FAQS on Foot Pain
Foot pain can arise from the foot, or it can be the result of a problem with the structures of the lower back. Many patients with serious back disorders have nerve root compression, which usually affects the sciatic nerves that run down the back of each leg into the toes.
This nerve is composed of five nerves that join at the lower spine, and when injured, inflamed, or compressed, symptoms of leg and foot pain occur. This is pain is known as sciatica.
What causes foot pain?
The feet can hurt due to a number of reasons, which include being on the feet for long periods of time, a foot deformity from birth (congenital), a deformity that develops later, or as a result of walking too much or extreme exercise. Aging of the foot bones can cause foot pain, as can being overweight. Any injury to the foot can lead to foot pain, as well, including ankle sprains, hairline fractures, and bruises.
What foot conditions are painful?
Many painful conditions and injuries that affect the feet. These include:
- Gouty arthritis – Common in the big toe, which gets red and swells.
- Bunion – A bump at the base of the big toe, caused from wearing narrow shoes or from improper bone alignment.
- Hammer toe – The toe curls downward into a claw-like position.
- Plantar fascitiitis – A painful condition that occurs from standing on hard surfaces.
- Fallen arches – Often referred to as flat feet.
- Morton’s neuroma – Thickening of nerve tissue between the toes.
- Diabetic neuropathy – Nerve damage associated with long-term diabetes.
- Calluses and corns – Thickened areas of skin, which occur from pressure or rubbing.
What symptoms are associated with foot pain?
Depending on the diagnosis, foot pain can occur in the long bone region (tarsals), the toes, the heel, or the sole. If the patient has a spine condition, certain symptoms could arise, including:
- Foot weakness and/or heaviness – Often referred to as “foot drop,” this occurs due to damaged or disease spinal nerve roots of the lower back (the fifth lumbar vertebra nerve). The foot feels heavy, weak, and flaccid. The patient often has trouble flexing the ankle to bring the foot upward.
- Inability to walk on tiptoes – When the bottom of the foot hurts due to sciatic nerve damage, this contributes to weakness of the gastrocnemius (calf) muscle, making walking on tiptoes difficult.
- Heel walk – This is the restriction of ability to bring the foot upward. Heel walk usually occurs when a spinal nerve root that innervates the sciatic nerve is damaged.
What low back conditions cause foot pain?
Several conditions of the lower back cause leg and foot pain. These include:
- Lumbar spinal stenosis – When degeneration of the discs and vertebrae occur, the spinal nerves become compressed. This leads to referred foot pain, as well as tingling, weakness, and numbness of the foot.
- Herniated lumbar disc – If the outer layer of the intervertebral disc becomes worn and weak, the inner portion (nucleus) can leak out. This material irritates or puts pressure a nerve root, which irritates the sciatic nerve and causes foot pain.
- Spondylolisthesis – This condition occurs when a vertebra slipping over the one below it. When this happens, the spine segment is compromised, which leads to a pinched nerve causing pain down into the foot.
How is foot pain treated?
Treatment options for foot pain depend on the cause of the pain. The goal of therapy is to cure or alleviate the underlying condition. Therapies include:
- Steroid injection – Used as anti-inflammatory agents for painful joints, nerve conditions, bursitis, painful trigger points, and post-operative scars, steroids reduce inflammation and lessen the bulk of soft tissue in the area being treated.
- Silicone injection – When there is loss of fibro fat padding on the foot sole, cores and pain occurs. Called an Innopad, medical grade silicone is used to pad a specific foot area.
- Hyaluronic acid injection – This injection is used to introduce an artificial lubricant into the joint to alleviate stiffness and pain.
- Epidural steroid injection (ESI) – This procedure involves the injection of a long-acting steroid into the epidural space, which is the layer of tissue outside the spinal cord. Based on clinical research studies, the ESI is 80-90% effective.
- Facet joint injection (FJI) – Often done in a series of three injections, this involves injection of an anesthetic, with or without a steroid medication, into the facet joint between the vertebrae. In a recent study, approximately 85% of patients reported functional improvement and relief of pain relief following this injection.