Foot Pain

Feet. They carry you from here to there every day. But you may not think much about them until they hurt. And when they do, you want relief. To get the right treatment, you need to know the problem. The first thing to consider is where your pain is located.

Heel Pain

If your pain is in your heel, you may have plantar fasciitis. That’s an irritation or inflammation of the band of tough tissue connecting the heel bone to the toes. Usually, it hurts the worst in the morning when you’re getting out of bed. You can feel it in your heel or in your arch.

To treat it:

• Rest your foot.
• Do heel and foot muscle stretches.
• Take over-the-counter pain relievers.
• Wear shoes with good arch support and a cushioned sole.

Heel spursare another source of foot pain. These are abnormal growths of bone on the bottom of your heel. You can get them from wearing the wrong shoes or from an abnormal walk or posture, or even from activities like running. The spurs may hurt while you’re walking or standing. Lots of people have them, but most don’t have pain. People with flat feet or high arches are more likely to have painful heel spurs.

To treat them:

• Wear a cutout heel pad.
• Use a custom-made insert (called an orthotic) worn in the shoe.
• Wear shoes that fit well and have shock-absorbing soles.
• Take over-the- counter pain relievers.
• Rest your foot.
• Try physical therapy.
• If you still have pain, ask your doctor about medical procedures.

A stone bruise is a deep bruise of the fat pad of the heel or ball of the foot. It’s often from an impact injury, but it can also happen after stepping on a hard object. The pain feels like you’re walking on a pebble. It will gradually go away on its own.

In the meantime:

• Rest your foot.
• Ice the area.
• Take over-the-counter pain relievers.

A heel fracture is usually a high-impact injury such as from a fall or car accident. Your heel bone may not just break, it could also shatter. Heel pain, bruising, swelling, or trouble walking are the main symptoms.

To treat it:

• Don’t put pressure on the heel. You can use crutches.
• Protect the heel with pads.
• Wear a splint or cast to protect the heel bone.
• Ask your doctor about over- the-counter or prescription pain relievers.
• Try physical therapy.
• If you’re still in pain, ask your doctor about surgery.

Psoriatic arthritis (PsA) is a mix of a skin disorder (psoriasis) and joint inflammation (arthritis). It’s a long-term condition that can run in families. PsA may cause stiffness and throbbing pain in the tendons over your fingers, toes, and other joints.

To treat it:

• For mild cases of PsA, your doctor may recommend a nonsteroidal anti- inflammatory drug (NSAID) to block the chemicals that cause swelling in your joints. You can get this medication at the pharmacy (aspirin, ibuprofen, or naproxen) or with a prescription.
• Try hot and cold therapy. Heat helps blood circulation to lessen stiffness. Cold lowers swelling.
• Manage your stress, which can make your PsA flare.
• For severe cases, you may need more powerful medications. Options include disease-modifying antirheumatic drugs (DMARDs), including biologics, and corticosteroids.

Ball of Foot Pain

Metatarsalgia. You feel this pain and inflammation in the ball of your foot. Ill-fitting shoes are the usual cause. But you might get it from strenuous activity, such as running or jumping. It’s sometimes called a stone bruise as well.

To treat it:

• Take pain relievers.
• Ice and rest your foot.
• Wear comfortable footwear.
• Try shoe inserts to relieve pressure on the ball of your foot.

Morton's neuroma causes a thickening of the tissue around the nerves between the bases of the toes (usually between the third and fourth toes). You typically feel pain, odd sensations or numbness over the ball of your foot. Women have it more often. It can be a result of wearing high heels or tight shoes.

To treat it:

• Wear shoe inserts to reduce pressure on the nerve.
• Get a steroid or other injection into the foot.
• Take pain relievers.
• Don’t wear high-heeled shoes or ones with a narrow toe box.
• Avoid activities that put pressure on the neuroma.
• Ask your doctor about surgery.

Sesamoiditis. Near your big toe are 2 bones that are connected only by tendons. They’re called sesamoids. You get sesamoiditis when the tendons surrounding them become injured and inflamed. It’s a form of tendinitis, common with runners and ballet dancers.

To treat it:

• Rest your feet.
• Ice where it hurts.
• Wear a foot pad under the toe in a comfortable shoe.
• Tape the big toe to immobilize the joint and allow for healing.
• Wear low- heeled shoes.
• Ask your doctor about steroid injections.

Arch Pain

Plantar fasciitis. This is the most common cause of arch pain. Plantar fasciitis can affect the heel, arch, or both. Treatment is the same regardless of the location. For persistent plantar fasciitis, an injection with a mixture of a steroid and local anesthetic can be helpful.

Fallen arches, or flat feet, happen when the arches of the feet flatten out (often when standing or walking), causing foot pain and other problems. Flat feet can be treated with shoe inserts, shoe adjustments, rest, ice, using a walking cane or brace, or physical therapy. Sometimes surgery is necessary.

Toe Pain

Gout, which is a form of arthritis, can causes pain in the toes. Crystals collect in toe joints, causing severe pain and swelling. The big toe is often affected.

To treat it:

• Rest the foot.
• Ice the area.
• Take medication such as a nonsteroidal anti- inflammatory drug (NSAID), prednisone, colchicine, or allopurinol.
• Avoid foods that can make gout worse.

A bunion is a bony bulge along the edge of the foot, next to the base of the big toe. It's associated with misalignment of the first toe joint. Anyone can get them, especially if they wear ill-fitting or uncomfortable shoes. It often shows up as people age. People with bunions often also have hammertoes as well. Try changing to more comfortable shoes or wearing shoe inserts. If you’re still in pain, your doctor may suggest surgery.

A hammertoe is when your second, third, or fourth toe bends at the middle joint, creating a hammer-like appearance. It can come from a muscle imbalance, but it can also be brought on by wearing ill-fitting shoes.

Your doctor will likely recommend you wear shoes with a wide, deep toe bed. They may also give you exercises to stretch your toe muscles. If you still have problems, you can talk to your doctor about surgery.

Claw toe is when your toe points down or up and is unable to straighten. It’s often the result of nerve damage from diseases like diabetes or alcoholism, which weakens the muscles in your foot. Without special footwear to accommodate the claw toe, you may develop irritation and calluses.

To treat it:

• Change to better-fitting footwear. Avoid high heels and tight shoes.
• Do stretches for your toes and toe joints.
• Try shoe inserts.
• Ask your doctor about surgery.

An ingrown toenailis when skin on one or both sides of a toenail grow over the nail. It can be painful and may lead to infections.

To treat it:

• Soak the foot in warm water four times a day.
• Once daily, wedge a piece of gauze between the nail and wet skin.
• If these treatments don’t work, see a doctor.

Turf toeis when you feel pain at the base of the big toe. It’s an overuse injury usually caused by strain. Turf toe may also be a form of sesamoiditis or a sesamoid fracture.

A toe sprain may happen when you jam or stub your toe, damaging the tendon or soft tissues of the toe. If you don’t have a fracture, the pain and swelling should go away within days.

A toe fracture, or broken bone, can happen in any of the bones of the toes. Minor fractures may only require rest, ice, and pain relievers. Serious fractures may need surgery. Go to a doctor to be sure.

Hallux rigidus (stiff big toe) is a type of arthritis at the base of the big toe. Symptoms are pain and stiffness of the joint that worsens over time. Treatment can include pain relievers and stretching exercises. Surgery may be needed in some cases.

Corns and calluses. Corns are thick buildups of tough skin on a point of irritation or pressure on the foot or toe. They sometimes look like horns. Calluses are wider areas of tough skin buildup on the toes or feet. They happen as a result of irritation or pressure. Calluses and corns are generally caused by poor-fitting footwear.

To treat them:

• Wear better-fitting shoes.
• Soak the foot and use a pumice stone to wear down the extra skin.

A sesamoid fracture is a break in the small bones (sesamoids) that are embedded in tendons attached to the big toe. Pain in and around the big toe is the main symptom.

To treat it:

• Rest, ice, and elevate your foot.
• Wear stiff-soled shoes or foot pads to relieve pressure.
• Take pain relievers.
• If you’re still in pain, talk to your doctor.

Pain on the Foot's Outer Edge

The outer edge of your foot, the fifth metatarsal bone, is a commonly broken bone in the foot. Pain, swelling, and bruising along the outer foot edge after an injury are symptoms. If you think you may have broken a bone, see a doctor and have an X-ray.

To treat it:

• Take pain relievers.
• Rest, ice, and elevate your foot.
• Don’t walk on it.
• Ask your doctor if surgery is necessary.
• A cast may be necessary in some circumstances.

Foot Pain That's Anywhere or Everywhere

Neuropathy, or nerve damage in the feet, is most often caused by diabetes. The pain can be burning, stinging, or feel like electricity. It can happen anywhere in the feet. Ask your doctor about pain relief options and ways to prevent further worsening.

Rheumatoid arthritis (RA) is a chronic autoimmune disease that can cause pain, stiffness, and swelling in the joints throughout your body. Almost everyone with RA gets symptoms in their feet and ankles. RA can affect the areas around your heels, the top of your feet, and the toes and the balls of your feet. Rest, ice, or nonsteroidal anti-inflammatory medication such as ibuprofen and naproxen may ease your symptoms. Shoe inserts can relieve pressure from the bone in your feet.

Osteoarthritis is when the cushioning cartilage in your joints wear out. Most often, the cause is aging. But osteoarthritis also can happen from injury or if you have flat feet or very high arches. You may have trouble walking, and your joints may feel stiff and painful.

To treat it, your doctor may recommend:

• Nonsteroidal anti-inflammatory drugs (NSAIDs)
• Custom shoe inserts
• Braces, a cast, or a boot to keep your foot immobile until the inflammation goes down
• Physical therapy to strengthen your muscles
• Steroid shots for more severe cases

Tendinitis is inflammation and irritation of tendons, the bands attaching muscles to bones. Tendons run along all the surfaces of the foot and can cause foot pain in many different locations.

To treat it:

• Rest your foot.
• Take pain relievers.
• Steroid injections can help.
• Surgery is rarely needed.

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