Types of Foot Pain
The types of foot pain are:
Conditions That Occur Anywhere on the Foot
Tendinopathy is an injury to a tendon. A tendon connects muscle to bone and helps move joints. This problem includes:
- Tendonitis—An inflammation of the tendon
- Tendinosis—Microtears in the tendon tissue with no major inflammation
Tendinopathy is often from overuse or repetitive motion. The strain on the tendon causes tiny tears in the tissue that build up over time.
A sprain is a stretch or tear of a ligament. Ligaments bind bones to each other. Sprains can be from overstretching a ligament during activity. It can also be from trauma, such as a fall.
Infections that happen on the skin or in soft tissue can spread to the bones without treatment. Infections that affect the foot can be bacterial, fungal, viral, or parasitic. Organisms can enter the body from a break in the skin, such as a scratch, cut, or ulcer.
Foot pain may be a sign of a more serious health problem, such as:
- Diabetes—People with diabetes have a greater risk of foot ulcers and neuropathy. Neuropathy limits nerve function and causes a person to have less feeling in the feet. It may also cause a burning or tingling feeling.
- Osteoporosis—A loss of bone mass may cause fractures in the foot or ankle.
- Arthritis—Joint pain and inflammation that can affect one or both sides of the body.
- Gout—A buildup of uric acid crystals in one or several joints causing pain and inflammation, often in the big toe.
Corns and Calluses
Corns and calluses are thickened layers of skin. They are caused by irritation. The corn is usually cone-shaped and has a knobby core that points in. This core can put pressure on the thin skin under it and cause sharp pain. Corns can be on top of or between the toes. Soft corns can happen between the toes. They are kept flexible by the moisture from sweat. Calluses happen on the bottom of the foot. Corns and calluses happen as a result of friction from the toes rubbing together or against the shoe. Calluses can happen anywhere on the foot.
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Corns are from:
- Shoes, socks, or stockings that fit too tightly around the toes
- Pressure on the toes from high-heeled shoes
- Deformed and crooked toes
Calluses are from:
- Poorly fitting shoes
- Walking on hard surfaces
- Flat feet
Bursitis of the Toe
Bursitis is an inflammation of the fluid-filled sacs that protect the toe joints, often the big toe. It can happen from irritation due to rubbing.
Ingrown toenails can happen on any toe. They are most common on the big toe. They can happen due to tight-fitting or narrow shoes. These put too much pressure on the outside of the big toe. This forces the nail to grow into the flesh of the toe. Poor toenail trimming can also add to the risk. Other problems that can lead to ingrown toenails are:
- Injury to the toe
- An unusual foot structure
- Repeat impact on the toenail from the shoe during high-impact exercise
A bunion is a painful swelling. It is from the movement of the base of the big toe away from the smaller toes. At the same time, the end of the big toe moves toward the smaller toes. This may cause the head of the metatarsal bone to stick out and rub against the side of the shoe. The tissue under it becomes inflamed. Bone growth may happen at the site of irritation.
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Bunions can be caused by things like:
- Injury in the joint
- Narrow high-heeled shoes with pointed toes that can put pressure on the front of the foot
A hammertoe is a deformity of the toe joint. The toe bends up slightly and then curls downward, resting on its tip. This can cause the tendons of the toe to contract and stiffens the toe into a hammer, or claw-like, shape.
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A hammertoe is most common in the second toe. It can also happen in any or all of the 3 middle toes if they are pushed forward in a shoe and do not have enough room to lie flat.
Hammertoes are often caused by wearing shoes that are too short.
Neuromas happen when a nerve, or the tissue around it, becomes enlarged and inflamed. One symptom is a burning or tingling feeling. Another symptom is cramping in the front of the foot. It can be caused by:
- Tight, poorly fitting shoes
- Injury, especially pounding of the feet
- Unusual bone structure
Morton neuroma is when the metatarsal bones in the middle toes pinch the nerve that runs between them.
A stress fracture in the foot usually happens in one of the five metatarsal bones. It is most common in the second or third. These fractures are caused by overuse during exercises, such as running and other high-impact sports.
Sesamoiditis is a problem with the small bones under the head of the big toe. The bones and tissues around the sesamoids can become inflamed and irritated. It is most common in people who do high-impact activities, such as ballet dancing and running.
When a cause cannot be found, any pain in the ball of the foot is called metatarsalgia. It is most likely caused by poor footwear or by high-impact activities. People with a high-arched foot are more likely to have this problem.
Tarsal Tunnel Syndrome
Tarsal tunnel syndrome is from compression of a nerve that runs through a narrow passage. It goes behind the inner anklebone down to the heel. It may be caused by injury to the ankle, such as a sprain or fracture. It may also be caused by a growth that presses against the nerve.
Pronation is the normal motion that allows the foot to adapt to uneven walking surfaces and to absorb shock. The outside of the foot turns upward when there is too much pronation. This flattens the arch. It also stretches and pulls the fascia. It can cause foot pain. It can also affect walking. This can lead to problems in the hip, knee, and lower back.
The heel is the largest bone in the foot. Heel pain is the most common foot problem. It can happen in the front, back, or bottom of the heel.
Plantar fasciitis happens from small tears and inflammation in the ligament-like structure that stretches from the heel to the ball of the foot. It supports the arch of the foot and helps to serve as a shock absorber.
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Plantar fasciitis is often from overuse during high-impact exercise and sports, especially running. Other things that may raise the risk are obesity, tight calf muscles, poorly fitting shoes, or an uneven stride.
Pain is around the undersurface of the heel. It often spreads to the arch. It may last a short time or happen for a long time. It is often better with rest. The pain may return.
Heel spurs are bony growths that stick out from the bottom of the heel bone. They are parallel to the ground. The spur happens where the plantar fascia attaches. The pain in that area is from irritation of the attachment. There is a nerve that runs close to this area and may add to the pain. Some people may not have symptoms.
Haglund deformity is a bony growth on the back of the heel bone. It irritates the bursa and the skin behind the heel bone. It is also called a "pump bump." It happens when the back of your shoe rubs against the back of the heel. This irritates the bursa and skin that is over the bone.
Achilles tendinopathy is break down of the tendon that connects the calf muscles to the heel bone. There are two common types: tendinosis and tendonitis. Tendonitis is an inflammation of the tendon. Tendinosis is more common and does not cause inflammation. The tendon suffers from too much stress and internal injury. A small area breaks down. Small internal tears may happen. Achilles tendinosis happens mostly in people who do high-impact exercise, such as running and tennis. People with tight calf muscles are at higher risk.
A stress fracture can happen in the heel. It is caused by overuse during strenuous exercise, such as running. Stress fractures are common in military training.
Arch and Bottom-of-the-Foot Pain
Flat feet is the lack of an arch in the foot. It is often inherited. The arch may also go away as a person ages. It is also called posterior tibial tendon dysfunction (PTTD). Some people may not have problems from it.
Abnormally High Arches
An overly high arch can cause problems. This is also known as cavus foot. It is much less common than the flat foot.
- Foot care 101. American Podiatric Medical Association website. Available at: http://www.apma.org/files/FileDownloads/myFEETFootCare101.pdf.
- Foot complications. American Diabetes Association website. Available at: https://diabetes.org/diabetes/foot-complications.
- Foot pain and problems. Johns Hopkins Medicine website. Available at: https://www.hopkinsmedicine.org/health/conditions-and-diseases/foot-pain-and-problems.
- Foot pain in adults—approach to the patient. EBSCO DynaMed website. Available at: https://www.dynamed.com/approach-to/foot-pain-in-adults-approach-to-the-patient.
- Warren A. Bodine, DO, CAQSM
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