Foot pain - Causes and Symptoms

Definition

Foot pain is an algic symptom that can recognize musculoskeletal, vascular, neurological or dermatological causes.

A musculoskeletal etiology is signaled by pain and tenderness at 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. The pain caused by lateral compression of the foot at the highest point of the arch, on the other hand, indicates a tarsal joint involvement.

Foot pain can be a consequence of arthritis, malalignment of the ankle, hallux valgus (bursitis) and hammer toe.

Tendinitis is characterized by amplifying pain during the contraction against resistance of the relevant muscle group and, often, during passive stretching.

The pain in the sole of the foot, especially in the heel insertion, suggests plantar fasciitis.

Morton's neuroma and synovial cysts are benign conditions that present themselves as painful nodules.

If the pain is of traumatic origin, it may represent the consequence of a lesion 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.

Vascular causes of foot pain include arterial insufficiency and atherosclerosis. These conditions can be determined by an embolic or vasculitic disease or a concomitant disease affecting the small vessels in patients with diabetes.

Venous insufficiency, on the other hand, can be associated with edema and stasis dermatitis.

Neuropathies and tarsal tunnel syndrome are neurological causes to consider in case of foot pain. Neuropathies can present with paresthesia, hyperalgesia (hypersensitivity to painful stimuli) and allodynia (perception of non-painful stimuli such as pain). Tarsal tunnel syndrome is instead characterized by pain and numbness in the fingers, the sole of the foot and the mid foot.

Other causes of foot pain are bacterial skin infection (cellulitis) and widespread inflammation of the soft tissues of the ankle and foot (periarthritis); such conditions can be difficult to distinguish from acute arthritis. However, focal pain away from the underlying joints is a useful sign to distinguish the dermatological causes of foot pain.