Foot Pain? Foot Problem? Or, Something Else

You’ve probably heard this expression before: “If it looks like a duck, swims like a duck, and quacks like a duck, then it probably is a duck.”

When it comes to foot troubles, though, this expression doesn’t always ring true. Pain in your foot doesn’t necessarily mean that you have a problem with your foot - it could be a sign of something else.

The reality is that many diseases can cause foot pain, some being mild and others being more serious. It almost always requires medical intervention to reach a diagnosis.

This post will look at many causes of foot pain, diagnose the cause and what conditions orthotics can treat.

The Many Causes of Foot Pain

There are hundreds of reasons why you may have foot pain and discomfort.

For the sake of this article, we’ll focus on two main types: primary and secondary causes.

Primary causes of chronic foot pain stem from illnesses and injuries that affect the foot itself, whether joint, ligament, tendon or muscle problems. Secondary causes of foot pain, on the other hand, include ailments that don’t necessarily start in the foot but affect the nerves and bones indirectly.

Primary Causes of Foot Pain

  • Poor arch development (Flat feet/high arches)
  • Ingrown toenails
  • Plantar fasciitis
  • Metatarsalgia (stone bruise)
  • Morton’s neuroma
  • Haglund’s deformity
  • Heel spur
  • Injury (i.e. sprain, fracture, tendinitis)
  • Warts
  • Hammer toes
  • Claw toes
  • Athlete’s foot
  • Corns
  • Calluses
  • Bunions

Secondary Causes of Foot Pain

  • Gout
  • Diabetic neuropathy
  • Rheumatoid arthritis
  • Peripheral arterial disease (PAD)
  • Obesity
  • Pregnancy
  • Fibromyalgia
  • Pinched nerves
  • Systemic lupus erythematosus
  • Medication-induced swelling of the feet

The list can and does go on, but these are the most commonly observed causes of foot pain diagnosed and treated by medical professionals. With that said, foot pain comes in a wide assortment of flavours so-to-speak and can strike different foot locations.

It can sometimes get tricky when doctors need to diagnose because some conditions produce similar if no, identical types of pain.

Types of Foot Pain

  • Stabbing
  • Stinging
  • Burning
  • Shooting
  • Dull
  • Throbbing

Generally, burning and shooting pains that feel sharp or fiery are indicative of nerve injury or damage. Dull and throbbing pains often involve the bones and muscles of the foot itself.

Of course, this isn’t a hard and fast rule since some conditions have overlapping symptoms.

Locations of Foot Pain

  • Dorsal - Top of the foot
  • Plantar - Bottom of the foot
  • Lateral - Side of the foot
  • Medial - Middle of the foot

Although some foot ailments can produce pain in the same region, foot pain is important because certain illnesses and injuries are location-specific.

For example, plantar fasciitis, which involves stretching the plantar fascia, causes pain at the bottom of your foot that extends to the heel.

On the other hand, chronic lateral foot pain is pain on the foot’s outer side, which may stem from a pinched nerve or arthritis.

Diagnosing Foot Pain and Problems

Diagnosing foot pain can be astonishingly simple or surprisingly tricky, depending on the type of pain, location, and overall health.

First and foremost, foot pain can be acute or chronic. For example, after strenuous activity or sport, sudden foot pain is indicative of an injury, and your doctor will likely assess you for a strain, sprain or fracture. However, sudden foot pain without any change in routine or lifestyle may warrant further investigation and testing.

Foot pain that has lingered for some time will likely require thorough testing to determine the cause, especially if you’ve had no accidents or injuries.

Of course, if you have a pre-existing condition that may cause foot pain, then your doctor may simply treat the discomfort with medications, therapy and orthotic solutions.

General Medical Testing

  • Medical History Evaluation - Your family doctor will likely ask if you’ve had any past injuries, accidents or illnesses. If foot pain seems to come out of nowhere and you can’t identify it, your doctor will order additional testing.
    • If your foot pain is accompanied by other pain or symptoms such as fatigue or weight changes, they will likely have you undergo a complete physical checkup.
  • Physical Examination - Blood work, urine samples, weight and blood pressure measurements should take precedence in cases of acute and chronic foot pain of unknown origin.
    • For example, blood work may be conducted to detect high levels of inflammatory blood proteins, which may indicate rheumatoid arthritis or lupus (both of which may cause foot pain).

Foot-Specific Testing

  • Visual Observation - An unusual lump or misshapen foot joint will be pretty apparent to you and your doctor. If you report it to them, they will inspect it and determine the next course of action, which may be a referral to a podiatrist/chiropodist or a physical examination. If the cause is an injury or accident, you will likely be referred for diagnostic imaging.
  • Gait & Posture Analysis - If the doctor has no reason to believe that a secondary ailment is the cause of your discomfort, they may refer you to a podiatrist. These specialists may perform a gait and posture analysis if there are no obvious visual defects to uncover more subtle biomechanical issues.

Diagnostic Imaging and Testing

  • X-rays - Abnormal bone shape, joint dislocations and suspected fractures will warrant X-ray imaging, especially after an injury or accident. Of course, your doctor may order X-rays for less obvious problems that appear to involve bones and joints.
  • MRIs - If your doctor suspects a soft tissue injury (i.e. muscle, ligament, tendons), they may order an MRI to identify damaged tissues that an X-ray can’t see. This applies whether you’ve had an injury or a chronic ailment.
  • CT Scan - Your physician probably won’t order a CT scan right away, but they will recommend it if they suspect you have a bone abnormality or a foreign object in your foot.
  • Ultrasound - If your doctor believes you have sustained a soft tissue injury or acquired a mass, they might recommend an ultrasound as a cheaper diagnostic alternative to MRIs and CT Scans.
  • Nerve Conduction Test - Depending on your medical history, your doctor may have reason to suspect that another condition is causing pain in your foot. Some of these conditions, such as diabetic neuropathy, may prompt your physician to recommend a nerve conduction test to assess nerve function.
    • Ultimately, this test aims to help determine whether the underlying condition needs more aggressive treatment.

Keep in mind that if the cause of your foot pain is less obvious, you may need a combination of tests and evaluations to determine the cause.

Orthotic Support and Lateral Foot Pain Treatments

Orthotic support for acute and chronic foot pain may or may not be a cure. If the cause of your foot pain is a foot problem, then orthotic support may reverse the problem. This is more likely to be the cause if you’ve adopted poor motion habits that can be retrained. In effect, your pain may virtually disappear.

However, structural and anatomical defects of the bone can’t be cured with orthotics - they can only help you manage the pain. If an underlying condition causes your pain, then orthotics will help manage the pain.

With that said, you may find a gradual or rapid improvement in foot pain if you’re able to keep the underlying condition under control.

Orthotic support is still a helpful treatment for many foot-related troubles. Custom orthotics, in particular, work by redistributing pressure on your foot, supporting your aches and controlling the alignment and movement of your feet. They are moulded to fit your foot shape and anatomy to correct imbalances that are unique to you.

Orthotics can also serve as a protective cushion to reduce the pressure on already painful joints (i.e. arthritis). They can also act as a shield against slow-healing, injury-prone and easily irritated skin (i.e. diabetes and diabetic neuropathy).

Injuries and Conditions Orthotics Can Treat

  • Arthritis
  • Back pain
  • Bunions
  • Bursitis
  • Diabetes
  • Flat feet
  • Hammer toes
  • Heel spurs
  • High arches
  • Injuries
  • Plantar fasciitis

Orthotics may treat other conditions and injuries that produce acute and chronic foot pain as well. However, it’s essential to avoid store-bought inserts and to rely on a podiatrist or chiropodist to help you determine if and what orthotics are right for you.

Know Your Pain, Make a Change

The source of foot pain can be evident in the case of injuries or an accident.

However, it often arises unexpectedly and identifying the cause can become an ordeal. But the proper diagnostic testing and imaging will help you find the reason.

If the problem is in the foot itself, orthotics will do wonders for your foot function and comfort. Orthotic support can still bring some much-needed relief even if you have an underlying condition.

The key, of course, with these underlying disorders is that you have to manage them according to your doctor’s treatment plan.

Foot pain isn’t something you have to live with; if you’re proactive, you can find relief both in the short and long term. 

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