Foot pain - pain on the feet

Pain on the foot

Foot pain can severely limit those affected in everyday life and cause walking difficulties. The treatment usually depends on the cause of the discomfort. Temporary pain on the foot often disappears on its own. However, if the symptoms suddenly occur, for example, after an accident or persist over a long period of time, medical advice should be sought. In addition to injuries, there are numerous other causes that can occur, among other things, due to overload, wear, inflammation, circulatory disorders and foot deformities and can sometimes cause severe pain in the foot.

Contents:
definition
Foot pain after injuries
Complaints of inflammation
Foot pain in foot deformities
Pain in joint wear
Foot pain in heel spur
Other causes of foot pain
risk factors
diagnosis
treatment options

definition

Foot pain is a condition that can occur in different places on the foot. The causes range from overload, unilateral stress, injuries and misalignments to diseases of the bones, articular cartilage, muscles, ligaments, tendons and blood vessels in the foot. Frequently, ankle complaints are also described as foot pain.

Foot pain is often seen in the area of ​​the sole of the foot, with high loads here often cause the cause. (Picture: leszekglasner / fotolia.com)

About a quarter of the bones of the human body are in the feet. Anatomically, the foot is divided into toes (digiti pedis) metatarsus and tarsus. The metatarsus consists of sole, heel, bale, instep (instep) and instep (outer edge). The longitudinal and transverse arch of the foot acts as a shock absorber and is therefore of major importance for the unrestricted function of the feet. Malpositions such as a flat foot or splay often cause discomfort.

Foot pain after injuries

Pain in the foot due to injuries such as foot kinking or accidents is very common. So-called overshoots (kinking or twisting) of the ankle can cause a sprain that damages the capsule-ligament apparatus. Those affected may still be able to move the joint, but its functionality is clearly limited and causes pain. Typically, the joint swells strongly. In addition, a bruise may occur. A stowage of the ankle usually heals without complications if the foot is spared some time. Nevertheless, it is advisable to have the stent examined by a doctor to rule out serious injury. This may be the case, for example, when dislocation (luxation) of the ankle occurs as a result of the kinking. The joint then shows a visible deformity and there are clear, painful movement restrictions.

Ankle injuries are among the most common sports injuries. (Image: SENTELLO / fotolia.com)

During sports activities it can also lead to ligament injuries due to the jerky heavy use. The most common ligament tears include the outer ligament tear of the upper ankle joint. Those affected usually complain of severe pain. There is also swelling of the joint and, in some cases, bruising. A torn ligament is usually treated conservatively by immobilizing the foot. In some cases, however, surgery may be necessary.

Another cause of pain in the area of ​​the foot, which can also occur as a result of exercise stress, is the Achilles tendon rupture (Achilles tendon rupture). Especially men between the 30th and 50th year of age are affected by this injury. Characteristic of an Achilles tendon tear is a loud noise like a whip-bang, when the tendon tears. In addition, there are acute, stabbing pains accompanied by bloodshot swelling around the heel. Affected are no longer able to tiptoe. The treatment is either conservative by immobilization of the foot or by surgery, in which the torn-off tendon parts are reunited. Depending on the type of Achilles tendon rupture, a fixation on the heel bone or reinforcement by adjacent tendon may be necessary. Following surgery, the foot is immobilized for several weeks.

The muscles around the foot can also cause discomfort. These range from slight muscle strains and tensions on muscle bruises to muscle fiber tears and muscle tears. Affected persons often suffer from severe pain. Muscle injuries usually occur as a result of physical activity. For minor injuries, a time of protection of the foot is sufficient for healing. If it is a torn muscle or torn muscle, surgery may be useful.

Foot pain resulting from fractures such as a metatarsal fracture or ankle fracture is very painful and is associated with severe swelling, discoloration of the skin, and marked restriction of movement, all the way to complete loss of functionality. The breakage can also result in a visible deformity of the foot. If a bone fracture is suspected, a doctor should be consulted immediately. Depending on the type of fracture, the therapy may be performed conservatively by restraining the foot or performing an operative procedure in which the fracture is directed and the bone is stabilized with screws, nails or plates, for example.

Complaints of inflammation

Pain in the foot that results from inflammation can have different causes. For example, one possible trigger of an inflammatory disease of the foot may be rheumatism (rheumatoid arthritis). The immune system fights and destroys the body's own tissue, resulting in inflammation in the joints. In rheumatism, the painful inflammations usually occur on both sides, ie on both ankles typically with swelling and overheating. More often than the ankles, however, lower parts of the wrist and foot joints are affected.

Arthritis (joint inflammation) can also be caused by a metabolic disease such as gout, by depositing uric acid crystals in the synovial fluid ("synovial fluid") and triggering inflammatory reactions. The situation is similar with the pseudogout, where calcium pyrophosphate crystals are precipitated. Both diseases can lead to the destruction of the articular cartilage.

In addition, bacteria can cause inflammation that has entered the ankle or other areas of the foot. Infection by bacteria can be caused, among other things, by a contaminated wound or during surgery. With open fractures or operations on the bone can be carried out a contamination with bacteria, which can cause a bone inflammation (Osteitis or Osteomyelitis, marrow inflammation). The treatment of such an inflammation can be very tedious and usually occurs surgically-surgically. Less commonly, bone inflammation can be caused by fungi or viruses.

In addition, inflammatory diseases in the foot can also be triggered by infections outside the foot area. Yersinia, Shigella, Chlamydia or Salmonella are considered as pathogens.

Mostly by overloading, more rarely by bacteria, the tissue surrounding the tendon can inflame. Then a tendonitis occurs. Most often, the wrist is affected by the so-called "mouse arm", which usually arises from one-sided stress when working on the computer. However, tendonitis can also occur in the foot when the tendon is overstressed. As a rule, sparing and / or temporary immobilization of the foot leads to healing. In chronic cases, surgery for pain relief may be useful.

Typical signs of inflammation in the foot include swelling, redness, overheating, pain and restricted mobility. If the joint is affected, an articular effusion may also occur.

Foot pain in foot deformities

Foot deformities may be innate or acquired. In addition to foot pain, there are often other symptoms that may affect the legs, knees, hips and spine.

The acquired foot deformity includes the splayfoot (Pes transversoplanus), which affects women in particular. Most complaints occur only in the second half of life. Obesity, inappropriate footwear and rheumatic diseases are the cause of spreading feet in question. The malposition is due to a reduction in the transverse arch of the foot due to splayed metatarsal heads, so that widened the forefoot. As a result, the main load points change from the outside to the inside when standing and walking, so that areas of the foot are loaded, which are not designed for it. There are strabismus over the second and third metatarsal bones, which can cause pain. Spreader feet are often associated with other toe and foot deformities like hallux valgus or hammer toes.

Flat feet can also cause foot pain. If the foot deformity is innate, sufferers usually suffer from further malformations such as spina bifida (open back) or hip dislocations. However, flat feet are more commonly acquired in the course of life, for example, due to congenital weakness of the connective tissue, permanent overload due to obesity, inflammatory processes in the area of ​​the foot, osteoarthritis or as a result of heel bone fracture. When flat foot especially the Fußlängsgewölbe is lowered, so that it rests on the ground. Foot pain occurs especially in those areas where the foot bones are in contact with the ground due to malalignment. It can cause pressure ulcers, which can lead to walking difficulties. In addition, the malposition may affect the overall health of the body, so it can also cause discomfort of the foot, such as back pain or knee pain.

Another foot deformity is the so-called Hackenfuß. This may be congenital, for example due to hereditary deformity or forced position in the womb, or acquired in the course of life. The latter can occur accidentally but also by misplacement in a plaster cast. Those affected increasingly walk on the heel, so that it is exposed to heavier loads. The foot is typically bent upwards and the sole of the foot turned outwards. The complaints include pain especially on the heel. In addition, pressure necrosis can occur on which the tissue dies due to the pressure load. Overall, heelfeet results in a flexed posture of the knees and hip, which can cause discomfort to the entire skeleton.

In the so-called Spitzfuß sufferers run on the forefoot. The settling and unrolling of the entire foot is not possible. As a result, the forefoot is exposed to enormous stress. Affected persons often suffer from walking difficulties and insecurity when walking, as the entire foot is necessary for stable standing and walking. In the case of children, the walk on tiptoe is a developmental phase in walking learning and usually not a malposition. Spitzfeße arise mostly after birth due to shortened calf muscles, excessive calf muscle tension or a disorder of the nervous system. The resulting difficulty walking can lead to foot pain but also complaints to the entire skeleton.

Another foot deformity is the so-called hollow foot, in which, in contrast to the flat foot, the Fußlängsgewölbe is greatly inflated. The toes are usually very curved and stiffened. Hollow feet may be innate or acquired. The latter may be caused, among other things, by paralysis or nerve damage of the foot muscles as well as a weakness of the foot muscles and ligaments. Sufferers often suffer from pressure points at the highest point on the instep, the ball and toes, which can be very painful and lead to walking difficulties. It often comes to the kinking and sprains of the foot.

Crease-lowering feet are especially common in children, where the heel X-position is strengthened and the arch of the foot is lowered. Usually, the malposition disappears in children alone. When adolescents and adults suffer from kink-lowering feet, weakness of the foot muscles due to lack of exercise and immobilization of the feet in shoes is usually the cause of foot deformity. Beneficial factors for kinked feet are obesity, muscle weakness, instability of the ligaments and tendons, and a strong X or O leg position. Sufferers often suffer from foot pain due to congestion of weak foot muscles, knee problems, heel spurs and spinal problems.

Even the so-called clubfoot can lead to foot pain. The sole of the foot is turned strongly inwards or in severe cases upwards. The heel is also inward-sloping. This foot deformity includes various deformities, which are noticeable in a pointed, sickle and hollow foot and the O-leg position. Most clubfoot are congenital, in rare cases they are caused by disorders of the nervous system. Sufferers can only stand and walk on the outer edge of the foot. This massive malposition should be treated as early as possible by surgery and / or plaster dressing.

In addition to foot deformities, toe deformities can also cause foot pain and walking problems. These include, among others, hammer and claw toes. The hammer toe has a permanently bent toe joint, the claw toe an overstretched ground joint, with the middle and toe end joint flexed. Factors favoring the development of hammer and claw toes include years of wearing too tight shoes, misaligned feet such as spread, kink and flat feet as well as neurological and accidental foot disorders. As the toe progressively shortens and becomes higher at the same time, there are often bruises, corns, calluses under the metatarsal heads.

Often the big toe is affected by a malposition. In the case of the so-called ball toe (Halux valgus), the tip of the big toe points in the direction of the other toes and the big toe bale is clearly thickened. In addition to hereditary deformations permanent wear too tight shoes, inflammatory joint changes as well as fractures healed in malposition are possible causes. Most pain in the area of ​​the big toe base occur. It can cause inflammation, swelling and bursitis.

Pain in joint wear

Our feet are exposed to enormous loads. In malposition of the foot or toe, but also by inflammation or injury (post-traumatic arthritis) it can lead to joint wear (osteoarthritis). In addition, among other things, metabolic, chemical, hormonal and genetic reasons and obesity for the development of osteoarthritis are discussed. Diseases such as diabetes mellitus, gout, pseudogout and hemophilia can contribute to the development of osteoarthritis. However, the cause of joint wear is often unknown.

Typical symptoms of osteoarthritis in the ankle area include pain in the foot or discomfort that occurs after a period of rest when the foot is moved again. In addition, there may be joint effusions, deformations, restricted mobility and joint noises, which arise due to the increasing unevenness of the cartilage surface.

Foot pain in heel spur

A common cause of foot pain is the heel spur (calcaneus spur), a bony appendage that may form like a spine on the heel bone. Here, a distinction is made between the lower and upper heel spurs. The lower heel spur develops on the underside of the calcaneal bone at the base of the tendon plate of the sole of the foot (Platafaszie) and occurs much more frequently than the upper heel spur, which forms at the back of the heel bone in the area of ​​the Achilles tendon attachment. Bone spur is the result of overloading when calcification occurs around the tendon insertion to provide more stability. Overweight, incorrect footwear, muscle weakness due to lack of exercise, foot deformity and sports activities in combination with low-damping shoes can be the trigger for a heel spur. Those affected often complain of a sharp, stabbing pain in the heel when they appear, especially in the morning after getting up.

Other causes of foot pain

Other causes of foot pain may include skin diseases in the foot, such as eczema or athlete's foot, nerve damage such as neuropathy, bone loss, blood clots such as thrombosis, tumors, circulatory disorders and bottleneck syndromes such as tarsal tunnel syndrome.

The symptoms and causes of foot pain listed here are just a selection. In case of persistent, recurrent or acute pain on the foot, a doctor should be consulted.

risk factors

Not only do our feet have to carry our body weight, but they also have to catch a multiple of it when running fast. Obesity is one of the main risk factors for foot pain due to the resulting increased stress. Inappropriate and too tight footwear can also cause discomfort on the feet. In addition, muscle weakness in the area of ​​the feet and legs due to lack of exercise also increases the risk of foot pain.

Depending on the cause of the foot pain, there are additional risk factors such as specific sports injuries, dietary habits, and other activities that cause overstressing of the feet or certain areas of the foot.

diagnosis

Due to the many causes of foot pain, a precise diagnosis is important. The doctor will initially ask questions about possible pre-existing conditions such as osteoarthritis or rheumatism or a previous accident. He also examines the foot and joints for visible changes such as swelling, or joint effusions and deformations, for example, in a fracture. In addition, the mobility of the foot is checked and determined whether there is redness and overheating due to inflammation. Most often followed by an X-ray, in which the foot can be placed in a specific position, for example, to detect a ligament injury.

Depending on the symptoms, further examinations such as ultrasound examinations, magnetic resonance imaging (MRI), joint arthroscopy and joint punctures, blood tests for inflammation and neurological and electrophysiological examinations may be necessary.

treatment options

The therapy depends on the cause of the complaints. Frequently, painful feet that appear after a short-term overload disappear on their own. Otherwise, exercise in the form of physiotherapy or manual therapy may be useful, or the temporary immobilization of the foot with ointment dressings, special bandages, plaster splints or plaster casts. In addition, sufferers receive anti-inflammatory analgesics, joint injections or joint rinses with cortisone-containing drugs. Heat or cold therapies, special muscle training and electrical and ultrasound therapy can also provide relief depending on the cause.

In certain fractures or joint fractures, ligament tears, a bottleneck syndrome or other non-conservative to treat diseases and injuries, an operation may be necessary in which the fracture straightened, sutured ligaments or created for the depressed muscles, blood vessels or nerves more space , The interventions can sometimes be performed endoscopically or minimally invasively.

Naturopathic treatment for functional foot pain

Frequently, natural remedies can be used as an alternative or supplement to conventional medicine for functional foot pain. Thus, osteopathy incorporates the overall statics of the body and, in particular, overloading or unfavorable stress distributions in the foot and leg during foot pain into the therapy. The so-called plantar aponeurosis, a large tendon plate in the area of ​​the sole of the foot, is considered more like the skate of a skate, which, however, runs over the heel into the Achilles tendon, over the calf musculature into the posterior muscles of the thigh to the buttocks. Therefore, the osteopath treats buttock, calf, Achilles tendon or back pain in foot pain. A similar approach is followed in the Rolfing, in which also the connections of body structures as well as the body statics are included in the treatment.

Heel pain from heel spur is seen in chiropractic in connection with possible blockage in the pelvis or lumbar spine. This can cause a one-sided load on the muscles and result in consequent overloading of the Achilles tendon.

The orthopedic expert Dr. Benedict DiGiovanni of the University of Rochester Medical Center in New York in 2004 showed that certain stretching exercises on the foot alleviate or completely eliminate discomfort caused by heel spur or irritation or inflammation of the plantar neoplasm. After his recommendation, the Achilles tendon should be stretched. But the affected foot should stand behind the healthy foot. The toes of the back foot point towards the heel of the front foot while leaning against a wall. Then the front knee is bent forward, while the rear knee remains stretched and the heel is firmly on the ground. In this position, the person concerned should stay until he has counted to ten.

To stretch the Plantaraponeurose according to Dr.. Benedict DiGiovanni the affected foot can be placed over the knee while sitting. Then the toes are to be pulled back to the shin until the strain in the foot is felt. It should be driven along with the thumb on the foot. It should be noticeable tension. The position should be held again until the person has counted to ten. (Ag)