Generality
Pain in the sole of the foot is a symptom that may depend on numerous pathological and non-pathological conditions.
In some cases, the disorder results from a simple fatigue ; other times, this manifestation is the consequence of articular, vascular or nervous pathologies . Plantar fasciitis, Morton's neuroma and hallux valgus are among the causes of foot pain. This disorder can be caused by severe mechanical stress and overloading (for example, in people who spend many hours standing).
The pain in the soles of the feet can be particularly annoying and can cause a significant deterioration in the quality of life, in terms of alteration in the ambulatory process and impairment in the performance of normal daily activities.
In addition to the painful sensation under the feet, tingling, burning, itching, stinging, swelling and a sense of numbness may also occur depending on the triggering cause.
The pain in the soles of the feet can have a transient duration and resolve spontaneously. However, if this symptom is persistent and particularly serious, it is always better to consult a doctor, in order to obtain a precise diagnosis.
Depending on the type of cause that triggers the pain on the sole of the foot, the doctor will indicate a specific and targeted treatment to solve the problem.
What's this
Pain in the sole of the foot: what is it?
More than other parts of the body, the foot performs the function of support and regulates the balance during walking, allowing the maintenance of the standing position and the adaptability to the various surfaces, despite the presence in nature of numerous forces (such as gravity) which affect our daily life. In addition, all the loads generated by the movement act on this structure.
The pain on the sole of the foot may be transient, but if it is persistent or frequent, it is advisable to undergo a careful medical evaluation to establish the cause of the disorder with certainty and suggest the correct strategies with which to intervene.
Foot sole: brief introduction
To understand the causes that can cause pain to the sole of the foot, we need to remember some notions related to his anatomy.
- The foot is an extremely complex structure formed by:
- Ankle, which connects him to the leg;
- Heel, ie the back;
- Metatarsus, the central part;
- Fingers .
- In the foot, there are about 28 bones, numerous muscles, joints, nerves and blood vessels. As for the bone component, it is possible to distinguish, by convention, three groups:
- Tarsus, comprising the short bones of the ankle and heel;
- Metatarsus, intermediate part of the foot, formed by five metatarsal bones;
- Phalanges of the fingers.
Plant pain can involve both feet ; in this case, the etiology is probably an inflammatory, traumatic or systemic pathology. Sometimes, however, the disturbance can occur at the expense of a single foot .
Pain can be concentrated at the level of the heel ( hindfoot ), of the toes ( forefoot ), of the midfoot (central part) or extends to the entire sole of the foot .
Causes and Risk Factors
The causes that can lead to pain in the soles of the feet are various. The search for the etiology of this event must be contextualized according to the conformation of the subject (for example, the overweight or a posture that requires a long standing clearly results in fatigue).
The pain in the sole of the foot is a symptom that recognizes:
- Musculoskeletal causes ;
- Vascular causes ;
- Neurological causes ;
- Dermatological causes .
Foot plant pain: Musculoskeletal causes
A problem of the plant of the foot of muscular and / or skeletal origin typically manifests itself with pain (and tenderness evoked by palpation), in correspondence of particular joints or tendons .
The lateral compression at the base of the fingers, for example, represents a good test to highlight the involvement of the metatarsophalangeal joint .
Plant pain caused by lateral compression of the foot, at the highest point of the arch, indicates a tarsal joint involvement.
The pain in the sole of the foot can be a consequence of:
- Arthritis ;
- Ankle malalignment ;
- Support defects;
- Hallux valgus (bursitis);
- Hammer finger .
The pain in the sole of the foot, especially at the heel insertion, suggests plantar fasciitis (inflammation of the plantar fascia). Morton's neuroma and synovial cysts are benign conditions that present themselves as painful nodules.
If the pain in the sole of the foot is of traumatic origin, it can be the consequence of an injury to the soft tissues - such as a sprained ankle - or a possible fracture . In the latter case, the symptom persists even after several days of trauma and is associated with a point of tenderness on the bony prominences.
Tendinitis is characterized by amplifying the pain in the sole of the foot during the contraction against resistance of the relevant muscle group and, often, in passive stretching.
Foot Plant Pain: Vascular Causes
The vascular causes of pain on the soles of the feet include:
- Arterial insufficiency;
- Atherosclerosis;
- Embolic disease;
- Vasculitis.
The pain in the sole of the foot can be determined by a concomitant disease affecting the small vessels in patients with diabetes. Venous insufficiency can be associated instead with edema and stasis dermatitis.
Foot Plant Pain: Neurological Causes
The neurological causes to consider in case of pain in the soles of the feet are neuropathies and tarsal tunnel syndrome .
- Neuropathies can present with paresthesia, hyperalgesia (hypersensitivity to painful stimuli) or allodynia (perception of non-painful stimuli such as pain).
- Tarsal tunnel syndrome is characterized by pain and numbness in the fingers, the sole of the foot and the mid foot.
Foot Plant Pain: Dermatological Causes
A focal tenderness far from the underlying joints is a useful sign to distinguish dermatological causes. The pain in the soles of the feet can be associated with a cutaneous infection of a bacterial nature ( cellulite ) or the appearance of epithelial hardening, such as calluses and calluses .
Other Causes of Pain Under the Foot
- Other causes of pain in the soles of the feet include the widespread inflammation of the soft tissues of the ankle and foot ( periartitis ), conditions that can hardly be distinguished from acute arthritis.
- The frequent presence of static and dynamic alterations (as in the case of the hollow foot or flat foot ) and the use of inadequate footwear, with a narrow tip and / or a high heel, are responsible for painful manifestations localized not only to the sole of the foot, but also upstream joints.
Many conditions of pain referred to the knees or lumbar spine and painful cramps in the calves are the consequence of a dysmetry of the lower limbs or of various alterations of the foot.
Symptoms and Complications
The pain in the soles of the feet can be more or less acute; this symptom gets worse in some hours of the day or when you spend many hours in an upright position. Other times, the disorder tends to occur when wearing shoes that are too tight and excessively high heels.
The pain in the sole of the foot can manifest itself in combination with generic symptoms, which then go on to become more specific based on the cause.
Symptoms associated with foot pain include:
- Difficulty in movement or walking;
- Muscle weakness;
- Numbness;
- Reduced skin sensitivity;
- Burning sensation;
- pricking;
- Itch;
- Swelling (edema).
Pain in the sole of the foot: when does it occur?
Depending on the cause, the pain in the sole of the foot may present itself as a manifestation.
- Sporadica (associated with a single episode, perhaps following a long training session at the end of the day);
- Recurrent (necessary until the underlying pathology is resolved).
On the other hand, some patients experience this sensation throughout the day. In the latter case, pain under the foot can make normal daily activities difficult.
Diagnosis
The diagnosis of the causes responsible for the pain on the sole of the foot is performed by the general practitioner, the orthopedist and / or the podiatrist . An analysis of its characteristics and any associated symptoms is necessary to interpret this manifestation, to understand its origin and its seriousness.
To investigate the causes of this symptom, first of all, the doctor asks a series of questions related to the symptomatology and personal medical history, then asks the patient to clearly describe the disorder and the correlation with other concomitant manifestations. Once the collection of anamnestic data has been completed, a careful objective examination is performed.
The doctor observes the feet to verify the possible presence of alterations or signs indicative of a certain disease.
The physical examination can further guide the diagnosis by focusing on:
- Time of debut;
- Type of pain on the sole of the foot (continuous, intermittent, acute, etc.);
- Location.
The results of medical history and physical examination help to decide if further tests are needed to establish the origins of pain on the sole of the foot.
Other surveys
If the diagnosis is unclear or the doctor cannot establish with certainty the triggers of pain on the sole of the foot, more in-depth investigations may be indicated to rule out important diseases, such as diabetes.
For example, the doctor could indicate an ultrasound to assess the status of the soft tissues, possible hematomas, edemas, lesions and thickening at the level of the plantar fascia. A baropodometric test is recommended, instead, if an overload disease is suspected.
Other useful exams to better frame the cause of pain on the sole of the foot may include:
- Blood analysis;
- Urinalysis;
- Microbiological cultures;
- Allergic tests;
- Magnetic resonance to the spine;
- X-ray of the legs;
- Angiogram.
Treatment
Treatment varies according to the aetiology of pain on the sole of the foot.
The strategies to alleviate this symptom, in fact, are many and it is necessary to intervene in a targeted way on the factors that triggered it.
In the event that the triggering cause may be of pathological origin, the pain on the soles of the feet can be relieved by topical drugs (cream, ointment, lotion or ointment to be applied directly on the area) or systemic (in the case of severe symptoms; these medicines are to be taken orally or another route of administration).
The treatment can include the intake of NSAIDs or corticosteroids, medicines useful especially in cases where the pain on the soles of the feet is related to diseases that cause severe inflammation. In the latter case, then, a functional rest of at least 15 days is required.
Other approaches may include physical therapy aimed at stretching the soft parts of the foot, ultrasounds and tecar therapy, possibly associated with local infiltration. In severe cases, even surgery may be necessary.
Symptomatic remedies
In addition to any necessary pharmacological treatment, there are several symptomatic remedies that can relieve the pain on the sole of the foot.
First of all, the choice of shoes can help to prevent the problem. In detail, the shoes should be comfortable and wide at the base and, at least in the symptomatic phase, high heels should be avoided (over 4-5 cm in height). Furthermore, the shoes must allow the weight of the body to be distributed evenly.
The pain on the soles of the feet can be relieved by massages or simple exercises to reactivate the circulation (such as, for example, stretching the tips of the feet repeatedly). In this regard, it is also necessary to remember to sit correctly, avoiding sitting with crossed legs or crossed for long periods of time.
To limit the duration and the frequency of the episodes of pain in the sole of the foot it is possible, for example, to resort to some small tricks, such as:
- Avoid potential irritants (eg narrow shoes) and overloads (note: on the advice of your doctor, to limit mechanical stress on the foot, you can use insoles, orthoses or orthopedic insoles);
- Make footbaths with warm water and mild detergents (alternatively, for an antibacterial and soothing function, add essential oils of lavender, tea tree or rosemary);
- Use emollients / moisturizers to restore the skin's barrier function.
Lifestyle is just as important for foot pain management.
Doing sport (avoiding running) or moving any day can help to avoid the onset of the disorder, as well as following a diet that is well balanced and without excess, especially with regard to salt and fatty foods.
Other useful tips to prevent pain on the soles of the feet are to limit as much as possible alcohol and smoking, which can greatly affect blood circulation.
