Our feet are a robust, complex and critical structure of our bodies. They bear our weight when we are moving and help ensure we can continue to move effectively and without pain. The foot contains 28 bones, 30 joints and more than a hundred ligaments, tendons and muscles that allow for a wide range of movement. Three of these bones – the tibia, fibula and talus – make up the ankle joint, and enable the up and down motion of the foot.
Foot pain is defined as discomfort felt in the toes, heels, arches, soles or other parts of the foot. It is an issue experienced by most people at some stage of their life, yet should not be considered normal. Although sometimes foot pain is only short lived, on occasion it continues for an extended period and when this occurs you should seek help from a podiatrist.
Foot pain is typically caused by a number of factors – lifestyle issues such as wearing unsuitable shoes, becoming overweight or pounding the feet on hard surfaces, medical conditions like diabetes, or an injury.
The ankle is the joint connecting the foot and leg, and is surrounded by a group of ligaments and tendons. It is a part of the body that absorbs a lot of stress and is prone to injury.
The most common foot and ankle conditions are Arthritis, Diabetic Neuropathy, Bunions, Ingrown Toenails, Metatarsalgia, Morton’s Neuroma, Stress Fractures, Flat Feet, Plantar Plate Injury, Sesamoiditis, Posterior Tibial Tendonitis and Arthritis.
You can find more information about the most common forms of foot and ankle pain below.
Neuropathy is a term used to describe a complication of a number of different medical conditions. It involves damage to one or more of the nerve types responsible for sensation, power, movement and bodily functions performed by the gut, bladder and sweat glands. Most cases of neuropathy are found in people with diabetes.
Diabetic neuropathy is the occurrence of neuropathic symptoms in a person with diabetes. If you suffer from type 1 or type 2 diabetes, this condition is something you should be aware of. Diabetic neuropathy can affect your feet, and without proper care this condition can lead to injuries in the feet that may develop into infected sores and foot ulcers. This can affect a person’s quality of life significantly and in severe cases amputation of an affected limb may be necessary.
The high blood sugar levels common in people with diabetes cause damage to blood vessels that supply oxygen and nutrients to the nerves in our feet. This can cause damage to the skin and the subsequent loss of sensation make the feet more susceptible to damage. The following risk factors have also been shown to contribute to a diabetic person’s likelihood of developing diabetic neuropathy:
Up to 50% of people with diabetic neuropathy have no symptoms at all. Others may experience symptoms that don’t seem serious but develop slowly over months and years. It is very important for people with diabetes to undertake regular medical checks to look for early signs of this condition. Some of the signs of diabetic neuropathy may include one or more of the following:
To establish if diabetic neuropathy may be present, a podiatrist would typically ask questions about your symptoms and health history. A physical examination would be conducted checking the sensation in your feet, the circulation, looking at the skin of the feet thoroughly and checking the tendon reflexes. It may be necessary for you to schedule a doctor’s appointment for more extensive testing based on the results.
There is no cure but controlling your diabetes properly and consistently is the best way to treat diabetic neuropathy. It is important to always keep your blood sugar levels within your target range to reduce symptoms.
It is also important to properly care for your feet. Diabetic neuropathy can cause the loss of feeling and sensation in the feet, increasing your chance of getting an unnoticed cut or scratch on your foot that can develop into a sore or ulcer, leading to the chance of serious infection.
Other treatments that may help to manage symptoms include:
Dan Everson Podiatry would recommend the following steps to help prevent diabetic neuropathy:
Diabetic Angiopathy is a serious disease of the blood vessels and is a common complication of chronic diabetes. It involves the decaying of the blood vessels and capillary tubes. There are two forms of Diabetic Angiopathy – micro-angiopathy which impacts the heart vessels and lower body limbs and macro-angiopathy which affects the eyes and kidneys. The triggers for Diabetic Angiopathy are the hormonal and metabolic disorders which stem from diabetes. Other risk factors include high blood pressure, smoking and regular alcohol consumption.
Symptoms of this condition include fatigue after exercise, and pain in the thighs and hips. This is followed by more acute pain in the feet when a person is lying down, which subsides during standing. At the condition’s most severe stage, the foot can become covered in ulcers and affected by gangrene. Diabetic patients should be checked regularly for Diabetic Angiopathy, and should immediately see their podiatrist if they suspect they have symptoms.
A bunion is a bony lump or deformity at the joint of the base of the big toe. A bunion can occur when the joint at the base of the big toe becomes deformed and develops at a sideways angle, pushing the big toe inwards towards your other toes and sometimes displacing the long bones in the forefoot (the Metatarsals). This condition is one of the most common seen by podiatrists.
Bunion sufferers will find it difficult to walk without pain. Thickening of the skin and tissues also occurs next to the base joint of the big toe and further contributes to the discomfort. A bunion will not go away of its own accord and will get worse over time, in some cases leading to permanent deformation and disability.
Although it can be difficult to determine the exact cause of a bunion, it is thought certain hereditary foot types contribute to a large number of cases. These foot types have a faulty mechanical structure or characteristic making the person more likely to develop a bunion.
Other contributing factors include conditions affecting the joints such as osteoarthritis and rheumatoid arthritis.
A person with a bunion may notice pain around the area and difficulty and increased pain when walking or running. The big toe will start to angle inwards towards your other toes – this can affect the second toe and cause it to become displaced also.
The area may become inflamed, swollen and painful to touch, with a lump of thickened and inflamed skin often appearing around the affected joint. Over time the foot may become too wide to fit into regular footwear. Arthritis of the big toe may also develop as a result.
Dan Everson Podiatry can diagnose a bunion through a physical examination of the foot.
There are several ways Dan Everson Podiatry would typically recommend, alone or in combination, to treat a bunion:
If you think you may be at risk of developing bunions, Dan Everson Podiatry would recommend seeing your podiatrist for advice on what kind of footwear is appropriate for you.
The most common causes of ingrown toenails are:
Ingrown toenails are usually quite painful, with the skin next to the nail becoming tender, swollen or overly firm. A usual sign is when the pain becomes worse when pressure is placed on the toe. If the toe becomes infected, people can experience more severe pain, pus leaking from the area and an overgrowth of skin around the toe.
A podiatrist can easily diagnose a case of ingrown toenails through a simple physical exam of the foot area.
People with diabetes, nerve damage in the leg or foot, poor blood circulation or a nail infection who believe they have an ingrown toenail should consult with their podiatrist immediately. The condition can easily return without responsible foot care.
Below is a selection of the methods Dan Everson Podiatry would typically recommend, alone or in combination, for patients with ingrown toenails:
Dan Everson Podiatry recommends the following activities to help prevent ingrown toenails.
Metatarsalgia is a term used to describe pain and inflammation in and around the long bones at the ball of the foot and can often include swelling around the joints in this part of the foot. These bones and joints absorb our weight when we walk and move. If damaged or weakened they can become painful and dysfunctional, causing discomfort and restricted movement.
Also commonly referred to as a “stone bruise”, it can be debilitating if left untreated. You may notice the pain appears gradually over several weeks.
Some of the more common causes of metatarsalgia include:
An X-ray and bone scan can be used to show any problems with the bones or joints in the foot.
Dan Everson Podiatry can diagnose a case of metatarsalgia through history taking, a physical examination of the foot and a Biomechanical Assessment to study your range of movement. It may also be necessary to undertake a blood test to identify if diabetes, arthritis or gout is present. An X-ray, bone scan or ultrasound may also be advised by your podiatrist.
People with metatarsalgia are likely to experience pain around the area of the forefoot, particularly at the ball of the feet and the toes. This has been described as feeling like you are walking on pebbles. Pain, general aching, burning or tingling sensations in the toes and tenderness of the forefoot area may increase when standing, walking and running. The general area at the ball of the foot will most likely feel tender when pressed.
Below is a selection of the methods Dan Everson Podiatry would typically recommend, alone or in combination, for patients suffering from this condition:
Dan Everson Podiatry recommends the following steps to help prevent metatarsalgia:
Morton’s Neuroma is a painful condition affecting the ball of the foot where the tissue tightens around some of the nerves leading to the toe, resulting in the nerve becoming swollen and irritated. It occurs most often in the area between the third and fourth toe, although it occasionally impacts the area between the second and third toe. Morton’s Neuroma is more common in women.
Approximately 75% of people with Morton’s Neuroma make a full recovery with appropriate care.
Morton’s Neuroma is most often brought about when the toes are squeezed together too often and for too long through activities such as wearing high heels or tight shoes.
Other contributing factors to Morton’s Neuroma are:
The main symptom experienced by people with Morton’s Neuroma is a clicking feeling in the forefoot, followed by a sharp and burning pain or sensation of pins, numbness or needles extending to the end of their toes.
These symptoms typically become worse over time, and can be heightened through wearing narrow fitting shoes or extended periods of standing or walking. People with Morton’s Neuroma can limp from the pain or feel forced to stop walking altogether.
A podiatrist can diagnose a case of Morton’s Neuroma through history taking and an investigation of your symptoms. Your feet will also be examined and a hands on examination will take place where your podiatrist will try to bring about your symptoms. You may also be encouraged to perform certain movements to help your podiatrist assess your foot alignment and function.
A blood test, foot X-ray, bone scan, ultrasound or MRI scans are sometimes required to firmly establish the cause of the pain.
It is imperative to treat this condition immediately as the pain can spread to the rest of the foot and legs, eventually impacting a person’s ability to move freely.
Dan Everson Podiatry will recommend a treatment option based on the nature and severity of your condition. This may include:
Dan Everson Podiatry recommends the following activities to help prevent Morton’s Neuroma.
A Metatarsal Stress Fracture is a common injury impacting athletes and is caused by an incomplete crack in one of the metatarsal bones of the forefoot. The metatarsal bones are the five long bones in the front of the foot that connect to the toes.
Weight bearing activity places a weight through the metatarsal bones. When the pulling forces placed on these bones through the attaching muscles become excessive, damage to the bones can gradually occur or can be caused by a sudden injury that can result in a Metatarsal Stress Fracture. The second metatarsal (closest to the big toe) is most often impacted, as this is the bone that absorbs the most pressure during movement.
Metatarsal Stress Fractures are often caused by contact sports, and can be experienced by athletes, dancers and runners. With appropriate care management, most people recover fully from a fracture of this type within three to nine months.
The most common causes of this condition are:
A person with a Metatarsal Stress Fracture will often experience a progressive pain in the front foot that gets worse when undergoing activities which bear weight on the foot such as walking and running. Swelling and tenderness around the area is often also experienced, with a sharp pain felt when pressure is applied to the metatarsal
.Dan Everson Podiatry can diagnose a Metatarsal Stress Fracture through an examination of the area in conjunction with a bone scan that will provide a precise image of the fracture and can confirm the injury in very early stages. X-rays may be recommended for severe cases or at a later stage of the injury. MRI scanning is occasionally used to diagnose this condition.
First and foremost, people with Metatarsal Stress Fractures must ensure they rest the area as much as possible. Your podiatrist will guide you as to the degree of rest required, depending on the nature and severity of your fracture. Below is a selection of other treatments Dan Everson Podiatry would recommend for this condition:
When the rest period determined by your podiatrist has been completed and you have remained free of pain for a fortnight, you are able to consider a gradual return to a reduced movement exercise program. Keep in mind the foot will be particularly vulnerable for the first four weeks when it is in repair mode.
Dan Everson Podiatry recommends the following activities to help prevent Metatarsal Stress Fractures.
Flat Feet is a condition in which the arch of the foot has not developed normally and is unusually low or flat. Several tendons of the foot and lower leg typically work together to form a foot’s arch. Flat Feet can occur in one or both feet.
It is normal for babies and toddlers to have flat feet as the foot’s arch normally develops between the ages of three and five, yet some people never develop arches and others experience a fallen arch as they get older.
Many people inherit Flat Feet, but occasionally the condition can result from:
Some people with Flat Feet don’t present with any symptoms or require treatment. Yet others may experience the following:
Dan Everson Podiatry will diagnose cases of Flat Feet through checking your health history and performing a Biomechanical Assessment during which your style of movement will be studied. The soles of your shoes may also be studied for insights about your wear patterns.
If a case of Flat Feet is resulting in pain and restricted movement, Dan Everson Podiatry may suggest one or more of the following methods:
Dan Everson Podiatry recommends the following activities to help prevent Flat Feet:
Plantar Plate Injury is one of the most common causes for pain experienced in the ball of the foot. It refers to damage of the strong supporting ligament structure of the toe, located on the ball of the foot. The plantar plate is a thick structure that provides a large amount of stability to the toe, cushions the foot during weight bearing activities and helps bring the toe to the floor when standing. The plantar plate attaches to the base of the toe and the metatarsal, a long bone that connects to the toe.
This condition is most often experienced by mature-aged women whose feet tend to roll in. Most people make a full recovery within a few months.
The most common causes of Plantar Plate Injury are:
Plantar plate injuries often result in ongoing pain and swelling in the ball of the foot that can extend towards the toes. This pain is likely to persist despite changes to footwear and lifestyle adjustments. Other common symptoms of this condition include:
Dan Everson Podiatry will diagnose a Plantar Plate Injury checking your health history and performing a Biomechanical Assessment during which your style of movement will be studied. An X-ray, MRI or ultrasound may be recommended.
If a Plantar Plate Injury is not treated adequately, there is a risk the condition can become chronic with a chance of deformity.
Dan Everson Podiatry would typically suggest one or more of the following treatments methods:
Dan Everson Podiatry recommends the following activities to help prevent a Plantar Plate Injury:
Sesamoiditis is a common condition impacting the forefoot that occurs when the sesamoid bones become irritated or fractured. The sesamoid bones are tiny bones found on the underside of the foot under the big toe joint within the tendons that run to the big toe.
Because of where the sesamoid bones are located, this condition also results in the tendons around the bones becoming irritated. They have a pulley-type function, increasing the leverage of the tendons controlling the toe. The sesamoid bones are often described to function like a kneecap for the big toe joint.
Sesamoiditis is most often experienced by young people, runners and dancers. With an appropriate care plan, most people fully recover from Sesamoiditis within several months.
The major causes of Sesamoiditis are:
People with Sesamoiditis often experience a dull pain in the ball of the foot, right underneath the big toe joint. This pain typically does not improve without treatment and can heighten to a sharp throbbing sensation. The sensations can come and go and usually become worse when wearing certain kinds of shoes or during particular movements.
Other common signs of Sesamoiditis include:
Dan Everson Podiatry is able to diagnose cases of Sesamoiditis through history taking, a physical examination of the area and a Biomechanical Assessment to study your style of movement. An X-ray may also be recommended.
Dan Everson Podiatry would typically suggest one or more of the following treatment methods:
Dan Everson Podiatry recommends the following activities to help prevent Sesamoiditis:
Posterior Tibial Tendonitis is a very common foot and ankle problem, experienced when the posterior tibial tendon becomes irritated or damaged. The posterior tibial tendon is one of the most important tendons of the leg, connecting the calf muscle to the bones on the inside of the foot, and helps to form the inside arch of the foot.
The main function of this tendon is to hold up the arch and support the foot during walking. Once this tendon becomes damaged, the arch will slowly collapse as a result over a period of time.
This condition is more likely to occur in women, people over the age of 40 and those who are obese, and have diabetes or hypertension.
The most common causes of Posterior Tibial Tendonitis are:
The tendon of people with Posterior Tibial Tendonitis typically provides less stability and support for the arch of the foot. This can result in:
More serious cases can result in a flattening of the inside arch of the foot resulting in flatfoot, and toes ‘splaying’ outwards.
A podiatrist can diagnose a case of Posterior Tibial Tendonitis through a physical exam of the foot and ankle area and an investigation of your symptoms. You may be asked to walk to help your podiatrist assess your range of motion and flexibility.
Your podiatrist may also recommend an X-ray, MRI, CT Scan or Ultrasound as part of the diagnosis process.
Dan Everson Podiatry will recommend a treatment option based on the nature and severity of your injury. These may include:
Dan Everson Podiatry recommends the following activities to help prevent Posterior Tibial Tendonitis.
Arthritis is the inflammation of one or more of the joints and can impact the small joints and surrounding tissue of the foot and ankle, making it challenging to move without pain. The joints of the feet help enable a wide range of movement, and are often surrounded by a soft connective tissue called cartilage that helps bones glide smoothly over each other when a person moves.
Arthritis cannot be cured, however there are many care options available to treat the symptoms and slow its progress to help reduce pain.
There are three types of arthritis most likely to impact the foot and ankle – these are osteoarthritis, rheumatoid arthritis and posttraumatic arthritis.
Osteoarthritis is the most common type of arthritis. It is a degenerative condition often experienced by middle-aged people. The cartilage in the joint disintegrates over time, becoming rough and minimising the protective space between the bones. As a result, the bones may rub together which causes the joint to become painful and inflamed.
In the foot, osteoarthritis most frequently impacts the big toe, although it occasionally occurs in the midfoot and ankle.
The below are common causes of osteoarthritis:
The condition develops gradually and results in pain and stiffness to the area that gets worse over time. People with osteoarthritis will usually find it difficult to walk, bear weight or bend the joint without pain. Bone spurs can also develop as a result of osteoarthritis.
Dan Everson Podiatry can diagnose osteoarthritis through history taking, a physical examination of the foot and ankle and a Biomechanical Assessment to study your range of movement, look for swelling in the joint and pain experienced through movement. An X-ray, MRI or CT scan may also be recommended to evaluate the stage of the illness.
Dan Everson Podiatry would typically suggest one or more of the following treatment methods:
Dan Everson Podiatry recommends the following activities to help prevent developing osteoarthritis in the foot and ankle.
Rheumatoid Arthritis is a chronic autoimmune disease that often impacts multiple joints of the foot and ankle. 90 per cent of rheumatoid arthritis patients will eventually experience symptoms in the foot and ankle.
This condition occurs when the immune system attacks its own tissues. The immune cells of people with this condition attack the soft tissue between the joint capsule and joint cavity of the synovial joints, which causes the area to become swollen. Over time, the synovium damages the bone, cartilage, ligaments and tendons and can cause joint deformity and disability. Mainly affects the lesser joints such as the metatarsal phalangeal joints of the feet.
This form of arthritis affects 1% of the population, with women more than twice as likely to develop the condition than men.
Symptoms are most often experienced in the toes and forefeet first, then in the back of the feet, and then the ankles.
The symptoms most often associated with rheumatoid arthritis are:
The causes of rheumatoid arthritis are presently unknown.
Dan Everson Podiatry can diagnose rheumatoid arthritis through history taking, a physical examination of the foot and ankle and a Biomechanical Assessment to study your range of movement, look for swelling in the joint and pain experienced through movement. An X-ray, MRI or CT scan may also be recommended to evaluate the stage of the disease.
Dan Everson Podiatry would typically suggest one or more of the following treatment methods:
There is no known way to prevent rheumatoid arthritis, as the causes are presently unknown. There are several ways to reduce your risk of major joint damage after a diagnosis of this condition:
Posttraumatic Arthritis typically develops after an injury to the foot or ankle – most commonly dislocations and fractures. This form of arthritis also sees the cartilage between joints erode, which can take place many years following an injury.
An injured joint is seven times more likely to develop into arthritis compared with an uninjured joint, even if the injury is professionally treated.
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