Foot Pain

Our feet literally support us in everything we do. So any feeling of foot pain, which can happen in the heel, toes or arch of the foot, can stop us in our tracks. Due to the fact that there are so many bones, joints, muscles and soft tissue that help the foot to flex, point and bend, there is great opportunity for damage. Determining the cause of pain is essential for finding the best treatment option. The California Pain Consultants team in the Escondido, El Centro, La Mesa, San Diego, and Chula Vista areas are experts in diagnosing and treating all forms of foot pain with a goal to help their patients comfortably get back on their feet. 

What is Foot Pain?

Foot pain is any feeling of discomfort in the foot. Unfortunately, it’s a very common pain condition that affects most people at some point in their life. Not only is the foot a complex structure, it also bears weight throughout the day and during almost every activity a person makes. You can’t walk, run, jump, sit or stand without your feet! 

Each foot has 26 bones, 33 joints, and hundreds of ligaments, muscles and nerves so there is no shortage of availability for pain for one individual component or several. Pain can be felt on the top, bottom or sides of the foot and could be the result of overuse, an injury, wearing improper shoes, or an underlying health condition. It’s important to identify the cause of pain so that the proper treatment can be utilized. 

What Causes Foot Pain?

Foot pain can be divided into two categories: structural or neuropathic. Structural causes include pain from a breakdown in the structure of the foot, so a fracture or break. Neuropathic refers to pain caused from damage done to the nerves in the foot. Again, there are unfortunately so many opportunities for damage because of the detailed makeup of the foot, which can lead to pain on the top of the foot, bottom of the foot, side of the foot, toes and heel. 

The most common structural causes of foot pain include: 

• Bone spurs: most often the result of arthritis, bone spurs are bony growths that typically develop where bone meets bone. They typically form at the front of the heel or in the center area at the top of the foot, which causes pain when walking. 
• Stress fractures: tiny fractures within the bones of the feet, usually caused by overuse or an injury
• Achilles tendonitis: injury of the Achilles tendon, which connects the calf muscle to the heel bone. This condition most often happens to people who participate in sporting activities that require the use of the calf and ankles, including running and basketball. 
• Bursitis: inflammation and swelling of the fluid-filled bursae, which are located between the joints (33 in the foot!) to provide cushioning. Foot bursitis is usually the result of an injury or overuse of the feet.
• Osteoarthritis: a degenerative joint disease, in which the tissues in the joint break down over time. Most common in older people, this can cause joint pain and stiffness after periods of inactivity. 
• Rheumatoid arthritis: an autoimmune and inflammatory disease where the immune system attacks healthy joint tissue, which causes painful inflammation. In addition to feelings of pain, rheumatoid arthritis can also cause foot deformities including claw toe or hammer toe. 
• Bunions: a bony bump that forms on the joint at the base of the big toe that happens when some of the bones in the front part of the foot shift out of place. Tight-fitting or narrow shoes, injury, genetics, and flat feet/low arches can cause bunions. 
• Plantar fasciitis: inflammation of the fibrous tissue (plantar fascia) that is located along the bottom of the foot where the heel bone connects to the toes. It is one of the most common causes of heel pain and can cause significant heel pain. 

Nerve pain might feel like a burning, tingling or electric shock sensation. The most common neuropathic causes of foot pain include: 

• Peripheral neuropathy: inflammation of the peripheral nerves in the leg and foot that could be caused by diabetes mellitus, infections and certain vitamin deficiencies
• Tarsal tunnel: caused by damage to the tibial nerve, which runs through the tarsal tunnel (a passage of bones and ligaments in the ankle). Symptoms could include pain, burning or tingling in the bottom of the feet and toes.
• Reflex sympathetic dystrophy (RSD): an abnormal neuropathic response that is most often caused by an injury to the foot. Symptoms include redness, swelling, and temperature changes. 
• Morton’s neuroma: swelling, thickening and irritation around one of the nerves leading to the toes. This can cause a sharp, burning pain in the ball of the foot.
• Lumbar radiculitis: occurs when nerve roots in the lower part of the spine are compressed, causing pain that radiates along the sciatic nerve all the way down into the foot 

Additional factors that could lead to foot pain include overuse, being overweight, standing for an extended period of time, aging, traumatic injury, and wear and tear. Because the causes of foot pain range, it’s important to seek help from a trained medical professional who can accurately diagnose and treat your specific cause of pain. 

Treatments for Foot Pain

Treatments for pain due to structural issues with the foot most often involve rest, pain medications (NSAIDs), a cast or splint, and possibly physical therapy. Severe instances might call for steroid injections or surgery, but your healthcare provider will always opt for conservative treatment methods first. 

Neuropathic injuries require more specific treatment options, depending on the specific type of nerve damage. In addition to rest, ice and/or braces, your provider might recommend: 

• Medications that are used to treat pain caused by neurologic diseases
• Epidural steroid injections: steroid medication placed next to the irritated nerve root with the goal to alleviate pain and reduce inflammation
• Lumbar sympathetic blockade: blocking pain sensations from reaching the brain by targeting the affected nerve
• Neuromodulation via TENS unit: using a low electrical current to block or change the brain’s perception of pain
• Spinal cord stimulation (SCS): an effective therapy for pain syndromes associated with peripheral neuropathy, SCS uses a small generator and two leads that are placed near the affected nerves, both of which works to block nerve pain from being received by the brain

The best way to treat foot pain is to seek the help of a pain management specialist who can expertly diagnose your specific foot pain and recommend the best treatment to relieve pain now and prevent pain in the future. If you are living with foot pain and would like to learn more about available treatment options, please schedule an appointment with the California Pain Consultants team in the Escondido, El Centro, La Mesa, San Diego, and Chula Vista areas today.