Foot Pain 101 – All Myths Answered (Incl. How to Treat Them)
Do you constantly feel pain on your foot? Sometimes, it comes and goes. Other times, it stays for awhile.
No matter what the cause and how long it may last, foot pain can be debilitating to an active lifestyle. Because no matter how mild, you just can’t ignore it - pain is one sensation that you simply cannot just ‘block out’.
To tackle them, you need to first identify what it is, and what’s causing it. Before anything though, it’s worthwhile to first understand the foot anatomy.
Understanding The Foot Anatomy
Now, we wouldn’t go too technical into the medical details but the foot, as you can see, is one of the most complex parts of the body.
Made up of 26 bones connected by multiple joints, muscles, tendons and ligaments, excess strain on any of these areas will cause pain, inflammation or injury.
In particular, these parts are more susceptible to stresses leading to foot pain:
Such pain can range from mild to severe, and it may last just a short while or be an ongoing issue.
Regardless, once strikes, they can result in limited movement and mobility which to put it simply, is quite the nuisance.
The 4 Common Foot Ailments
Amongst all orthopedic complaints, there are a few very common ones that continue to plague the majority of our community. These include:
A heel spur is a bone growth on the heel bone. Like such:
You see, there is a long band of connective tissue running from the heel to the ball of the foot located on the underside of the heel bone (where it attaches to the plantar fascia). These tissues hold your arch together and act as a shock absorber during any activity.
If the plantar fascia is overstretched for whatever reason, it can cause stress and inflammation on the tissue pulling on the bone.
Over time, the body responds to this stress by building an extra bone extending between your heel bone and arch, resulting in what’s called ‘heel spurs’.
- Feel warm to the touch at the affected area
The above are not conclusive, as some heel spurs may not have any symptoms at all.
Which is why detecting heel spurs can be rather tricky as they do not always cause pain. It’s best to go to an orthopedic surgeon or a podiatrist if you suspect you have it because heel spurs are often only discoverable through X-rays and professional medical assistance.
Symptoms generally start at the front of and underneath your heel before spreading to the arch of your foot.
They can get up to half an inch in length and while they may not be necessarily visible to the eye, you may see a small bony protrusion eventually.
Also, they develop gradually. They do not just suddenly appear one fine morning or after a workout session and they tend to occur when you ignore early symptoms like heel pain.
But then again, keep in mind that not all heel pain is related to spurs.
Some common causes include repetitive stress from walking, running or jumping on hard surfaces.
Apart from that, arthritis, excess body weight or wearing the wrong shoes can also cause heel spurs.
The latter, in particular, is a common cause. Wrong shoes can be those that are worn-out, fit poorly or simply do not provide support for your. Wearing flip-flops too often can also be a factor, too.
Ah, plantar fasciitis, another nemesis of many.
Characterized by severe pain in the heel of the foot, this is a condition of inflammation of the fascia, a tough fibrous tissue running between your heel bone and toes when the sole surface (plantar) is overused.
Many who have heel spurs also have plantar fasciitis, likewise, if you have plantar fasciitis, it increases your risk of developing heel spurs eventually.
Plantar fasciitis pain can feel dull or sharp,although there are some that feel a burning ache. In all situations, pain develops gradually over time and it is usually worse in the morning.
A telling sign will be when you take your first steps out of the bed (or if you’ve been sitting or lying down for awhile) and you feel this sharp jolting pain.
Another will be that after prolonged activity, you feel the pain flaring up.
This is due to increased irritation or inflammation. Climbing stairs can also become very tasking as you feel this stiffness at your heel.
One distinctive nature of plantar fasciitis will be that you won’t feel pain during the activity, but rather just after stopping.
Pain is felt at the bottom of the heel.
Sometimes, it can be at the bottom mid-foot area although some may also feel a burning ache at the bottom of the foot extending outward from the heel.
It usually affects just one foot, but it can also affect both feet.
Plantar fasciitis can be a result of putting too much pressure on the feet causing tearing or damage to the plantar fascia ligaments. When this happens, the plantar fascia becomes inflamed and this in turn, causes heel pain and stiffness.
Women are more susceptible than men, especially those that are pregnant (particularly during late pregnancy).
It is also more commonly diagnosed in active men and women age between 40 to 70 - the avid runners and those that have a very active job involving being on the feet often i.e. working in a factory, restaurant server etc.
You are also at greater risk of developing plantar fasciitis if you’re obese or overweight, especially if the weight gain is sudden. This is because of the increased pressure on the plantar fascia ligaments.
Other than that, people born with structural foot problems such as having very high arches or very flat feet are also in the high risk group. Tight Achilles tendons (those that attach your calf muscles to your heels) may also be one contributing factor.
That being said, plantar fasciitis can simply be caused by wearing shoes that have too soft a sole or poor arch support.
Heel Spur vs Plantar Fasciitis - The Difference
Mid break: we'd like to delve a bit more between these two before continuing on with the rest of foot ailments because when conduct a preliminary self-diagnose, one is often mistaken for the other.
Understandably so, given both are pretty similar in many aspects from symptoms to pain area. But know this - one is not the other.
So while the two are closely related, there’s a distinct difference between a heel spur and plantar fasciitis.
The former is a bony projection that varies in size but is usually no larger than half an inch. Often discoverable only via an X-ray, a heel spur may not even have any symptoms associated with it. As the American Association of Orthopaedic Surgeons (AAOS) found, only 1 in 20 of people with heel spurs experience pain.
On the other hand, plantar fasciitis is a painful condition where there is an inflammatory process occurring.
The pain will not be something you’d miss but as a general rule, plantar fasciitis can subside on its own over a period of time regardless of the treatment. A heel spur though, will not heal without surgery. Fortunately, surgery isn’t usually needed.
That being said, heel spurs and plantar fasciitis do share similar causes. These include:
Likewise, you can treat heel spurs almost the same way as you would treat plantar fasciitis. This includes (but is not limited to) resting, icing, taking pain medications and using shoe inserts to ease the symptoms.
In any case, we recommend having your foot looked by a doctor especially if you’re experiencing severe/chronic pain to get a proper diagnosis so as to be able to get the right and adequate treatment.
Another foot problem is varicose veins. More common than you would have thought, around 25% of adults in our population are actually plagued with varicose veins.
Also known as varicoses or varicosities, this is a condition where your veins become enlarged, dilated and overfilled with blood.
If you don’t already know, our veins have one-way valves that prevent blood from flowing backward. It is when these veins are not functioning properly that people develop varicose veins.
Rather than flowing towards your heart, blood begins to collect in the veins which result to them being enlarged.
And because the veins in your legs are farthest away from your heart, that, plus gravity, makes it even harder for blood to flow upward.
This explains why varicose veins often affect only the legs for most people.
Unlike those above, varicose veins symptoms are highly visible.
Your veins appear swollen and raised, and they have a bluish-purple to red tinge to it. Over or around these enlarged veins, you will feel:
- Misshapen veins
- Swelling and discolouration
- Bleeding and ulcers (in severe cases)
Appear mostly on the lower legs, women are more susceptible to this leg ailment.
Some potential causes include:
- Old age (above 50)
- Standing long periods of time
- Family history
This type of foot problem includes weakness, numbness and pain in the feet (also often in hands and other body parts) as a result of damage to the nerves outside of the brain and spinal cord – peripheral neuropathy.
Symptoms depend on the type of nerves affected but pain is one telling sign.
People with peripheral neuropathy generally describe such pain as stabbing, burning or tingling. Other symptoms include:
- Muscle weakness
- Gradual onset of numbness, prickling or tingling in the feet or hands which can spread upwards into the legs and arms
- Pain during activities that shouldn’t cause pain
- Lack of coordination and falling
- A feeling of wearing gloves or socks when you’re not
As the peripheral nervous system connects the nerves from your brain and spinal cord to the rest of your body, any area is susceptible to neuropathy. This includes the arms, hands, internal organs, mouth and face.
For the feet though, it can be that of the whole foot and leg.
Quite different from all the foot ailments above, peripheral neuropathy is not one single disease.
It can result from traumatic injuries, infections, inherited causes, exposure to toxins or metabolic problems. One most common cause though, is diabetes.
Diabetes affects the nerves as well as blood vessels and blood flow throughout the whole body, including the legs and feet.
People with diabetes would have to have their feet checked regularly to identify any sores or wounds before complications develop.
In addition, a podiatrist will need to be sought to help manage diabetes-related foot problems.
Treatments / Easing the Pain
Although different foot ailment requires different treatments, there are actually a few things you can do to ease the symptoms regardless of what the orthopaedic problem is.
One of it being – the foot massage.
One universal method in easing foot pain, foot massage dates back as far as 5000 years ago having been found evident in Asian, African, European and North American cultures.
Specifically, reflexology, where pressure is applied to specific reflex points on the foot, is found to induce a healing response and alleviating ailments not just limited to the foot but other organs and areas of the body as well.
You see, the bottom of the foot holds numerous acupuncture points that are connected to the whole of our body. By applying pressure at these points, you get to alleviate symptoms and pains in other body areas that you want to target as well.
Anyway, back to our point.
Daily foot massage has long been the holistic approach to long-term pain management caused by the aforementioned orthopaedic problems.
Broadly speaking, there are two massage techniques that are commonly used – compression and kneading.
The former is mostly used on the calf muscles to stretch and loosen them for immediate muscle pain relief while the latter targets at trigger points at the bottom of the foot to soothe and relieve pressure.
Perhaps the following table will paint a clearer picture for you in terms of how massage helps alleviate different foot pain:
Compression applied to the calf muscles
- ease stiffness
- stimulate blood circulation
- relax calf muscles
- lessen stress on the fascia to relieve the heel spur
Reflexology roller massage at the bottom of the foot
- stretch and loosen tight muscles and tendons
- reduce pain in nerve endings
- improve circulation and blood flow simultaneously
Varicose Veins / Circulatory Issues
A combination of compression and kneading massage
- double the circulation
- reduce inflammation and soreness
- provide effective pain relief to keep veins under control
Air compression massage
- stimulate circulation to provide relief of numbness, tingling pain and burning sensations
Leg & Foot Fibromyalgia
Powerful kneading massage specifically targets trigger points and tender points associated with fibromyalgia leg pain
- release pressure through soothing and gentle rubbing motion
Now, you can get regular foot spa sessions at your local massage parlour, or you can invest in an at-home foot massager.
The latter will save you much time and money, and you can enjoy a foot massage anywhere, any time of the day.
There are different types of foot massagers available i.e. foot bath massager, foot and calf massager, air compression leg massager or your simple foot-only massager – the choices are aplenty and they come in different price points to suit everyone’s budget.
If you choose to go down this path, we have a few pointers that may help you in choosing the best foot massager that suits your specific ailment:
Heel Spur / Plantar Fasciitis
It's best to go for a plain foot massager for plantar fasciitis, you know, the open-toe ones.
A foot spa massager will do too if you’d like the soothing water effect but a foot calf massager may not be necessary. This is because you’d want to focus on just the foot unless of course, if you’d prefer to get the full leg massage package then by all means, go for it.
We have a foot massager review here that look at some of the best foot massager for plantar fasciitis currently in the market which you may be of interest.
Varicose Veins / Circulatory Issues
On the other hand, if your primary problem is varicose veins or generally, just poor circulatory issues i.e. cold hands and feet, then getting a foot and calf massager will be more all-rounded.
In any case, a foot and calf massager will be the answer to it all.
However, because it is also one of the priciest amongst all foot massagers that’s available, there may be some who cannot afford one. Hence the above tip to help those with a budget choose the best foot and leg massager that suits their needs.
Of course, different ailment would still require its own specific treatment plans but generally, foot massage is one great method to ease the pain.
Wear The Right Footwear
Mentioned repeatedly above, wearing the wrong footwear is one of the most common cause for foot conditions like heel spur and plantar fasciitis.
Indeed, how can pain or problems not develop if the shoes you’re wearing do not fit properly? Or they are so worn out, there is basically no more foot support? Not to mention the high heels.
Naturally then, wearing the right footwear becomes one key solution to it all.
Find supportive shoes that have a good arch support and avoid shoes that are so flat, there’s basically no consideration to the foot shape. Replace your athletic footwear regularly (around 400-500 miles is the limit).
Make sure your shoes fit and by that, we mean they cannot be too tight, nor should they be too loose.
In particular, shoes with the following characteristics make for the best footwear for plantar fasciitis:
- Ample arch support
- A firm but flexible midsole
- Cushioning in the forefoot
- A removable insole (if you're using plantar fasciitis insoles)
These make for the best shoes for walking with plantar fasciitis.
So yes, wearing the right footwear is one of the very first steps you should take to ease any foot pain.
For certain conditions like heel spurs and plantar fasciitis, there are foot supports that you can buy to ease the pain and discomfort.
Used in conjunction with appropriate footwear, they can provide an all-around foot protection.
Not just any kind of foot supports though, but orthotic shoe inserts/heel pads/ arch supports that can give your arch and heel the support they need to reduce pain.
In any case, they prevent further wear and tear to the plantar fascia / worsening the existing condition.
Night splints are another treatment that can help stretch your calf and the arch of your foot. This, especially, works as an effective foot support for plantar fasciitis.
As pictured left, night splints are a type of brace.
It holds your foot in a flexed position to help lengthen the plantar fascia and Achilles tendon.
Wear overnight and it helps prevent morning pain and stiffness to a great extent.
Here are two great choices to consider – they continue to be bestsellers in their own regard despite the many competition in the industry.
For the more severe cases, you may want to get a boot cast. This will immobilize your foot and reduce strain while your plantar fascia heals. It may not be the most convenient, but it does help accelerate the healing process.
Then there are the compression socks or stockings for varicose veins and diabetic neuropathy sufferers. These work by placing enough pressure on the legs so that blood can flow more easily to the heart, and they also help decrease swelling.
While we’re on the topic, another common way of treating plantar fasciitis is via incorporating specific foot exercises in your daily life.
Foot exercises for plantar fasciitis
Stretching is the key.
Gentle stretches can help relieve and even prevent plantar fasciitis. By stretching your calves and the plantar fascia itself, muscles are loosen and heel pain is reduced.
It is fairly easy to stretch, all you need is just a few common props.
Cross one leg over the other and grab your big toe.
Pull it gently towards yourself and hold for 15-30 seconds. Repeat three times.
Then do the same with the other foot.
Place a stretch strap under the arches of both feet. Grab the ends of the strap and gently pull the tops of your feet towards you. Hold for 15-30 seconds and repeat this three times.
If you don’t have a stretch strap, you can fold a towel lengthwise to replicate it.
Very simple, but oh so effective. Not only do they help reduce heel pain, if you do this regularly before each workout, it will certainly prevent you from developing plantar fasciitis.
Keep in mind that not all exercises are suitable. For example, it is important that you take time off from running to give the plantar fascia time to heal.
Choose low-impact exercises such as swimming as they won’t worsen the heel pain. Remember to stop and stretch while exercising to keep the pain from returning.
Foot exercise for heel spurs
Likewise, heel spur exercises consist of stretching the heel and plantar fascia muscles.
You can do this any time of the day, though it can be especially helpful at night before bedtime.
Last but not least, depending on the foot ailment you have (and its severity), you may need to make some changes in your daily lifestyle.
For example, if you have varicose veins, you should avoid standing for extended periods of time.
Just by elevating your legs when you rest or sleep may help so much in preventing them from forming or becoming worse.
Do your best to stay at a healthy weight. If you’re overweight, try to lose some weight. This will reduce pressure on your plantar fascia which in turn, help you avoid quite the few orthopaedic problems.
And yes, exercise. Incorporate low-impact exercises into your routine such as swimming or bicycling to improve your circulation. Avoid frequent running that will overwork your plantar fascia. Before exercising, be sure to stretch your calves, Achilles tendon and plantar fascia.
Amongst all body parts, the feet is probably one of the hardest working component. How can they not, when they bear the whole of your body weight be it standing or walking and they bring you anywhere you need to go.
So take care of them and give them the pamper they deserve once in a while. Do not overstrain them and look for soothing remedies once you feel any discomfort or pain.
You certainly do not want to wait and let it deteriorate until surgery is the only solution.