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Foot Pain


What is foot pain?

A bunion is a common deformity affecting the big toe joint. Medically it is known as ‘Hallux Valgus’. It is effectively osteoarthritis of the joint.

The main symptom is a change in the shape of the big toe joint. Not everyone will get pain, but the bunion may cause problems with footwear which in turn, causes rubbing on the skin.

Bunions can be divided into two types: 

Type one: Footwear related bunions - usually there is a bony prominence which rubs on the shoe, causing it to become red and painful.

Type two: May have the same feature as type one, but a deep joint pain will also be experienced. 

Most people’s feet have a gap where the inner part of the foot (the arch) is raised off the ground when they stand. The height of this arch varies. 

Some people’s feet, however, have a low arch or no arch at all, which is referred to as flat feet or fallen arches.

When someone with flat feet stands, their inner foot or arch flattens, and the foot may roll over to the inner side (known as over-pronation). This is often apparent if the heels of shoes wear out quickly and unevenly. Over-pronation can damage your ankle joint and Achilles tendon (tendon at the back of your ankle).

The symptoms of flat feet vary depending on how severe the condition is but the following are common:. 

  • Pain /swelling behind medial malleolus (the ankle bone above the arch of your foot) and along the arch/instep of your foot 
  • Change in foot shape
  • Decrease in walking and balance
  • Ache on walking long distances
  • Are you able to perform a one legged heel lift? 

Plantar fasciitis is a common foot condition that causes pain in the heel, across the sole of the foot and sometimes into the arch area of the foot too.

It is caused by swelling of the ‘plantar fascia’ ligament. This is a very important ligament, connecting the heel to the ball of the foot and playing a vital role in supporting the arch of your foot - taking the strain when you stand, walk or run.

The condition can affect anybody, but it is most common amongst people over the age of 40. Overusing this ligament is thought to be the most common cause of plantar fasciitis, along with being excessively overweight or having altered biomechanics e.g. people with flat feet or high arched feet or those with tight calves.

If you have a lump or bump on your foot that has recently developed, which is painful, getting bigger or just concerning you, please consult your GP. In 99.9% of cases the problem is benign, but reassurance is important and if it’s causing pain we can help.

Dealing with Foot Pain

Firstly, just because you have a bunion does not mean you have to do anything. If it’s not bothering you, leave it alone.

However, bunions can be painful and can have a big impact on your mobility. They can also cause people to become self-conscious of their feet.

The best thing to do is to ask an older family member who also has bunions what theirs did.

There only a few treatments and a number of these can be self administered, so your symptoms may be resolved without even seeing a health professional.

Getting the right footwear is extremely important for dealing with acquired flat foot. Key things you can do are:

Supportive shoes

Wearing supportive well-fitted shoes can relieve any aching caused by flat feet.

Insoles and orthotics

If you can do one or two heel lifts before it’s painful, then in the first instance an over-the-counter,  insole or orthotic (supportive device) can take pressure and pain away from the arch.

There are a vast range on the market, so to help select the right type for you we have identified a list of ones that might be suitable:

Simplyfeet: They supply a number of orthoses that maybe suitable which include: AirPlus Gel arch support, Orthoheel (regular and sports)

Heel Fix Kit (http://www.heelfixkit.com/eCommerce/product.aspx?loc=3&prod=10) They supply pressure perfect insoles.

However, an orthotic only helps when it is worn in the shoe, and the benefits only last while you are actually wearing the device.

A flat foot caused by a ruptured tendon or arthritis can often be treated with painkillers and an insole.

Management Continued

If the condition does not respond or you can only do one heel lift, but its painful, or none at all because of the pain, then please consult your GP immediately as further specialist assessment and treatment may be required.

As with many other foot and ankle conditions, plantar fasciitis can be easily treated by you, at home.

Plantar fasciitis is an injury caused by overusing the ligament that attaches your heel to the ball of your foot, so the best way to deal with the condition is to rest, or at least make changes to the amount of activity you do. 

However, completely avoiding putting weight on your foot is difficult. Day-to-day routines such as going to work and doing the daily chores means you need to use your feet. For this reason, the pain may take a while to fully resolve, but by initially reducing your activity levels and gradually increasing them as the condition improves, you can make a full recovery.

Low-dye taping is designed to offload the plantar fascia ligament. It is a short term treatment and the effects vary from patient to patient. However, as a general rule, you should leave the tape on for a maximum of three days, but some might find it needs to be replaced more frequently in order remain effective.

Insoles, or 'foot orthotic devices' are designed to help with your foot, leg or postural problems. They are custom made devices that should not be worn by anyone else.

It's important to remember that when you stand on your devices for the first time, you may not feel fully comfortable. Slight discomfort is normal and shoulde ease within a short period of time.

For this reason, you must wear your devices in gradually, to let your feet and legs gently adjust to the new mechanical positions. If you see any signs of rubbing, redness, swelling or breaks in the skin you must stop wearing your orthotics immediatley and contact your clinician.

Choosing the right footwear

Ninety per cent of the population wears shoes that are one size too small. For the majority of people this is not a problem.

However, there are a number of foot and ankle conditions in which poorly fitting shoes can be an aggravating factor. Therefore, it's important to check your shoes regularly and, if necessary, replace any footwear that is not up to scratch with more suitable shoes. 

WHAT NOT TO WEAR
A shoe that compresses the foot, or collapses under the weight applied to it. Shoes like this offer minimal support and result in extra pressure being placed on the plantar fascia ligament which can lead to plantar fasciitis.

Shoes with an unstable, non-supportive and flimsy heel. Wearing shoes with a slight heel (up to one and a half inches) can actually be helpful, especially if you have tight calves and have always worn shoes with a heel.

Thin soled shoes. Try and find shoes that have cushioned soles, particularly in the heel area.

Badly worn, ill-fitting and distorted shoes. Avoid shoes that do not fit correctly. Stop wearing shoes that have become badly worn and distorted. The following picture gives an example of what a good shoe should look like from behind (example A). Avoid wearing shoes that look like example B from behind.

Getting the right shoes

 

HOW TO CHECK YOUR SHOES FIT CORRECTLY
For an in-depth guide to what types of shoes are suitable for dealing with and/or avoiding foot and ankle problems, please visit www.healthy-footwear-guide.com.

A lot of shoe shops have staff that are qualified to find the right fit for the customer. Find your nearest shoe fitting specialist by visiting www.shoefitters-uk.org.

 
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