Orthopedics-Online

Pain in the foot

Introduction / General

Pain on foot can have many different causes. Because the foot consists of many small ones TarsusIf there is multiple joints, muscles, and tendons, there are many possibilities for foot pain. Most often, accidents or incorrect loading are the cause of the pain. But also Skin disorders, bad footwear or Inflammation can lead to pain. Depending on the cause, these pains can have a different character and thus contribute to the diagnosis.

Figure pain ankle

Foot pain

Achilles tendonitis /
Achilles tendon rupture
Broken bones - toes,
Metatarsus, tarsus
(here outer ankle fracture)
Ligament stretch / torn ligament
at the ankle
Lower and upper heel spurs
Calcaneus spur
Hammer toe and claw toe
(Deformities of the toe bones)
Digitus malleus
Plantar warts
Verrucae plantares
Hallux valgus -
(Deviation of the big toe
in the base joint)
Hallux rigidus -
(Joint wear of the
Metatarsophalangeal joint)
Inflamed nails / nail fungus
Osteoarthritis / arthritis -
degenerative change of
Joints / inflammation of the joints

You can find an overview of all Dr-Gumpert images at: medical illustrations

Appointment with ?

I would be happy to advise you!

Who am I?
My name is dr. Nicolas Gumpert. I am a specialist in orthopedics and the founder of .
Various television programs and print media report regularly about my work. On HR television you can see me every 6 weeks live on "Hallo Hessen".
But now enough is indicated ;-)

Athletes (joggers, soccer players, etc.) are particularly often affected by diseases of the foot. In some cases, the cause of the foot discomfort cannot be identified at first.
Therefore, the treatment of the foot (e.g. Achilles tendonitis, heel spurs, etc.) requires a lot of experience.
I focus on a wide variety of foot diseases.
The aim of every treatment is treatment without surgery with a complete recovery of performance.

Which therapy achieves the best results in the long term can only be determined after looking at all of the information (Examination, X-ray, ultrasound, MRI, etc.) be assessed.

You can find me in:

Lumedis - your orthopedic surgeon
Kaiserstrasse 14
60311 Frankfurt am Main

Directly to the online appointment arrangement
Unfortunately, it is currently only possible to make an appointment with private health insurers. I hope for your understanding!
Further information about myself can be found at Dr. Nicolas Gumpert

Pain in the foot as a result of injury

Foot injuries often occur as a result of accidents. A torn ligament as a result of an ankle trauma, for example during sport, is particularly common. This can lead to an outer or inner ligament tear. Tendon injuries (e.g. Achilles tendon tear), bone fractures in the area of the foot or joint injuries can also occur in the context of an accident. But muscle tension or muscle injuries caused by overloading the foot also lead to pain.

also read: Pain in the outer ankle

Pain in the foot as a result of inflammation

Inflammations in the area of the foot do not usually arise suddenly, but develop a little more slowly. However, they are no less painful. A Joint inflammation (arthritis) develops due to prolonged improper stress and usually lasts for a long time. In some patients the inflammation persists, so that one speaks of chronic arthritis.

Tendinitis (Tendovaginitis) usually occur in the context of a sustained permanent load. If the tendons are rubbing vigorously over the bones, they can become inflamed and then lead to severe pain when the load is renewed. Also Tendons in the metatarsus can become painful. In contrast to the previously mentioned inflammations, the inflammation of the bone (Osteomyelitis) very rare.
It is a bacterial inflammation of the bone. The bacteria enter the bone through an external portal of entry (for example a small injury) and can damage the bone. It is a serious illness with massive general symptoms, so that the affected patients have to be treated as inpatients.

More simple inflammations, such as superficial inflammation of the skin or a toenail, also lead to pain. However, they can usually be treated with local antibiotics or antiseptic and usually do not require inpatient therapy.

Also read: Tendinitis in the foot and Tendonitis on the sole of the foot

Pain in the foot as a result of foot deformities

Numerous types of Misaligned feet can lead to pain due to the resulting incorrect load or pressure points. The misalignments can be congenital or acquired and only develop in the course of life. Congenital malpositions are the Arched arches and the Clubfoot. Of the Flat foot, of the Arches foot and the Equinus can be present at birth as well as arise in the course of life. All of these misalignments are based on changes in the bones or tendons. Often the bones and tendons are not put on correctly, or their anatomy changes due to incorrect loading or incorrect footwear. Diseases like that hallux valgus (Ball of big toe) and the hammer and Claw toes are also caused by incorrect loading or incorrect footwear. However, they are never innate but develop in the course of life.

Other causes

Neurological causes of foot pain

The Tarsal tunnel syndrome (Syn. Bottleneck Syndrome) leads to pain and sensory disturbances due to a narrowing of the tibial nerve. Likewise, a Polyneuropathy as nerve damage, for example as a result of chronic blood sugar disease (Diabetes mellitus) lead to pain and sensory disturbances in the area of the legs and feet.

Tumors

Tumors in the area of the foot, for example a Bone tumor, are rare diseases that can lead to pain at rest and during exercise. The Osteosarcoma is the most common bone tumor in both children and adults. The Ewing's sarcoma is the second most common bone tumor disease in children. Adults are rarely affected by this tumor.

Joint disease

A wear and tear of the Ankle (arthrosis) can occur in the course of life if the load is too long. The pain usually occurs at rest and improves with movement. A Rheumatoid arthritis of the foot is also possible and leads to pain under load. Due to the inflammation of the small ankle joints, therapy often has to be systemic.

see also: Ankle pain and ankle pain

Diagnosis of pain in the foot

In many cases, the foot pain disappears quickly, especially if it has occurred as a result of heavy or new stress. However, if the pain does not go away, it is important to see a doctor for a diagnosis. A precise anamnesis is usually taken first. The most important factors here are the nature of the pain, the duration of the pain and the timing of the complaints. Previous events such as an accident or inflammatory changes are particularly important. In addition, the doctor asks about accompanying symptoms such as fever, feeling weak, weight loss, diabetes mellitus or a rheumatic disease. Information on whether osteoarthritis has already occurred in other joints can also be important. The foot is then thoroughly examined. Swelling or tenderness at one point would suggest a traumatological cause, such as a broken bone. Immobility or severe pain when performing a particular movement would be indicative of a muscle or ligament injury. Redness, overheating, or a visible bacterial infection can be signs of an inflammatory origin. This is usually followed by an X-ray with a held exposure, for example if a ligament is suspected. An MRI image of the foot is also possible. If inflammation is suspected, blood values and the inflammation parameters are determined. Blood values should also be determined if a tumor is suspected. In addition, the bone can be punctured and samples can be taken in order to secure the tumor diagnosis. Neurological examinations such as the nerve conduction velocity or an electromyography (EMG) can be carried out as well as the puncture for a joint effusion or an ultrasound examination (sonography).

Also read: Growing pains in the foot

Pain in the foot depending on where it occurred

Pain on the outside

Pain that occurs on the outside of the foot can be caused, for example, by the so-called "tailor's ball" (small toe ball). This is a misalignment of the little toe, which usually occurs as a result of splayfoot. The spreading creates a bulge on the outer edge of the foot.With this malposition of the foot, the little toe is pressed inwards, the base joint is then overloaded and can swell. Pressure points form over the base joint due to the changed shape of the foot. In order to prevent or alleviate the pain in the foot, we recommend wearing wide shoes, wearing custom-made insoles or even doing without shoes yourself, i.e. walking barefoot. If none of these measures help, there is still the option of corrective surgery. Another cause can be, for example, misalignment of the legs, which causes the pain due to an incorrect rolling movement while running. A strain on the ligaments located there can of course also cause pain in the foot.

Read more on this topic at: Pain on the outer edge of the foot

Pain on the inside

There may be pain on the inside of the foot occur acutely from injury, but they often arise chronically by themselves foot deformities that develop over the years. Above all, the Lowering /Flat foot (Pes planus) and the buckle foot (Pes valgus) a role. The flat foot is caused by a Weakness of muscles and ligaments. These actually serve to maintain the arch of the foot, which is known as the longitudinal and transverse arches. Due to the constant stress of standing and walking, the weakness of the structures gradually develops a Flattening in the longitudinal vault, so that the flat foot occurs. Through the changed statics there is now pain in the foot, which mainly occurs on the inside. Pain in the calf or knee area can also occur as a result. Not only the flat feet can lead to pain in the foot, but also the flat foot. However, it is often associated with flat feet. With the buckle foot there is one Lowering of the inner edge of the foot and one Raising the outer edge of the foot. As a result, one kinks inwards. Here, too, there is a change in the statics, which not only affects the foot, but also the entire statics of the body. Therapeutically becomes a Structure of the holding muscles recommended through targeted training. If the complaints increase, there is also a Supply of deposits We recommend.

Pain in the heel

Injuries, accidents, bruises or that too Running on hard surfaces wearing the wrong shoes can lead to heel pain. Another cause can be what is known as a heel spur. This is located at the tendon attachment as a bony spur. He can look at the attachment for the Achilles tendon (upper calcaneal spur), as well as the approach for the so-called Plantar tendon (lower heel spur) are located. The patient notices the symptoms knife-prick painthat are worst especially in the morning. The pain may subside under light exertion, but it may then worsen again. To reduce the pain in the foot while running, the The rolling movement shifted to the outer edge of the foot. There are several causes that can lead to heel spurs. Overweight people, especially great people or very active people tend to such education. To find out where the heel pain is coming from, there are a number of possible examinations. In addition to the physical examination by the attending physician, an ultrasound examination, an X-ray or even an MRI can help guide the diagnosis. One can also be important computer-aided footprint measurement be to make a statement about eventual Misaligned feet and to be able to meet increased pressure areas. Therapeutically, the patient can use certain physiotherapy measures, insoles or orthopedic shoes or by a Injection of a local anesthetic be helped very well at the point of greatest pain. Sometimes that turns out to be Application of cold as helpful.

Big toe pain / rigidus

Toe pain is very common. Often the cause lies in too tight or bad shoes, but also ingrown nails or Bruises can be identified as the cause. Pain in the foot that affects the big toe is often caused by hallux valgus (Bunion). This is mainly caused by incorrect footwear or family stress. The big toe tilts in the direction of the other toes and leads to one permanent malalignment. The bunion is a visual diagnosis so that the practiced and experienced doctor does not have to carry out any further diagnostic equipment. There are many therapeutic options available to the patient, from Toe splints and insoles, over active foot and toe gymnastics up to surgery are enough to relieve the pain and deformity. Hallux rigidus represents osteoarthritis of the metatarsophalangeal joint of the big toe, i.e. the Wear and tear of the cartilage. Causes of osteoarthritis can be, for example, injuries to the joint with cartilage involvement, the metabolic disease gout or improper stress and overload. This condition affects men more often. It comes to Pain and restriction of movement in the joint, the toe can often only be moved upwards with pain. Initially, the pain can be reduced by using special insoles and the next step is an operation to improve mobility. If the disease is at an advanced stage, joint preservation is often no longer possible, so that a stiffening or a Joint replacement represent the last option. Gout can also cause pain in the foot. It is particularly common in the big toe. The base joint of the big toe is reddened, swollen and hurts at the slightest touch. In gout, too much uric acid builds up in the blood, causing the body to do so Uric acid crystals forms that accumulate and deposit in joints and internal organs. Gout is often an acute condition which subsides after a few days. The disease is treated in two stages. In an acute attack of gout, drugs are given to relieve the attack by taking Reduce pain and inflammation. High doses are used for this anti-inflammatory agents prescribed. For long-term therapy, drugs are given that are supposed to permanently lower the uric acid level in the blood. Often times it is necessary for the patient to have a Changing his diet to reduce the intake of foods that raise uric acid levels in the blood. Meat and alcohol in particular should be avoided.

therapy

The therapy for foot pain depends on the cause of the pain. Acute painful events in the context of an accident often do not require therapy, but disappear on their own. Often, a brief immobilization of the foot is sufficient until the pain subsides. In some cases are Bandages, Ointment dressings, one Plaster splint or a plaster cast necessary to immobilize the foot.

Anti-inflammatory drugs like Acetylsalicylic acid or Diclofenac can also relieve pain. In the case of chronic joint diseases, stronger drugs to inhibit the immune system and reduce inflammation are often necessary (Cortisone). In some cases, conservative therapy is not effective, so that surgery must be used. This can for example be with a Heel spur become necessary. A joint speculum (Arthroscopy) is often performed when there is a suspicion of chronic joint wear (osteoarthritis). By physical therapy, Cold and heat treatments, Muscle training, Electrotherapy or ultrasound therapy, any therapy can be supported and symptomatic relief. In any case, it is important to have the right footwear in order to avoid possible misalignments or incorrect loads. Which further therapy is necessary and useful should be discussed with the attending physician.

Summary

Foot pain is a broad field with numerous different causes. These can be divided into individual subgroups such as traumatological causes, bone tumors, inflammation, chronic diseases or neurological diseases. All of these causes can be followed by pain in the foot when moving or at rest. In addition to the pain, there are many other symptoms that serve to confirm the diagnosis. Here are above all blood values, Inflammation parameters, the X-ray, the exact anamnese and other special ones Investigations necessary. Depending on the diagnosis, a conservative or operational Therapy. Partly needs therapy medicinal can be supplemented or taken for life. The exact therapy is specific and should be decided by the attending physician.