Pain in the feet - these are the causes

definition

Pain in the feet is a phenomenon that affects many people. A distinction is made between pain in the feet that occurs at rest and pain that only causes problems when exercised. The symptoms can be limited to certain areas depending on the cause. In addition to direct damage to the feet due to incorrect loading or trauma, diseases affecting the whole body can also lead to pain in the feet.

The causes are varied. When treating pain in the feet, physiotherapeutic and medicinal measures can be considered. In most cases, pain in the feet is harmless and can be treated well.

Causes of pain in the feet

The causes of pain in the feet can be very different. The most common reason for this type of discomfort is chronic overload. Bad posture and incorrect footwear as well as being overweight play a major role. The shoes can be too small and tight or cause a bad posture due to a heel. Especially people who have to stand or walk a lot quickly suffer from pain in their feet. A common bad posture in this context is a kinked big toe, known as hallux valgus. These complaints are favored by a congenital flat or hollow foot.

Heel spurs are another cause of pain in the feet. It is a bony protrusion on the heel that is found in 10-20% of people. When overloaded, the tissue becomes inflamed and pain occurs on the back of the feet. This can also be caused by an overloaded Achilles tendon.

A corn can also develop in particularly stressed areas.
In addition to the causes mentioned, there are also underlying diseases that manifest themselves in the foot. Above all, diabetes mellitus should be mentioned here. Many diabetics have problems with their feet, as this is where the nerves are damaged first. There is sore spots and inflammation, causing pain in the feet. Other causes can be rheumatism and gout. A herniated disc can also radiate painfully into the feet.

The pain by localization

Pain on the inside

Pain in the feet often occurs on the inside. You can start from the entire inside and partially radiate down to the back of the foot or under the foot. The most common cause here is incorrect loading caused by shoes that are too tight. Similar to the hand, the foot is made up of tarsal bones and elongated tubular bones. These bones are pressed together by shoes that are too tight. Bad posture develops, which causes pain in the feet, especially on the inside.

Furthermore, a kinked big toe (hallux valgus) leads to pain on the inside. This misalignment can be recognized by an outward bending of the big toe, while a protruding bone forms on the metatarsophalangeal joint of the big toe. Corns are also found mostly on the inside of the toes. Overloaded feet from long walking and standing usually hurt all over the foot. However, the pain in the feet can also be especially on the inside.

Foot injuries caused by diabetes can often occur on the inside of the ankle.

In the case of a herniated disc in the lower lumbar vertebrae, nerve fibers that supply the inside of the foot are compressed. This can also lead to pain in the feet on the inside.

Finally, the gout can cause pain on the inside. Gout is a metabolic disease that can occur as a result of excessive consumption of meat and alcohol. It often first manifests itself as a fit in the metatarsophalangeal joint of the big toe. This occurs acutely and is very painful.

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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.

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Pain on the outside

There may also be pain in the feet on the outside. Here, too, the main reasons are overloading of the feet and chronic misalignments caused by the wrong shoes. Pumps and high heels are particularly problematic in this regard.

Herniated discs in the sacral areas, i.e. in the area of ​​the sacrum below the lumbar spine, can cause pain on the outside. Likewise, a diabetic foot manifests itself on the outside. Pain in the feet is the result. The inflammation of the small joints known as rheumatism can also be felt in the feet. The pain is particularly localized over the small toe joints, but can also occur on the outside.

Pain in the sole of the foot

Pain in the feet on the sole of the foot is the typical localization of pain as a result of overload. Anyone who has already set out on long hikes or a shopping tour through the city knows the feeling of pain in the feet on the soles of the feet. Overweight people in particular suffer from these complaints. With each step, the foot has to carry more weight than it can withstand. Cushioning insoles and springy shoes can relieve the pain in the feet on the soles of the feet.

Another cause can be fatigue fractures. Of these, e.g. Marathon runners affected. Due to the extreme stress, even a healthy foot can have the smallest cracks and breaks in the bones. The result is pain on the sole of the foot.

Pain in the heels

Pain in the feet on the heels is relatively common. Many adolescents, especially males, suffer from heel pain as they grow.The reasons are not yet fully understood, but the pain can be treated with insoles and will go away over time.

In adults, the most common causes of heel pain are heel spurs and aching Achilles tendon. Heel spurs are usually harmless. However, with a lot of stress it can cause discomfort. The Achilles tendon, which attaches to the heels and transfers the power of the calf muscles to the feet, can also be irritated by overload. There is pain in the feet on the heels.

Read more about the topic here: Therapy of heel spurs

Concomitant symptoms

With pain in the feet, accompanying symptoms may appear in some cases. Inflammatory processes such as a gout attack or rheumatic disease are usually associated with reddening and overheating of the affected regions. Other accompanying symptoms are possible. In gout, you may be able to feel a hardening of the joint. Heavily stressed feet often show swelling of the foot. Depending on the cause, this can mainly be seen either in the evening after a long day or in the morning after getting up.

In some cases of pain in the feet, the causing deformity can be clearly seen. This is e.g. the case with hallux valgus or flat and hollow feet. With diabetic feet, pain is a late symptom. Damage to the skin and nerves can usually be observed as accompanying symptoms. Open spots that may be inflamed and tingling or numbness are not uncommon with pain in the feet as a result of diabetes. These abnormal sensations also occur with a herniated disc. Further accompanying symptoms with incorrect footwear are clear pressure points on the back of the foot and the sides. Often, however, pain in the feet is accompanied by no other accompanying symptoms.

Pain combined with swollen feet

The phenomenon that the feet are swollen is often associated with pain in the feet. Usually swollen feet result when you have to stand and walk a lot during the day. Due to the force of gravity, water gradually collects in the feet. This causes pain in the feet, especially in the evening.

You can prevent this by putting your feet up in between. Another cause of swollen feet is the side effect of certain high blood pressure medications. These so-called calcium antagonists can in rare cases cause the feet to be swollen. However, this usually goes hand in hand with no pain in the feet. If the feet are swollen in the morning, there is another mechanism behind it.

Pain in the feet with accompanying leg pain

In some cases there is pain in the feet and also leg pain. If these two symptoms occur at the same time, it should not be long in coming to see a doctor. Pain in the feet and leg pain can indicate a blood clot in the blood vessels of the legs (thrombosis in the leg).

Swelling and a feeling of tension in the leg also occur here. If there is pain in the foot and leg pain while walking, an insufficient supply of blood may be the cause. In many cases of pain in the feet and leg pain, however, the causes are harmless. So pain can present itself through overload in the foot and leg. However, it makes sense to see a doctor for longer or severe complaints.

Pain in the morning after getting up

Some people complain of swelling and pain in their feet, especially in the morning after getting up. Here an overload or a misalignment is less responsible. Rather, this is a sign of poor heart pumping (heart failure). This is particularly problematic when lying down, because then more blood is in front of the heart due to the body position and gravity. This also applies to sleeping at night. At some point, a weak heart can no longer pump this blood adequately through the circulation. It then backs up in the veins.

This also happens in the feet, causing swelling and pain in the feet. You can see this most clearly in the morning after getting up. During the day, the symptoms initially improve. However, in the evening swelling may reappear due to the sagging blood. Swollen feet in the morning should be neglected if they occur once. However, if you notice swelling and pain in your feet after getting up for a longer period of time, you should consult a doctor. He can look for the cause and accurately assess the cardiac output. If you have swollen feet after getting up, you should also watch out for other symptoms of heart failure. These can e.g. Loss of performance, fatigue, and breathing problems. Older people are particularly affected by heart failure. Also, people with a history of heart disease are at high risk for a weak heart.

Pain especially at night

If pain in the feet occurs especially at night, the cause may be the “restless legs syndrome”, in German for example the syndrome of restless legs. It is a neurological disorder that typically causes pain in the feet and legs at night. In addition, there are discomforts and the need to move. The cause is an imbalance of messenger substances in the brain. This is also the starting point for the drugs used. Other causes of pain in the feet, especially at night, are overexertion during the day. Often, pain in the feet is only really noticeable when you come to rest.

Pain in the feet only when stepping / walking / running

In some cases, pain in the feet is only observed when stepping, walking, or running. There is pain with almost every step. Depending on the cause, these can occur on the sole of the foot, the heel or on the side. The most common reason for pain only when stepping on or walking is here too, permanent overload of the feet. This mostly occurs in connection with obesity and unhealthy footwear. The pain occurs here after prolonged exposure. If symptoms arise after just a few meters, there must be another cause of the pain in the feet. Here it is worthwhile to inspect the feet from all sides. Defects that may be the cause of the pain may already be noticed.

If the pain is only felt when stepping, walking, or running, some causes become unlikely. A herniated disc will cause pain and tingling even at rest. Inflammatory processes are not only noticeable when they occur. However, they would be felt more strongly here. The first therapeutic option is to take a break and protect your feet. Pain in the feet is a signal from the body that something is wrong here. One should take that seriously. The symptoms are often better after a break. However, if there is pain in the feet only when walking and running over a certain period of time, it makes sense to clarify.

diagnosis

Different aspects come into play when diagnosing pain in the feet. First, a detailed survey on the type, duration, occurrence and extent of the complaints is in the foreground. The type of shoes and behavior with regard to standing or walking activities should also be inquired about for diagnosis. With a detailed examination, the doctor can identify misalignments, pressure points and skin damage.
In diabetics, the sense of touch is also tested. Movement tests and testing for tenderness are essential. An X-ray examination of the feet can be useful if the symptoms are severe. Pain in the feet caused by swelling may require an electrocardiogram and ultrasound examination of the heart.

Treatment / therapy

The treatment of pain in the feet depends of course on the cause of the discomfort. In most cases, conservative therapy is sufficient. This helps with overloaded and incorrectly loaded feet. Rest and foot massages quickly provide relief here. In the evening or while working at the desk, e.g. Balls for foot massage are a good means of relaxation and exercise.

Severe complaints can be treated by a trained physiotherapist. Eliminating triggering factors is an important pillar of treating foot pain. In the case of obesity, this includes weight loss and, in all cases, wearing suitable shoes. High and tight shoes should be avoided. Often times, if the feet are misaligned, such as flat and hollow feet, special insoles are helpful because their shape counteracts the misalignment.

If there is an underlying disease, treating it is of great importance. In the case of diabetes, for example, the blood sugar must be precisely adjusted. In addition, regular preventive examinations of the foot should be encouraged. For gout, avoiding meat and alcohol is an effective method. Rheumatic diseases are treated with a complex therapy regimen consisting of pain medication and agents that suppress the immune system. Heart disease that causes pain in the feet needs to be evaluated and treated by a cardiologist.

Duration

Pain in the feet can vary in duration. Pain in the feet due to excessive strain subside relatively quickly and should have improved significantly the next day. If the pain is caused by a misalignment, the duration can be longer. Until the correction is made, there is unlikely to be any real improvement. This can take some time, but insoles provide quick relief from the discomfort.

Pain in the feet caused by diabetes or gout can go back at different rates. An acute attack of gout can be quickly controlled with the right therapy, whereas treatment for diabetes is long-term.

Pain in the feet with accompanying fatigue

Sometimes pain in the feet occurs at the same time as fatigue. Causes that can be found directly on the foot are usually not associated with fatigue. This symptom, however, occurs with rheumatic diseases. Therefore, pain in the feet with fatigue should suggest rheumatic inflammation of the small ankles.

In some cases, other inflammations in the body also cause fatigue. In connection with pain in the feet, tired muscles can also mean tired muscles in the leg. This often happens after heavy loads. At rest, pain in the feet with tiredness in the legs can indicate thrombosis.

Rheumatism as the cause

Rheumatic diseases are a broad field of medicine. Rheumatism is colloquially referred to as rheumatoid arthritis, i.e. the inflammation of joints caused by rheumatism. It mainly manifests itself in the small joints of the fingers and toes. Therefore, rheumatism can be a cause of pain in the feet. Rheumatism is a likely cause, especially if other joints in the body are also affected.

Rheumatism is diagnosed with a clinical examination of the painful joints and blood tests. In the case of rheumatism, a specialist uses drug therapy consisting of painkillers and substances that inhibit the immune system.

Polyneuropathy as the cause

Polyneuropathy is a medical term that means that several nerves are damaged in some way. This can lead to pain, tingling and loss of movement. The term polyneuropathy has a special meaning in the context of pain in the feet. It is a typical consequence of diabetes mellitus. The nerves are damaged by the high sugar concentration in the blood, which very often begins in the feet.

In addition to pain in the feet, numbness can also cause wounds and skin damage. The extent of the polyneuropathy on the feet is determined with sensitivity tests. It can be avoided through a well-controlled diabetes.

Pain in the feet after pregnancy

Some women complain of pain in their feet after pregnancy. What is special is that the pain in the feet only occurs after delivery. This can be due to tension in the muscles or back nerves, which must first adapt to the new stress situation after the birth. Another theory blames the hormonal changes after pregnancy for the pain in the feet. These can also affect the connective tissue of the feet. As a rule, the pain subsides after a few days. The pain can be relieved through rest, elevated positions and light massages.

Pain in the feet after chemotherapy

After chemotherapy, in addition to the actual effect, there are often a variety of side effects. One of them is pain in the feet. On the one hand, they can be caused by the polyneuropathy described above. Chemotherapy drugs attack nerve structures, causing pain in the feet after chemotherapy.

Another cause of foot pain after chemotherapy is hand and foot syndrome. This is rare but causes pain in the feet and hands. These side effects can be partially prevented by taking preventive measures.

The symptoms often subside after the end of chemotherapy.

Read more about the topic here: Side effects of chemotherapy

Pain in the feet in diabetes

A major complication with diabetes is what is known as the diabetic foot. The disease causes damage to the nerves (polyneuropathy), which in turn leads directly to pain in the feet and later numbness. The foot is also indirectly damaged in diabetes. By not feeling anything, small wounds and injuries are overlooked. These can expand and cause severe pain in the feet. In addition, the blood flow is reduced in diabetes.

Therefore, the care and prevention of the feet is of great importance with diabetes. You should inspect your feet every day and have your nerves checked regularly.

Pain in the feet despite the insole

Insoles for shoes are a frequently used therapeutic measure for pain in the feet. In some cases, however, the pain in the feet does not get better despite the insole. For one thing, it takes some time for the therapy to take effect. So at the beginning there can still be pain in the feet despite the insole. On the other hand, it may be that the actual cause of the pain was wrongly identified and cannot be treated with shoe insoles. Therefore, you should arrange for a check-up appointment with the attending physician in the event of pain despite the insert.

He or she may be able to adjust the insole or carry out more detailed examinations for the pain in the feet. Nonetheless, insoles are a good and helpful measure for many causes of foot pain.