Foot

Foot pain - pain in the feet

Foot pain - pain in the feet



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Foot pain - causes, treatment and prevention

Foot pain can severely limit those affected in everyday life and lead to walking difficulties. Treatment usually depends on the cause of the symptoms. Temporary pain in the foot often disappears on its own. However, if the symptoms suddenly appear, for example after an accident, or if they persist for a longer period of time, medical advice should be sought. In addition to injuries, there are numerous other causes, such as overload, wear, inflammation, circulatory disorders and foot deformities, which can sometimes cause severe pain in the foot.

Foot pain - an overview

Almost everyone knows pain on the feet as a result of long strains and all parents should be familiar with their children's sentence “My feet hurt, I can no longer” when walking. But foot pain can also be caused by numerous other causes, some of which urgently need medical attention. Here is a brief overview of the symptoms:

  • definition: Foot pain is a symptom that can occur in different places on the foot and is further differentiated according to its direct location, for example, in the sole of the foot, ankle pain, toe pain, etc.
  • causes: Acute injuries to the ligaments, muscles and bones in the foot, overloading, inflammatory diseases of the joints (such as rheumatism, arthritis or gout), joint wear, heel spurs, foot misalignments, but also skin diseases in the area of ​​the foot, nerve damage, bone loss, thromboses, Circulatory disorders, bottleneck syndromes and tumors.
  • Consultation with a doctor is required in the case of acute injuries, persistent or even increasing pain, significant swelling of the foot, hematoma, difficulty walking, known joint disorders, (suspected) misaligned feet or accompanying symptoms such as fever or headache.
  • diagnosis: Thorough medical history with questions about possible previous illnesses or a previous accident, external examination for visible changes such as swelling, redness or deformation, checking the mobility of the foot, subsequent confirmation of the diagnosis - as required - using imaging methods such as X-rays, ultrasound examination, MRI, Arthroscopy, joint punctures, blood tests as well as neurological and electrophysiological tests.
  • treatment: Depending on the cause! In the case of current injuries, the patient is often temporarily immobilized (e.g. bandages, plaster casts or plaster bandages). However, surgery is required for certain bone fractures or joint fractures and some bottleneck syndromes. Otherwise, depending on the cause, physiotherapy, special muscle training, anti-inflammatory pain relievers, cortisone-containing medications, as well as electro and ultrasound therapy are used.
  • Naturopathy and holistic medicine: Especially heat and cold treatments, manual therapies and movement therapies are helpful measures for many forms of foot pain. Other holistic treatment options include acupuncture, Kneipp treatments and ointments based on medicinal plants (e.g. comfrey), whereby the application is always based on the causes of the symptoms.

About a quarter of the bones in the human body are in the feet. Anatomically, the foot is divided into toes (digiti pedis), metatarsus and metatarsus (tarsus). The midfoot consists of the sole, heel, ball, instep (back of the foot) and instep (outer edge). The longitudinal and transverse arch of the foot acts like a shock absorber and is therefore important for the unrestricted function of the feet. Misalignments such as flat feet or spreading feet often lead to complaints.

Foot pain after injury

Pain in the foot due to injuries such as ankle twisting or accidents are very common. So-called over-movements (twisting or twisting) of the ankle can lead to a sprain, in which the capsule-ligament apparatus is damaged. Affected people can still move the joint, but its functionality is clearly limited and causes pain. Typically, the joint swells a lot. A bruise can also occur. Ankle stowage usually heals without complications if the foot is spared for a while. However, it is advisable to have the stowage examined by a doctor to rule out a serious injury. This can be the case, for example, if the ankle is dislocated as a result of the twisting. The joint then shows a visible deformity and there are clear, painful restrictions on movement.

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

Another cause of pain in the foot area, which can also occur as a result of exercise, is Achilles tendon tear (Achilles tendon rupture). Men between the ages of 30 and 50 are particularly affected by this injury. Characteristic of an Achilles tendon tear is a loud sound like a whip crack when the tendon tears. In addition, acute, stabbing pain occurs, which is accompanied by a bloodshot swelling in the area of ​​the heel. Affected people are no longer able to tiptoe. Treatment is either conservative by immobilizing the foot or by surgery, in which the torn tendon parts are reunited. Depending on the type of Achilles tendon tear, heel bone fixation or reinforcement by neighboring tendons may be necessary. After an operation, the foot is immobilized for several weeks.

The muscles in the area of ​​the foot can also cause discomfort. These range from slight muscle strains and tensions to muscle bruises to muscle fiber tears and muscle tears. Those affected often suffer from severe pain. Muscle injuries mostly occur as a result of sporting activity. In the case of minor injuries, a time of protecting the foot is sufficient for healing. If it is a muscle fiber tear or a muscle tear, an operation can be useful.

Foot pain due to fractures such as one Metatarsal fracture or one Ankle fracture are very painful and are accompanied by severe swelling, discoloration of the skin and significant movement restrictions up to the complete loss of functionality. The fracture can also result in a visible misalignment of the foot. If a broken bone is suspected, a doctor should be consulted immediately. Depending on the type of fracture, the treatment can be conservative by immobilizing the foot or a surgical procedure in which the fracture is straightened and the bone is stabilized with screws, nails or plates, for example.

Symptoms of inflammation

Pain in the foot resulting from inflammation can have different causes. One possible trigger for an inflammatory disease of the foot can be rheumatism (rheumatoid arthritis). The immune system fights and destroys the body's own tissue, causing inflammation in the joints. In rheumatism, the painful inflammation usually occurs on both sides, i.e. on both ankles typically with swelling and overheating. However, the carpal and finger base joints are affected more often than the ankles.

A arthritis (Inflammation of the joints) can also result from a metabolic disorder such as gout, in which uric acid crystals are deposited in the synovial fluid (“joint lubrication”) and trigger inflammatory reactions. The situation is similar with pseudogout, in which calcium pyrophosphate crystals are precipitated. Both diseases can lead to the destruction of the articular cartilage.

In addition, bacteria can cause inflammation that gets into the ankle or other areas of the foot. Bacterial infection can result from a contaminated wound or surgery. In the case of open bone fractures or operations on the bone, contamination with bacteria can occur Inflammation of the bones (Osteeitis or osteomyelitis, inflammation of the bone marrow). The treatment of such an inflammation can be very lengthy and is usually done by surgery. Less often, inflammation of the bones can also be caused by fungi or viruses.

In addition, inflammatory diseases in the foot can also be caused by Infections outside the foot area to be triggered. Yersinia, shigella, chlamydia or salmonella are possible pathogens.

The tissue that surrounds the tendon can become inflamed, mostly due to overloading, less often due to bacteria. Then tendonitis develops. The wrist of the so-called “mouse arm” is most often affected, which is usually caused by one-sided stress when working on the computer. However, tendonitis can also occur in the foot if the tendon is overused. As a rule, protection and / or temporary immobilization of the foot leads to healing. In chronic cases, surgery for pain relief can be useful.

Typical signs of inflammation in the foot are swelling, redness, overheating, pain and restricted movement. If the joint is affected, joint effusion can also occur.

Foot pain in deformed feet

Deformed feet can be congenital or acquired. In addition to foot pain, there are often other symptoms that can affect the legs, knees, hips and spine.

One of the malalignments acquired is the splayfoot (Pes transversoplanus), which mainly affects women. The symptoms usually only appear in the second half of life. Obesity, inappropriate shoes and rheumatic diseases are possible causes of spreading feet. The misalignment is due to a lowering of the arch of the foot due to spreading of the metatarsal heads, so that the forefoot widens. As a result, the main stress points change when standing and running from the outside to the inside, so that areas of the foot are loaded that are not designed for this. Squint forms over the second and third metatarsals, which can cause pain. Spreading feet often go hand in hand with further toe and foot misalignments such as hallux valgus or hammer toes.

Flat feet can also cause foot pain. If the deformity of the foot is congenital, sufferers usually suffer from other malformations such as spina bifida (open back) or hip dislocations. However, flat feet are only acquired more frequently in the course of life, for example due to a congenital weakness of the connective tissue, permanent overloading due to being overweight, inflammatory processes in the area of ​​the foot, arthrosis or as a result of a broken heel bone. In the flat foot, the longitudinal arch of the foot is lowered so that it lies on the floor. Foot pain mainly occurs in areas where the foot bones are in contact with the ground due to the misalignment. Pressure sores can develop, which can lead to difficulty walking. In addition, the misalignment can affect the overall statics of the body, which can lead to complaints of the foot, such as back pain or knee pain.

Another foot misalignment is the so-called Heel foot. This can be congenital, for example due to hereditary deformation or forced position in the womb, or acquired in the course of life. The latter can also be caused by incorrect storage in a plaster cast due to an accident. Affected people walk more on the heel, so that they are exposed to greater loads. The foot is typically bent upwards and the sole of the foot is turned outwards. The complaints include pain, especially in the heel. In addition, pressure necrosis can occur, on which the tissue dies due to the pressure load. Overall, heel feet lead to a bent position of the knees and hip joint, which can lead to complaints on the entire skeleton.

With the so-called Pointed foot Those affected run on the forefoot. It is not possible to set down and roll off the entire foot. This places an enormous strain on the forefoot. Affected people often suffer from walking difficulties and insecurities when walking, since the entire foot is necessary for stable standing and walking. In children, walking on tiptoe is a development phase in learning to walk and is normally not a misalignment. Pointed feet usually develop after birth due to shortened calf muscles, excessive calf muscle tension or a disorder of the nervous system. The resulting walking difficulties can lead to foot pain but also complaints to the entire skeleton.

Another foot misalignment is the so-called Hollow foot, in which, in contrast to flat feet, the longitudinal arch of the foot is greatly inflated. The toes are usually very curved and stiffened. Hollow feet can be congenital or acquired. The latter can be caused, among other things, by paralysis or nerve damage to the foot muscles and weakness of the foot muscles and ligaments. Affected people often suffer from pressure points at the highest point on the instep, the ball of the foot and the toes, which can be very painful and lead to difficulty walking. Ankle twists and sprains occur more frequently.

Buckling feet occur especially in children in whom the X position of the heel is reinforced and the arch of the foot is lowered. In most cases, the deformity in children disappears on its own. When adolescents and adults suffer from kink-flat 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. Favorable factors for kink-flat feet are overweight, muscle weakness, instability of the ligaments and tendons as well as a strong X- or O-leg position. Affected people often suffer from foot pain from overloading the weak foot muscles, knee problems, heel spurs and spinal problems.

Also the so-called Clubfoot can cause foot pain. The sole of the foot is turned inwards or in severe cases upwards. The heel is also inclined inwards. This misaligned foot contains various deformities that are noticeable in a pointed, sickle and hollow foot as well as the O-leg position. Mostly club feet are congenital, in rare cases they are caused by disorders of the nerve supply. Affected people 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 cast.

In addition to misaligned feet can also Toe deformities cause foot pain and walking problems. These include hammer and claw toes. The hammer toe has a permanently flexed toe joint, the claw toe has an overstretched base joint, with the central and toe joints flexed. Favorable factors for the development of hammer and claw toes are the years of wearing shoes that are too tight, misaligned feet such as spreading, kinking and flat feet, as well as neurological and foot diseases acquired through accidents. As the toe becomes shorter and shorter over time, pressure sores, corns, calluses under the metatarsals often arise.

The big toe is often also affected by a malposition. With the so-called Bale Toe (Halux valgus) shows the tip of the big toe towards the other toes and the big toe ball is significantly thickened. In addition to hereditary deformations, permanent wearing of tight shoes, inflammatory changes in the joints and broken bones that have healed in the wrong position are possible causes. Pain usually occurs in the area of ​​the big toe base. Inflammation, swelling and bursitis can occur.

Pain caused by joint wear

Our feet are exposed to enormous loads. Wrong positions of the foot or toes, but also due to inflammation or injuries (post-traumatic arthrosis) can lead to joint wear (arthrosis). In addition, metabolic, chemical, hormonal and genetic reasons as well as being overweight for the development of arthrosis are discussed. Diseases such as diabetes mellitus (diabetes), gout, pseudogout and haemophilia (blood disease) can be involved in the development of osteoarthritis. However, the cause of joint wear is often unknown.

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

Heel spur foot pain

A common cause of foot pain is the heel spur (calcaneus spur), a bony appendage that can form like a thorn on the heel bone. A distinction is made between the lower and the upper heel spur. The lower heel spur develops on the underside of the heel bone at the base of the tendon plate of the sole of the foot (plateau fascia) and occurs much more frequently than the upper heel spur, which forms on the back of the heel bone in the area of ​​the Achilles tendon attachment. A bone spur arises from overload when there is limescale in the area of ​​the tendon insertions to ensure more stability. Overweight, wrong footwear, muscle weakness due to lack of exercise, misaligned feet and sporting activities in combination with low-damping shoes can trigger a heel spur. Sufferers often complain of a severe, stabbing pain in the heel when they occur, which occurs especially in the morning after getting up.

Other causes of foot pain

Other causes of foot pain can include skin diseases in the area of ​​the foot such as neurodermatitis or athlete's foot, nerve damage such as neuropathies, 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. If the pain in the foot persists, recurses or occurs acutely, a doctor should be consulted.

Risk factors for foot pain

Our feet not only have to support our body weight, but also have to absorb a multiple of them when running fast. Overweight is one of the main risk factors for foot pain due to the resulting increased stress. Inappropriate and too tight shoes can also cause foot discomfort. In addition, muscle weakness in the feet and legs due to lack of exercise also increases the risk of foot pain.

Depending on the cause of the pain in the foot, there are additional risk factors, such as injuries in certain sports, eating habits and other activities that lead to overloading of the feet or certain areas of the foot.

Diagnosis

Because of the diverse causes of foot pain, an accurate diagnosis is important. The doctor will first ask questions about possible previous illnesses such as osteoarthritis or rheumatism or a previous accident. He also examines the foot and joints for visible changes such as swelling or joint effusion and deformation, for example in the case of a fracture. In addition, the mobility of the foot is checked and it is determined whether there is redness and overheating due to inflammation. This is usually followed by an x-ray, in which the foot can be brought into a special position, for example to identify a ligament injury.

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

Foot pain treatment

The therapy depends on the cause of the complaint. Often, foot pain that occurs after a brief overload will go away on its own. Otherwise, exercise in the form of physiotherapy or manual therapy can make sense, or temporary immobilization of the foot with ointment bandages, special bandages, plaster casts or plaster bandages. In addition, those affected receive anti-inflammatory painkillers, joint injections or joint irrigation with medications containing cortisone. Heat or cold therapies, special muscle training as well as electrical, shock wave and ultrasound therapy can also provide relief depending on the cause.

In the case of certain broken bones or articular fractures, torn ligaments, a bottleneck syndrome or other diseases and injuries that cannot be treated conservatively, an operation may be necessary in which the fracture is straightened, injured ligaments are sewn or more space is created for the depressed muscles, blood vessels or nerves . Some of the interventions can be performed endoscopically or minimally invasively.

Naturopathy for foot pain

Naturally, naturopathic treatments can be used as an alternative or in addition to conventional medicine for functional foot pain. In this way, osteopathy includes the overall statics of the body and in particular overloads or unfavorable stress distributions in the foot and leg for foot pain in the therapy. The so-called plantar aponeurosis, a large tendon plate in the area of ​​the sole of the foot, is considered more similar to the skate of a skate, but which runs over the heel into the Achilles tendon, over the calf muscles into the back muscles of the thigh to the buttocks. This is why the osteopath also treats buttocks, calves, Achilles tendon or back problems in the case of foot pain. A similar approach is also followed in Rolfing, in which the connections between body structures and body statics are also included in the treatment.

Heel pain from a heel spur is seen in chiropractic in connection with a possible blockage in the pelvis or in the area of ​​the lumbar spine. This can result in a one-sided strain on the muscles and subsequently lead to an overload of the Achilles tendon.

So-called Kneipp cures and alternating showers can also be used to treat foot pain associated with circulatory disorders, whereby instructions from experienced therapists are advisable. In addition, acupuncture and moxa therapy for functional complaints are well worth trying.

Prevent foot pain

The orthopedic expert Dr. Benedict DiGiovanni of the Medical Center at Rochester University in New York showed in 2004 that certain stretching exercises on the foot alleviate or completely alleviate symptoms caused by a heel spur or caused by irritation or inflammation of the plantar aponeurosis. According to his recommendation, the Achilles tendon should also be stretched. To do this, 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 floor. Affected persons should stay in this position until they have counted to ten.

For stretching the plantar aponeurosis, according to Dr. Benedict DiGiovanni the affected foot placed above the knee while sitting. Then the toes should be pulled back to the shin until you can feel the stretch in the foot. The thumb is to be used on the foot. You should feel tension. The position should be held again until the person concerned has counted to ten.

In general, a gentle warm-up and stretching is advisable before exercising to prevent injuries. In addition, existing excess weight should be reduced as far as possible, attention should be paid to suitable shoes, and overloading or incorrect loading should be avoided in order to prevent foot pain. (ag, fp)


Author and source information

This text corresponds to the requirements of the medical literature, medical guidelines and current studies and has been checked by medical doctors.

Dipl. Geogr Astrid Goldmayer

Swell:

  • Awale, A.a; Hagedorn, T.J .; Dufour, A.B .; Menz, H.B., Casey, V.A .; Hannan, M.T .: Foot Function, Foot Pain, and Falls in Older Adults: The Framingham Foot Study .; in Gerontology 2017; 63 (4), pages 318-324, karger.com
  • Penelope J. Latey, Joshua Burns, Claire E. Hiller, Elizabeth J. Nightingale: Relationship between foot pain, muscle strength and size: a systematic review: in Physiotherapy, March 2017, Volume 103, Issue 1, page 13-20, physiotherapyjournal .com
  • Hans-Henning von Albert: foot pain; in: From neurological symptom to diagnosis; Springer, 2002


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