Up to 25% of women and 19% of men will experience foot pain significant enough to affect their activity. At risk groups are the elderly, the overweight, and sports men, sports women and ballet dancers. If minor foot problems such as toenail disorders, minor toe deformities, corns and calluses and bunions and skin problems are included, up to 75% of people will be affected. Army personnel and sportsmen are prone to ankle and foot injuries, with some developing chronic pain from stress fractures especially that of the navicular bone.
Foot pain that is persistent tends to indicate a more serious injury or a medical condition that mimics injury. In other cases, there might be pain only when a certain part of the foot is stressed. Injuries to tendons and joints result in sharp pain especially in the early stages. The pain becomes more dull in nature once the injury has become more chronic. Burning pain will suggest a nerve being involved, most commonly seen in tarsal tunnel syndrome or Morton’s neuroma. This is especially so if there is numbness or paraesthesia or radiation of the pain in the foot, which usually indicates a nerve compression at the level of the spinal cord or a peripheral nerve.
Pain that occurs or is noticed more at night is typical of diabetic neuropathy and tumours. Pain that occurs only during the day when walking around will be more typical of conditions such as plantar fasciitis, tendinopathy and metatarsalgia. Achilles tendinopathy presents as heel pain very commonly in those who do a lot of running as the stress to the tendon accumulates over time. Gout and diabetes can cause pain despite there being no injury. Changes in footwear and weight may also change the forces across the foot and stress different aspects, causing conditions like plantar fasciitis to occur.
The pain from Morton’s neuroma is relieved by wearing a shoe with a wider front and this may give a clue to is origin. The pain from bunions tend to run in families as foot structure is inheritable. Pregnancy which results in water retention and swollen foot and ankles and ligamental laxity along with an increase in weight is also a frequent cause of foot pain; this arises because of increased stresses across the arch of the foot and over the metatarsals.
Common conditions affecting the hindfoot include:
- Plantar fasciitis
- Achilles tendinopathy and Haglund’s deformity
- Tarsal tunnel syndrome
- Peroneal tendon injury
Other conditions that might affect the foot include:
- Ankle impingement
- Sinus tarsi syndrome
- Piezogenic papules
- Heel contusions