How To Treat Common Types of Foot Pain
Millions of people experience foot pain every year, and for a significant number the pain is chronic. Here are some ways to treat common types of foot pain, including results of a new study on an effective approach to one of the most common types of foot pain.
Do your feet hurt?
Think about it: each foot has 26 bones, 33 joints, and more than 100 muscles, ligaments, and tendons, and you depend on your feet to bear the burden of your weight every day. With all that responsibility assigned to a complex yet relatively small portion of your body, it’s no wonder so many people suffer with foot pain.
Heel pain is the most common reason people visit a doctor for their feet. Pain in the heel is usually caused by plantar fasciitis, a condition that occurs when the fibrous plantar fascia ligament that runs along the bottom of the foot between the heel bone and toes develops tears.
The tears in the plantar fascia ligament are irritated with each step, resulting in inflammation and stabbing, burning, or aching pain in the heel. Treatment of plantar fasciitis is most effective if started as soon as symptoms appear.
- Rest: stay off the foot as much as possible
- Ice: Apply ice for about 5 minutes several times a day
- Massage: Gentle massage of your foot can facilitate healing
- Medication: Over-the-counter anti-inflammatory drugs such as ibuprofen can provide relief
- Stretching: Gentle stretching of the ligament several times a day. To stretch the ligament, sit with your leg extended in front of you. Slowly and gently move your toes toward you and hold for about 5 seconds, then release back to the starting position. Repeat 5-10 times several times a day
If plantar fasciitis is chronic, there is a treatment many find effective. In a new study appearing in the American Journal of Physical Medicine & Rehabilitation, the authors reported on a meta-analysis of 11 studies of the effectiveness of extracorporeal shock wave therapy (ESWT) for treatment of chronic plantar fasciitis. ESWT is a noninvasive therapy that uses high pressure sound waves to initiate healing.
The reviewers found that:
- ESWT overall was effective in relieving morning pain
- Moderate-intensity ESWT was effective in reducing overall pain and pain associated with activity
- Moderate- and high-intensity ESWT were beneficial in improving functional outcome
- ESWT also was associated with side effects; namely, heel pain and redness of the heels
Other ways to treat foot pain
Treatment for foot pain depends on which part of the foot is hurting and the cause of the pain. Here are a few treatment options for common types of foot pain.
Heel spurs. These abnormal growths of bone on the bottom of the heel bone affect about 10 percent of the population, but only about half of those individuals experience any foot pain. Surgery is reserved for only the most severe cases; otherwise, you can get significant relief by wearing wear cutout heel pads or customized orthotics and taking OTC pain relievers as needed.
Toe pain: The most common cause of toe pain is arthritis, especially gouty arthritis, also known as gout. This inflammatory, painful condition is caused by the accumulation of uric acid, which results in the deposit of crystals in the joints, especially the big toe.
Conventional treatments of gout include ibuprofen or more potent nonsteroidal anti-inflammatory drugs (NSAIDs), colchicine, probenecid, prednisone (oral or injectable), xanthine oxidase inhibitors (e.g., allopurinol), and avoiding items high in purines such as red meat and alcohol. Natural remedies that can be helpful include drinking lime juice or black cherry juice, which can assist in breaking down uric acid in the kidneys; and garlic, which helps remove uric acid from the body.
Arch pain: Pain in the arches is most often associated with plantar fasciitis (in which case the treatment options for that condition can be helpful) or with having flat feet. Treatment of flat feet can be managed by using orthotics, use of ice and massage, or physical therapy. Surgery is rarely necessary.
Ball of the foot pain. Known as metatarsalgia, this type of foot pain is usually caused by ill-fitting shoes or vigorous activity. You can try shoe inserts designed to relieve pressure on the ball of the foot, change to different shoes, and/or take OTC pain relievers.
Ingrown toenail: When a sharp corner of a toenail digs into the skin of the toe (usually the big toe), you have an ingrown toenail, also known as onychocryptosis. An untreated ingrown toenail can become infected and so should be corrected as soon as possible.
Treatment depends on how far along the ingrown toenail has become. If the toe is already infected, you should see your healthcare provider. If not, you can soak your feet in warm (not hot) water with 2 tablespoons of Epson salts to help the nail grow out naturally and treat the toe with an OTC antibacterial cream.
Generally, if you are kind to your feet, you are much less likely to experience foot pain. That means you should:
- Wear shoes that fit well (not too tight nor too loose) and that have a low or no heel, adequate arch support, good heel support, enough room in the toe box (front of the shoe), and that are appropriate for your activity. For example, wear sturdy footwear with ankle support for hiking and shoes with a low heel and all-around support for dancing.
- Check your feet often (even daily, especially if you have diabetes) for any abrasions, redness, cuts or bruises, blisters, and other abnormalities and take care of them before they get worse.
- Treat your feet to a foot massage. You can do it yourself or have a partner or spouse do it for you. A foot massage can relieve tension in your feet, improve circulation, and just feel great.
Foot pain can be more than uncomfortable; it can be serious if ignored. Be sure to take the time to identify the cause of any foot pain and then take the appropriate action before it gets worse.
Dizon JN et al. Effectiveness of extracorporeal shock wave therapy in chronic plantar fasciitis: a meta-analysis. American Journal of Physical Medicine & Rehabilitation 2013 Apr 2