Foot pain is a very common problem in the Indian population. It can broadly be divided into fore foot, mid foot and hind foot, according to the site of pain. The cause of foot pain could be mechanical or pathological, and it can affect the aforementioned sites.
Fore foot pain
Technically termed metatarsalgia, its common causes are:
- Ill-fitting foot wear
- Narrow foot wear
- Previous injury like fractures
- Congenital problems like club foot or flat foot
- Age related
Mid foot pain
Along with the above causes, sometimes there might be an inflammation of the ibialis posterior tendon, which can cause pain in the mid foot region.
Hind foot or heel pain
Technically, planter fasciitis is a disease that is characterised by sharp pain in the heel region after getting up from bed, along with difficulty in walking, which subsides after taking a few steps.
This might be caused due to bony spur or bony overgrowth in the heels. The back of the heel aches at times, and this is due to the inflammation in the bursa at the base of the heel. It is caused by wear and tear or raised uric acid levels in blood. The diagnosis hinges upon X-ray in which bony overgrowth, arthritic changes, & malunited fractures can be observed. Laboratory findings give us information about whether the patient is suffering from raised uric acid (Gout), diabetes, rheumatoid arthritis or ankylosing spondylitis.
The GAITRite system is an added advantage for foot labs where abnormal stress zones in the foot can be mapped out when the patient walks over a foot pressure sensitive mat. A computer linked to the mat maps out the areas that are the worst affected, and helps us in designing footwear.
The management of foot pain rests upon:
Proper footwear: Footwear should be of the proper size, well-padded & not narrow or constricting. That does not mean one cannot wear high heels or pointed shoes. Those designer shoes can be worn but not for a prolonged period of time. In case of mechanical problems, modifications like precisely located pads in the insole and medial arch support may be used. Foot hygiene must be maintained and regular pedicure needs to be done.
Medical management: Diabetes, gout, osteoarthritis, rheumatoid arthritis & obesity have to be treated. The advice of the medical consultant is essential.
Exercise your feet
Various exercises for your ankles, feet and toes will help stretch, strengthen and relax them. Try toe curls by picking up objects with your toes and moving them from one pile to another. Also try standing and then rising up on your toes by lifting your heels off the ground. Do ankle pumps by moving your foot up and down. Making circles with your ankles is also good. Stretch your calf muscle by doing the runner’s stretch or wall stretch. Roll the bottom of your foot on a frozen water bottle, tennis ball or golf ball.
Surgical management: Severe cases of deformity in the foot resulting in foot pain have to be treated by surgery, and correction of the deformities has to be done. For this the patient needs to be seen by an orthopaedic surgeon.