms that are difficult to distinguish from other problems.
Cause
Most cases of osteomyelitis are caused by staphylococcus bacteria, a type of germs commonly found on the skin or in the nose of even healthy individuals. The bacteria can enter a bone via the bloodstream from other parts of the body to a weakened spot in a bone, infected tissue or prosthetic joint, or open wounds near a broken bone.
Treatment
Once considered an incurable condition, osteomyelitis can be successfully treated today. Most people require surgery to remove dead or damaged bone, followed by strong antibiotics, often delivered intravenously, typically for at least four to six weeks.
What It Is
Paget’s disease of bone interferes with the body’s normal recycling process, in which new bone tissue gradually replaces old bone tissue. Over time, the disease can cause affected bones to become fragile and misshapen. Paget’s disease of bone affects the heel bone (calcaneus) as well as the legs, pelvis, spine, and skull.
Symptoms
The most common complaint is “bone pain.” As the bones weaken, they may bend.
Cause
The disease causes the body to generate new bone faster than normal, producing bone that is softer and weaker than normal bone. The condition leads to bone pain, deformities, and fractures. The cause of Paget’s disease of bone is unknown. Scientists suspect a combination of environmental and genetic factors contribute to the disease.
Treatment
Osteoporosis drugs (bisphosphonates) are the most common treatment for Paget’s disease of bone. If surgery is necessary, the most common procedure is joint replacement.
What It Is
A disorder that occurs when the nerves are damaged or destroyed, and no longer function properly.
Symptoms
Pain, prickling, or numbness that can spread up from the feet into the legs; can be sharp, stabbing pains and have a burning or tingling sensation. Weakness is also a symptom.
Cause
Those with a family history are more likely to develop the disorder, which can be caused by diabetes, high blood pressure, or being overweight. It may also be the result of an injury to the nerves (accident, fall, or fracture).
Treatment
Treatment is based on the cause of the disorder, and can include pain medication and anti-inflammatory drugs, TENS, ergonomic casts, and splints.
What It Is
One of the most common causes of heel pain. It involves inflammation of the tough fibrous tissue that connects the heel bone to the base of the toes (fascia). It is common in people who have occupations that require standing or walking on hard surfaces.
Symptoms
Pain and stiffness in the bottom of the heel. The pain may be dull or sharp, and the bottom of the foot may also ache or burn. The pain may be worse in the morning when taking the first few steps, after standing or sitting for a while, climbing stairs, after intense activity, walking, running, and jumping sports.
Cause
Normally, the plantar fascia acts like a shock-absorber, supporting the arch of the foot. If tension and stress on it become too great, small tears can arise in the fascia. Repetitive stretching and tearing can cause the fascia to become irritated or inflamed. It is most common in runners, people who are overweight, and those who wear shoes with inadequate support, and who are on their feet throughout the day.
Treatment
Most recover with conservative treatments, including resting, icing the painful area, and stretching over the course of several months. Nonsteroidal anti-inflammatory medication can help ease the pain and inflammation. Stretching and strengthening exercises (physical therapy), night splints; and daytime orthotics (arch supports) help distribute pressure more evenly to the feet. Steroid injections, extracorporeal shock wave therapy (sound waves) can help stimulate healing. Tenex, a minimally invasive procedure to remove scar tissue without surgery, may be helpful. Surgery to detach the plantar fascia from the heel bone is the last option when the pain is severe, and all else fails.
What It Is
Small growths that usually appear on the heels or other weight-bearing areas of your feet. This pressure may also cause plantar warts to grow inward beneath a hard, thick layer of skin (callus).
Symptoms
Pain or tenderness when walking or standing caused by a small, fleshy, rough, grainy growth (lesion) on the bottom of the foot, usually at the base of the toes and forefoot or the heel. A hard, thickened skin (callus) over a well-defined “spot” on the skin, where a wart has grown inward. Can appear as black pinpoints that are small clotted blood vessels (commonly called wart seeds), and may also appear as a lesion that interrupts the normal lines and ridges in the skin of the foot.
Cause
Plantar warts are caused by HPV, a virus that enters the body through tiny cuts, breaks or other weak spots on the bottom of the feet.
Treatment
Most plantar warts are harmless and go away without treatment, though it may take a year or two. If the warts are painful or spreading, nonprescription medications or home remedies may help, but warts may return. If self-care has not helped, a medical professional can prescribe wart medications with salicylic acid, freezing medication (cryotherapy), laser treatment, or surgical removal.
What It Is
A condition that causes some areas of the body (such as fingers and toes) to feel numb and cold in response to cold temperatures or stress. Smaller arteries that supply blood to the skin narrow, limiting blood circulation to the affected areas (vasospasm). For most people, Raynaud’s disease isn’t disabling but can affect quality of life.
Symptoms
Signs and symptoms depend on the frequency, duration, and severity of the blood vessel spasms that underlie the disorder. The symptoms include cold toes, color changes in the skin in response to cold or stress, numb, prickly feeling, or stinging pain upon warming or relief of the stress. During an attack, affected areas of the skin usually first turn white. Then they turn blue, and feel cold and numb. As you warm and circulation improves, the affected areas may become red, throb, tingle or swell. Although the disease most commonly affects your fingers and toes, the condition can also affect other areas (nose, lips, and ears).
Cause
Doctors don’t completely understand the cause of Raynaud’s attacks, but blood vessels appear to overreact to cold temperatures or stress. The arteries to the fingers and toes narrow (go into vasospasm) when exposed to cold or stress, and temporarily limit blood supply to the area. Over time, these small arteries may thicken slightly, further restricting blood flow.
Treatment
Dressing for the cold in layers, and wearing gloves or heavy socks is usually effective in dealing with mild symptoms of Raynaud’s. Medications are available to treat more severe forms of the condition. The goals of treatment are to reduce the number and severity of attacks, prevent tissue damage, and treat the underlying disease or condition. Medication are also affective to widen (dilate) blood vessels and promote circulation. For some severe cases, chemical injections to block nerves can help, or surgery may be necessary to cut the nerves in the affected area.
What It Is
Joint pain and swelling triggered by an infection in another part of your body that targets knees and the joints of your ankles and feet (sometimes called Reiter’s syndrome).
Symptoms
Pain and stiffness; inflammation of soft tissue where it enters the bone (muscles, tendons, and ligaments); swollen toes that may be so swollen they resemble sausages. A variety of skin problems that include a rash on the soles of the feet.
Cause
Reactive arthritis develops in reaction to an infection in the body, which the patient might not be aware of if the symptoms are mild. Numerous bacteria can cause reactive arthritis including Salmonella.
Treatment
The goal of treatment is to manage your symptoms and treat an infection that could still be present. Antibiotic medication may be prescribed if a bacterial infection was the trigger. To address the arthritis, Nonsteroidal anti-inflammatory drugs (NSAIDs) can help relieve the pain and inflammation, corticosteroids can help reduce inflammation, topical steroids can help relive skin rashes, and rheumatoid arthritis drugs can help relieve pain and stiffness. In some cases, physical therapy can help with strengthening exercises to develop the muscles around the affected joints.
What It Is
A chronic inflammatory disorder that can affect more than just the joints. In some people, the condition can also damage a wide variety of body systems, including the skin, eyes, lungs, heart, and blood vessels.
Symptoms
Signs and symptoms of rheumatoid arthritis may include tender, warm, swollen joints, joint stiffness that is usually worse in the mornings and after inactivity, fatigue, fever, and weight loss. Early rheumatoid arthritis tends to affect your smaller joints first — particularly the joints that attach the toes to the feet. As the disease progresses, symptoms can spread to the ankles.
Cause
As autoimmune disorder, rheumatoid arthritis occurs when your immune system mistakenly attacks your own body’s tissues. Rheumatoid arthritis occurs when your immune system attacks the lining of the membranes that surround joints (synovium). The resulting inflammation thickens the synovium and can eventually destroy the cartilage and bone within the joint. The tendons and ligaments that hold the joint together weaken and stretch until, gradually, the joint loses its shape and alignment. Doctor’s don’t know what begins the process, but a genetic component appears likely.
Treatment
Nonsteroidal anti-inflammatory drugs (NSAIDs) can relieve pain and reduce inflammation. Corticosteroid medications can reduce inflammation and pain, and slow joint damage. Disease-modifying antirheumatic drugs (DMARDs) can slow the progression of rheumatoid arthritis and save the joints and other tissues from permanent damage. Biologic agents, a newer class of DMARDs, which target the parts of the immune system that trigger inflammation and causes joint and tissue damage.
What It Is
Septic arthritis is a painful infection in a joint. The infection can come from germs that travel through your bloodstream from another part of your body.
Symptoms
Septic arthritis typically causes extreme discomfort and difficulty using the affected joint. The joint could be swollen, red and warm, and you might have a fever.
Cause
Septic arthritis can be caused by bacterial, viral, or fungal infections. Bacterial infection with Staphylococcus aureus (staph) is the most common cause. If a penetrating injury delivers the germs directly into a joint, septic arthritis can occur. Infants and older adults are most likely to develop septic arthritis. Knees are most commonly affected, but septic arthritis can also affect other joints. The infection can quickly and severely damage the cartilage and bone within the joint, so prompt treatment is crucial.
Treatment
Doctors rely on joint drainage and antibiotic drugs to treat septic arthritis. Removing the infected joint fluid is crucial. Drainage methods include withdrawing the infected fluid with a needle inserted into the joint space via arthroscopy (scope). A flexible tube suction and drainage tubes are then inserted through small incisions around the affected joint. Surgery may be necessary if the joint is difficult to drain. Antibiotics are then administered depending on the specific microbe that caused the infection.
What It Is
A break in the two small bones of the foot (sesamoids) that have embedded tendons attached to the big toe.
Symptoms
Pain in and around the big toe.
Cause
Generally caused by poor-fitting footwear.
Treatment
Wear better-fitting shoes, soak foot and use a pumice stone to wear down the extra skin.
What It Is
A form of tendinitis common with runners and ballet dancers affecting the tendons surrounding the two bones near the big toe.
Symptoms
Inflammation.
Cause
Injury to the foot.
Treatment
Rest, ice packs, shoe pad insert under the toe in comfortable shoes, tape the big toe to immobilize the joint, wear low-heel shoes, steroid injections.
What It Is
Abnormal stretching or tearing of a ligament that supports a joint.
Symptoms
Pain, inflammation, swelling, and spasms that may develop after the initial injury.
Cause
A sprain can be caused by repetitive activities that put the body under physical stress forcing the muscles and joints to perform movements for which they are not prepared or designed, or an injury. The ankle is the most common joint sprained.
Treatment
RICE – Rest, Ice, Compression, and Elevation are key to the initial treatment.
What It Is
A deep bruise of the fat pad of the heel or ball of the foot.
Symptoms
Pain that feels like walking on a pebble.
Cause
Often an impact injury, but can also happen after stepping on a hard object.
Treatment
It will gradually go away on its own. Until it does, rest the foot, ice the area, and take over-the-counter pain relievers.
What It Is
Abnormal stretching or tearing of a muscle or tendon.
Symptoms
Pain, inflammation, swelling, and spasms that may develop after the initial injury
Cause
A strain can be caused by repetitive activities that put the body under physical stress forcing the muscles and joints to perform movements for which they are not prepared or designed, or an injury.
Treatment
RICE – Rest, Ice, Compression, and Elevation are key to the initial treatment. Anti-inflammatory medications will help decrease the pain and inflammation.
What It Is
Stress fractures are tiny cracks in a bone from repetitive force, often from overuse (repeatedly jumping or running long distances). Stress fractures can also arise from normal use of a bone that’s weakened by a condition such as osteoporosis. They can occur in the toes, metatarsal bones, or heel.
Symptoms
At first, you might barely notice the pain associated with a stress fracture, but it tends to worsen with time. The tenderness usually originates from a specific spot and decreases during rest. There may be swelling around the painful area, but no bruising. Pain occurs with or after normal activity, then goes away when resting, but returns upon standing or with activity.
Cause
Stress fractures often result from increasing the amount or intensity of an activity too quickly. A bone adapts gradually to increased loads through remodeling, a normal process that speeds up when the load on the bone increases. During remodeling, bone tissue is destroyed (resorption), then rebuilt. Bones subjected to unaccustomed force without enough time for recovery resorb cells faster than your body can replace them, which makes you more susceptible to stress fractures.
Treatment
To reduce the bone’s weight-bearing load until healing occurs, you might need to wear a walking boot or brace, or use crutches. Although unusual, surgery is sometimes necessary to ensure complete healing of some types of stress fractures, especially those that occur in areas with an inadequate blood supply.
What It Is
Tarsal tunnel syndrome is similar to carpal tunnel syndrome, which occurs in the wrist. Both disorders arise from the compression of a nerve in a confined space. Tarsal tunnel syndrome is a compression, or squeezing, on the posterior tibial nerve (a branch of the sciatic nerve) that produces symptoms anywhere along the path of the nerve running from the inside of the ankle into the foot.
Symptoms
Symptoms include tingling, burning, or a sensation similar to an electrical shock, numbness, pain (including shooting pain). Sometimes the symptoms of the syndrome appear suddenly brought on or aggravated by overuse of the foot, such as in prolonged standing, walking, exercising, or beginning a new exercise program.
Cause
Tarsal tunnel syndrome is caused by anything that produces compression on the posterior tibial nerve. A person with flat feet is at risk, because of the outward tilting of the heel with “fallen” arches can produce strain and compression on the nerve. It can also be caused by an enlarged or abnormal structure within the tarsal tunnel that can compress the nerve (e.g., varicose vein, ganglion cyst, swollen tendon, and arthritic bone spur). An injury, such as an ankle sprain may produce inflammation and swelling in or near the tunnel, resulting in compression of the nerve. Systemic diseases such as diabetes or arthritis can cause swelling and compress the nerve.
Treatment
A variety of treatments (often in combination) may relieve symptoms, including rest, ice, nonsteroidal anti-inflammatory drugs (NSAIDs), immobilization, restricting movement with a cast, ultrasound therapy, exercises, and other physical therapy modalities. Injections of a local anesthetic can provide pain relief. An injected corticosteroid may be useful in treating the inflammation. Custom shoe inserts may help maintain the arch and limit excessive motion that can cause compression of the nerve. Supportive shoes and bracing may be helpful. Surgery may be necessary in some cases, based on the cause of the condition.
What It Is
Tendinitis is inflammation or irritation of a tendon — any one of the thick fibrous cords that attaches muscle to bone in the foot.
Symptoms
Symptoms tend to occur at the point where a tendon attaches to a bone, and typically include pain (often described as a dull ache, especially when moving the joint), tenderness, and mild swelling. The symptoms occur just outside the joint, and commonly around the heel.
Cause
Although tendinitis can be caused by a sudden injury, the condition more likely stems from the repetition of a particular movement over time. Most people develop tendinitis because their jobs or hobbies involve repetitive motions, which put stress on the tendons needed to perform the tasks.
Treatment
The goals of tendinitis treatment are to relieve your pain and reduce inflammation. Often, rest, ice, and over-the-counter pain relievers may be all that’s necessary. Additional therapies include corticosteroid injections to help reduce inflammation and ease pain. Specific exercise and physical therapy designed to stretch and strengthen the affected muscle-tendon unit is often helpful. In some cases, depending on the severity, surgical repair is necessary, especially if the tendon has torn away from the bone.
What It Is
Damage to the ligaments or soft tissue of a toe.
Symptoms
Pain and swelling.
Cause
Caused by jamming or stubbing the toe.
Treatment
If the toe is not fractured, the pain and swelling will go way in a few days.
What It Is
An abnormal growth of cells that may be benign (non-cancerous) or malignant (cancerous).
Symptoms
Symptoms include a fracture from a slight injury, bone pain (often at night at the site of the tumor), and occasionally a mass of swelling in the area. May appear as a ‘bump’ on the foot or ankle.
Cause
Possibly a primary tumor (originating in the foot), or a secondary tumor (originating in another part of the body).
Treatment
Removal of the tumor through surgery, chemotherapy, or radiation. Pain control with medication or other methods.
What It Is
An injury, or sprain, to the big toe and joint at the base of the big toe (ball of the foot). The sprain may involve damage to the ligaments or bone as well.
Symptoms
Symptoms include pain in the ball of the foot. Depending on the severity, the pain may be present with or without movement. Patients may also experience a reduction of strength and range of motion, if the injury is acute. Walking and maintaining balance may be difficult.
Cause
This injury is common in athletes trying to push off the ground, causing a stretch or hyperextension injury to the structures on the bottom of the big toe. It can also be caused by plantar fasciitis, arthritis, contusions, blisters, bunions, neuromas, sesamoiditis, hammertoe, fractures, and gout.
Treatment
RICE – Rest, Compression, and Elevation. Over-the-counter or prescription medications for pain and inflammation. Stretching and strengthening exercises.