Pain in the foot is the most common among the pathological conditions of the musculoskeletal system between the ages of 20 and 50, accompanied by pain. We can conclude that it is the able-bodied part of the population that suffers, since the legs bear a considerable load, and the foot does not always withstand intensive sports and injuries painlessly and without consequences. I identify a group of reasons for which the leg hurts at the bend of the foot, and the reasons are not always associated with diseases of the joints; pain in the ankle, including the bend of the foot, can be due to pathologies of blood vessels, muscles, and compression of nerve endings. Sometimes pain in the feet is a consequence of a problematic spine or systemic diseases occurring in the body.
In total, there are 26 bones of various sizes in the structure of the foot, but in the area of interest to us - on the bend, the ankle joint (larger and fibula, talus), calcaneus, navicular bone and the metatarsal-tarsal area can hurt. All these bones and the ankle joint are surrounded by a muscular-ligamentous apparatus that protects against injury, especially dislocations and fractures in the ankle. By the way, it is worth noting that women are much more susceptible to pain in this area, since they tend to sacrifice health for the sake of beauty and image. Let's look at the main reasons that lead to the feeling of pain in the bend of the foot.
Causes of pain syndrome
Long-term research and medical practice indicate a variety of factors leading to painful sensations in the foot. It can be:
- injuries;
- muscle failure;
- autoimmune pathologies;
- uncomfortable shoes;
- lack of calcium;
- hygroma;
- incorrect anatomy.
It should not be ignored if there is pain in the top of the foot or in other parts, swelling, or fever. This may be a sign of serious malfunctions in the body that can lead to disability.
As a rule, discomfort covers the entire foot, which complicates diagnosis and requires high medical skill. Complaints should be addressed to:
- orthopedist;
- traumatologist;
- rheumatologist.
Of course, narrow specialists are available only in specialized clinics. In the clinic, a surgeon is in charge of diseases of bones, cartilage and joint tissue.
Features of pain on the outside of the foot
Typically, patients complain that the foot begins to hurt after or during walking and subsides somewhat with rest. There is increased abrasion of the sole of the shoe along the outer edge and deformation of the heel. It is important to determine the cause of the pain in time and take all measures to prevent it from becoming chronic.
The outer side of the foot is the main “line” of support when walking and running. There are several important anatomical structures in this area, each of which can hurt when overloaded.
What diseases cause pain?
1. Injuries
In the process of life, the foot is often subject to trauma. For example, something heavy falls on the leg, the foot gets twisted, dislocations, fractures, sprains and torn ligaments occur. The complexity of the injury is determined using x-rays.
Treatment involves:
- reduction of dislocation;
- plaster application;
- wearing a splint;
- wearing an orthosis.
In 85% of cases when visiting a traumatologist, sprains are determined. If the ankle moves outward, the reason why the talus and surrounding connective tissues hurt is a sprain, a rupture of the ligaments. The person feels severe sharp pain, swelling and hematoma immediately occur. Even after treatment, patients note instability of the joint.
If a person has suffered a sprained ankle, they may develop dislocation of the small bones in the foot, which doctors call cuboid syndrome. Symptoms are morning pain, swelling, redness, pain on the outside of the foot, extending to the toes. It happens that a person lives with this disease for a long time. Meanwhile, it is cured quite quickly with a professional approach.
A stress fracture, that is, a miniature crack in one of the bones, makes itself felt by mild pain, which tends to intensify. Practice shows that this type of fracture is typical for the calcaneus, metatarsal, and scaphoid bones. It is typical for injuries that the top of the foot is swollen and painful.
2. Gout
Acute pain in the foot near the toes on top often occurs due to gout. The disease causes a metabolic failure in which uric acid salts are poorly excreted from the body. They accumulate in joints for years, form entire salt deposits there, damage cartilage, and disable joints. This disease is typical for men, but also occurs in women. An exacerbation is manifested by such acute pain that it is impossible to endure. Without professional treatment, the patient eventually develops non-functioning limb joints.
3. Even ordinary calluses, if they have grown deep into the sole; a nail that has grown into a finger; warts - can cause pain.
4. Systemic diseases
A common disease today that affects joints, damages blood vessels, and leads to pinched nerves is arthritis. Common types are rheumatoid and degenerative arthritis. The joints will be swollen, their work will be reduced to almost zero.
Osteoarthritis, i.e. destruction of cartilage tissue on the extremities affects the fingers and ankles, slowly leading to the proliferation of osteophytes and deformation of the fingers.
Osteoporosis manifests itself as pain in the foot during exercise. The disease occurs in older people and is caused by:
- lack of calcium;
- hormonal imbalances.
The diagnosis is confirmed by hardware texts, treatment consists of taking medications with calcium, vitamins, and hormones.
5. Developmental defects
Various physiological abnormalities can cause pain in the navicular bone of the foot, heels, instep, or outer part of the foot. For example, congenital pathology - tarsal coalition, i.e. fusion of bones leads to convulsions and abnormal gait. A disease with the romantic name bunion deforms the thumb. Bursitis of this finger has a genetic predisposition. Surgery may be necessary to correct the defect.
Deforming pathologies include clubfoot and pes equinus. Flat feet, no matter what type it is, always deforms the leg, complicates movement, and worsens gait. Pain in the top of the foot while walking and at rest should prompt a person to seek medical attention.
6. Inflammation
One of the common inflammatory ailments is plantar fasciitis. This is a connective tissue pathology that manifests itself as morning pain. Inflammation of the joint capsules, i.e. Bursitis is felt in painful areas near the fingers and in the joints. Ligamentitis and tendinitis—inflammation of tendons and ligaments—contribute to pain.
7. Infectious diseases
The reason that when walking the foot hurts not only in the middle above, but also in other places is infections, for example:
- brucellosis;
- Lyme arthritis;
- pseudotuberculosis.
Streptococci and staphylococci lead to panaritium, inflammation of the fingers. Due to infection, the finger will turn red, swollen, and fester in a matter of hours. The surgeon will have to quickly open the abscess and disinfect it.
What is on the foot between the heel and toe?
Each foot has about 26 bones that are connected by ligaments. The strongest and largest of them is the plantar fascia (aponeurosis). It looks like a wide plate connecting the heel and the base of the toes. If you imagine that the arch of the foot is the shaft of a bow, the fascia is its bowstring, it keeps the arch from sagging and springs for shock absorption.
Why does the middle of my foot hurt?
A healthy plantar (or plantar) fascia is quite elastic and only stretches slightly under load. If the height of the arches falls, the attachment points of the fascia diverge and it becomes tense. With even greater tension, a tightly stretched ligament no longer stretches, but breaks.
A strained ligament can lead to a variety of symptoms. All of them definitely affect the health of the feet and sharply limit activity. Inflammation of the fascia is called plantar fasciitis and can manifest itself in several forms:
- Proximal fasciitis. A sharp, acute or aching pain appears in the depths of the heel area. A “heel spur” on an x-ray is just a sign that the fascia has been tense for a long time. The pain is not caused by a bone spike, but by damage to the fibers of the ligament.
- Middle form. It occurs very often. My foot feels like it's splitting with every step. The sole aches and hurts, sometimes the discomfort simply makes it impossible to move. Rarely, a large rupture of the plantar ligament may occur: the pain becomes unbearable, the foot swells, and the arches become flattened.
- Distal form. The pain is in the area closer to the fingers. It is less common and can imitate the symptoms of transverse flatfoot and Morton's disease.
How is plantar fasciitis usually treated?
The acute phase of the disease is usually treated symptomatically. The patient is advised to walk less and apply ice packs through a cloth to the painful area. If the discomfort is significant, it is recommended to take anti-inflammatory drugs. These are absolutely correct prescriptions for a short-term fight against exacerbation.
It is somewhat worse if the doctor begins treatment of fasciitis with rather dangerous and unreliable methods. Although they can relieve pain quickly, there will be more complications in the long term. Methods that are still actively practiced contrary to international recommendations include:
- Blockades with steroid hormones. This is “heavy artillery” that dampens pain well, but often causes more harm. Steroids slow down regeneration, reduce the strength of ligaments, and reduce local immunity. The most dangerous side effect is the resorption of the fatty pad of the heel. Sometimes a single injection of the hormone is acceptable, but regular use will certainly lead to complications.
- Radiotherapy. You can also meet patients who try by all means to get an X-ray of their heel, believing that it will remove the “heel spur.” In fact, a bone thorn can only be eliminated by a special radiation device, which is used to fight tumors. On its way, a concentrated beam of radiation destroys all cells, and its use is justified only in oncology.
Treatment
Due to the large number and heterogeneity of diseases that cause pain, there is no single treatment regimen. Pathologies such as arthritis and arthrosis are treated conservatively, prescribing painkillers, anti-inflammatory drugs and drugs that restore cartilage tissue. To get rid of gout, in addition to medications, a specific diet is of no small importance.
Injuries require fixation of the limb and gentle motor mode.
Infectious pathologies require a course of antibiotics.
Deformities can be treated over a long period of time. As a rule, doctors try to make do with therapeutic methods, orthopedic devices, physiotherapy and therapeutic exercises. In extreme cases, surgery has to be performed.
If your feet hurt on the top, sides or soles, there are a huge number of reasons. Self-treatment is unacceptable, because many ailments have similar symptoms, and it is very easy for a non-specialist to make a mistake with the diagnosis. An incorrect diagnosis can cause disability.
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Transverse flatfoot of the foot: general information
The foot adapts to uneven surfaces and absorbs impacts when moving due to its arched structure and developed ligaments. The transverse arch is located at the base of the fingers and is responsible for the ability to spring and push off the surface. Ligaments provide elasticity, maintain the arched shape, and stabilize the forefoot.
But even a properly formed foot has a limit of strength. Intense loads and age-related changes lead to weakening of the ligaments, the arch drops, and the foot flattens. Transverse flatfoot develops slowly in adults. The bones located behind the phalanges of the fingers spread out like a fan. Muscle traction is redistributed, the thumb deviates outward (valgus deformity). In the area of the phalanx, an osteochondral growth is formed, in other words, a lump or bone. When the arch is lowered, depreciation deteriorates, and the unabsorbed shock load is distributed to the joints of the foot and lower leg.
Stages of flat feet
The orthopedist determines the severity of the foot deformation based on the condition of the arches, range of motion, impression of the sole, and x-ray. For an objective assessment, computer podometry (diagnosis of the load on the foot) is prescribed.
There are four degrees in total, which are characterized by the following:
- Slight fatigue of the legs, swelling, the big toe is not displaced, redness is noticeable on the side joint.
- Distinct pain towards the end of the day, the thumb deviates up to 20 degrees.
- The angle of inclination increases to 30°, the range of movement is limited, and there is no transverse arch. The pain spreads to the knees.
- The thumb deviates more than 40° and may become curled. The swelling does not subside, my legs, lower back, and head hurt. It is difficult to walk in ordinary shoes.
Types of severe back pain that radiates to the legs
The nature of pain during hernias/protrusions of the lumbosacral region greatly depends on the location of the hernia, the individual characteristics of the patient (diameter of the intervertebral foramina, diameter of the spinal canal, age and severity of degenerative changes). The size of the hernia can also affect the severity of pain.
Drawing, burning, shooting pains in the back and legs are characteristic of the acute period of the disease, immediately after the onset of an attack of lumboischialgia. They are poorly relieved by analgesics, and may last 1-2 weeks before improvement.
Aching pain in the back and legs is often chronic and can last for years if the patient neglects a visit to a neurologist or treatment. Periodically, there may be periods of exacerbation associated with physical activity or heavy lifting.
Shpidonov Gennady Stanislavovich
Neurologist
Rostov State Medical University (neurology)
10 years of experience
How to relieve back and leg pain
A short course (2-3 days) of nonsteroidal anti-inflammatory drugs, or NSAIDs, can be used to relieve back and leg pain. Drugs in this series have the ability to fight inflammation and can relieve pain of various origins. When the sciatic nerve is pinched, they have average effectiveness. It is strictly forbidden to take NSAIDs for more than 5 days due to the high risk of complications such as stomach ulcers and gastric bleeding. Rest and a firm bed may relieve pain in some patients. However, for others, these measures may lead to increased pain. You should try to find the optimal position in which the pain becomes less severe. Wearing an orthopedic corset can also be effective - it relieves pain by unloading the diseased spine, acting as a muscular frame.
How to treat?
Therapy is selected depending on the severity of pathological changes. The younger the patient and the smaller the foot deformity, the more optimistic the prognosis. Inserts, massage, exercises, physiotherapy for I-II degrees of the disease give positive results.
Treatment of grade III-IV transverse flatfoot in adults is reduced to relieving pain and preventing complications. The deformity is corrected surgically and by wearing orthopedic insoles and shoes during the rehabilitation period.
Corrective therapy
Orthopedic shoes tightly fix the back and middle part of the foot, with a rigid heel. The arch of the foot is supported by arch insoles, which evenly distribute weight and prevent further deformation, help correct the shape of the foot, improve posture, stabilize blood circulation, and reduce wear on joints.
Orthopedic insoles for adults support the arch, protect deformed areas, relieve or prevent pain, and soften the impact on the heel. With physiologically correct placement of the foot, the musculoskeletal system is not overloaded, and the disease does not progress to a severe stage.
Effect of wearing insoles:
- The shock absorption function is restored.
- The muscles of the sole and lower leg are strengthened.
- The feeling of fatigue and heaviness in the legs disappears.
- Dry calluses do not form on the pads.
Author: Serdyuchenko Sergey Nikolaevich Orthopedic traumatologist of the highest category
How is back and leg pain diagnosed?
The first stage of diagnosing the causes of back pain radiating to the legs is a consultation with an experienced neurologist. Radicular syndrome can be diagnosed during a routine neurological examination. A characteristic sign is the positive Lasègue symptom, which consists of increased pain in the leg when it is raised up while lying on the back. It is also called the spinal cord root tension symptom.
A neurological examination also reveals other disorders - decreased sensitivity of the skin to pain, absence or blurred reflexes, atrophic phenomena, weakness of the muscles of the lower extremities. To confirm the diagnosis, it is best to use magnetic resonance imaging of the lumbosacral spine.
Localization of pain in the back and legs
The localization of pain in the lower back and lower extremities depends on the location of the protrusion or herniation of the intervertebral disc. There are lateral, central (horizontal hernias) and internal (Schmorl's hernia) herniations of the intervertebral disc.
Pain radiates to right leg
Pain radiating to the right leg occurs with a lateral or horizontal herniation of the intervertebral disc that occurs on the right. In this case, the right spinal nerve is pinched, and the pain, accordingly, will radiate to the right leg.
Pain radiates to left leg
Pain radiating to the left leg occurs due to hernias/protrusions of the left half of the intervertebral disc.
Pain in the lower back and lower back
Isolated lower back pain of the lumbago type occurs with a central location of a hernia or protrusion, strictly at 12 o’clock. In this case, the hernial protrusion is directed into the spinal canal; there is no pinching of the spinal nerves in the intervertebral foramen, as occurs with lateral hernias. Because of this, there is no pain radiating to the legs. The source of pain is the posterior longitudinal ligament of the spine stretched by a hernia.