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According to the Society of Chiropodists and Podiatrists, painful foot problems may be inherited, develop from illnesses during middle age or result from the pressure of ill-fitting shoes. Foot conditions and symptoms vary in severity, but most can be treated using a conservative approach. Foot and ankle health is important, as foot structure and function affect the other joints of the lower extremity and spine. Common, painful foot conditions include plantar fasciosis, Morton’s neuroma and tarsal tunnel syndrome.
According to the Merck Manual, plantar fasciosis involves pain at the attachment point of the calcaneus bone and the plantar fascia, which is a thick layer of connective tissue that supports the foot’s arch. Those with plantar fasciosis may experience pain on the medial or inside aspect of the arch.
Traditionally, pain syndromes of the plantar fascia have been called plantar fasciitis, however, the Merck Manual states that because inflammation of the tissue is rarely present, and there is often evidence of tissue degeneration, the term plantar fasciosis is more appropriate.
The pain associated with plantar fasciosis may be the result of acute or chronic stretching, tearing or degeneration of the fascia where it attaches to the calcaneus. The conservative treatment of plantar fasciosis, according to Dr. Ray McClanahan, a sports podiatrist based in Portland, Ore., includes appropriate footwear, cryotherapy, taping procedures, foot exercises and physical therapy modalities, among other treatments.
According to the Mayo Clinic, neuromas are benign growths of nerve tissue that may arise in various parts of the body. Morton’s neuroma develops in the foot, usually between the third and fourth metatarsal bones, and causes a thickening of the nerve tissue that innervates the toes.
Those with Morton’s neuroma may experience sharp or burning pain at the ball of the foot, along with stinging, burning or numbness in the toes. Morton’s neuroma occurs when the common intermetatarsal nerve, the nerve traveling to the toes in the forefoot, becomes pinched and stretched.
The Mayo Clinic adds that Morton’s neuroma may be caused by tissue irritation or injury. Dr. McClanahan believes that ill-fitting shoes are the principle cause of Morton’s neuroma, especially shoes possessing toe spring and tapering toe boxes.
The conservative treatment of Morton’s neuroma involves wearing footwear that is flat, wide in the toe box and flexible. Metatarsal pads also are helpful, as they spread the metatarsal bones and reduce pressure on the nerve where it travels under the ball of the foot.
According to the American College of Foot and Ankle Surgeons or ACFAS, tarsal tunnel syndrome occurs when the posterior tibial nerve is compressed or squeezed as it passes through the tarsal tunnel. The tarsal tunnel is a small space on the inside of the ankle through which arteries, veins, tendons and nerves must pass.
When a person’s posterior tibial nerve is pinched, he may experience symptoms that include pain, numbness, tingling or burning anywhere along the nerve’s path from the ankle into the foot. ACFAS notes that tarsal tunnel syndrome is similar to carpal tunnel syndrome, which is a wrist condition involving entrapment or pinching of the median nerve as it travels from the forearm into the hand through the confined space of the carpal tunnel.
According to an article by R. Vincent Davis, D.C., on the Dynamic Chiropractic website, tarsal tunnel syndrome may be treated conservatively with cryotherapy, specially prepared ointments delivered to the tissues by pulsed phonophoresis and interferential current. Davis states that later stage cases of tarsal tunnel syndrome should be referred for neurosurgical consultation.
Some types of foot conditions may be debilitating or excruciatingly painful, including stress fractures, arthritis and gout. According to the American Academy of Orthopaedic Surgeons or AAOS, stress fractures may develop due to overtraining, wearing inappropriate footwear or performing harmful training techniques.
Stress fractures may also result from bone insufficiency. The AAOS states that there are three types of arthritis that can affect the feet and cause significant pain: osteoarthritis, rheumatoid arthritis and post-traumatic arthritis. Gout, which involves the deposition of uric acid crystals in the joints and tendons and their surrounding tissues–and which often affects the big toe–also can be extremely painful.