Overuse injuries and inflammatory conditions that affect the legs and feet can be debilitating to the active lifestyle.
Common causes of chronic leg and foot pain include inflammatory arthritis, osteoarthritis, tendinopathy, plantar fasciitis, neuropathy, stress fractures, bunions and bone spurs.
Persistent swelling, aching, sharp pains, numbness and tingling in the feet and legs should never be ignored.
Arthritis
Arthritis can affect any of the 33 joints within the foot.
It will often present as stiffness, pain, and swelling around a joint.
Symptoms and associate structural changes cause difficulties with ease of movement and fitting of shoes.
Numerous inflammatory diseases and arthritic diseases will manifest painful symptoms within the feet, including:
- Rheumatoid arthritis
- Gout
- Psoriatic arthritis
- Systemic lupus erythematosus
- Vasculitis
- Reiter’s disease
- Osteoarthritis
A podiatrist can assist in easing your foot pain by identifying your foot health needs and providing expert footwear advice, nail and callus treatment, and supportive foot orthoses to maximise your foot function.
Plantar fasciitis
The vast majority of heel pain is caused by plantar fasciitis.
The plantar fascia is a broad band of fibrous tissue that runs along the bottom of the foot from the heel to the forefoot.
It acts as a key stabilising feature that enables the foot to remain a solid structure when propelling body weight forward with each step.
Inefficient loading of the foot can cause altered stretch on the fascia, which often will result in inflammation and pain at the attachment to the bottom surface of the heel. It often presents as pain first thing in the morning or immediately upon weight bearing activity following rest periods.
Often in the initial stages of heel pain presentation, the pain will slowly improve with walking and then repeat the pain cycle after any periods at rest.
It is not uncommon to experience these symptoms as a result of poor choices in footwear or when we have increased our usual weight bearing activity level in a rapid fashion.
Prime examples of this include starting a higher intensity gym program or drastically increasing the distance of a run.
Peripheral neuropathy
Peripheral neuropathy results from damage to the peripheral nervous system either through disease, injury or toxicity.
Symptoms can include:
- Anaesthesia (numbness)
- Paraesthesia (tingling, prickling sensation)
- Muscle weakness
Diseases that are associated with peripheral neuropathy include:
- Diabetes
- Rheumatoid arthritis
- Guillain-Barre syndrome
- Various kidney disorders
- Charcot-Marie-Tooth disease
Treatment is all dependent upon diagnosis and the root cause.
Disease associated neuropathy may improve with appropriate treatment of the specific disease.
Diabetic neuropathy is the exception here whereby it does not improve.
When associated with injury or localised compression of the nerve, such as in instances of Morton’s neuroma, podiatrists are able to offload pressure through varying techniques and footwear modification.
Stress fractures
Stress fractures are fractures that occur due to repetitive stress on the bone, which is not sufficient enough to actually cause an acute fracture.
Over 80% of stress fractures occurring in the general population occur in the bones of the lower leg or the foot.
Most stress fractures that occur within the foot can be attributed to fatigue of muscular activity.
They present with pain and even mild swelling in the affected area and the pain is often relieved with rest.
Due to the prolonged mild nature of these types of fractures in comparison to acute fractures, conservative treatments are well tolerated by patient and sufficient to allowing fracture sites to heal in a timely manner.
Treatments usually consist of offloading the site from ground pressure and reduction of physical activity to allow bone healing.
Bunions
Bunions are a very common ailment in our shoe-wearing society.
They occur with lateral deviation of the big toe towards the little toes and medial deviation of the first metatarsal bone and as they progress, arthritic changes cause a painful bony lump on the inner side of the first metatarsal phalangeal joint (the joint at the base of the big toe!).
There are numerous factors that can influence the development of bunions such as structural foot type and function, ligament laxity, neurological disorders, types of footwear and hereditary factors.
Podiatry will provide you with expert advice on how to manage your bunion and conservative treatment options dependent upon the stage of the process and arthritic involvement.
Conservative management, if recognised in the early stages, can include footwear advice, intrinsic muscle strengthening, orthoses to correct foot function and night splints.
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