Standing, walking, going up and down stairs, playing sports, all our actions and movements are limited when pain arises in the arch of the foot. Often, this pain and burning under the foot (called metatarsalgia) intensifies over time: it is therefore necessary to take care of it before it becomes disabling and reduces mobility. Overview of the different causes at play and the remedies to relieve them, with Dr Maurice Demol, general practitioner and sports doctor.
Foot anatomy: what is the arch of the foot?
The foot consists of 26 bones, 16 joints, 107 ligaments and 20 muscles. Complex structure, rigid and flexible at the same time, it allows standing, propulsion when walking and supports up to 4 times the weight of our body when running. It is also what informs our brain about our balance thanks to multiple nerve fibers. These numerous functions and constraints make it an area very exposed to pain and illness.
The arch, on the other hand, is the lower part of the foot. It extends from the forefoot to the heel. Made up of connective tissues, muscles, tendons, ligaments, bones and fascia (aponeuroses or fibrous tissues), it has an arcuate shape (hence its name). “Its role: stabilize our balance, absorb shock, support the weight of the body when walking, running or standing and relieve the other joints of the lower limbs.explains Dr Maurice Demol, general practitioner and sports doctor in Brussels.
There are three types of arches, depending on the individual:
- The normal or medial arch of the foot which presents a slight curvature towards the inside of the foot and which is the most common anatomically;
- The flat arch of the foot : it is characterized by a reduction in the curvature of the foot and a larger contact surface with the ground;
- The high arch of the foot : it has an accentuated curvature and increased support for the plantar arch.
Several types of pain can appear under the foot. They can affect the heel, the toes, the center of the arch of the foot, but also a nerve, a bone or a joint.
Pain under the foot: what are the consequences?
When you have pain under your foot, your whole body feels it. Imbalance, bad posture, lameness, pain that extends to the joints of the lower limbs or even the back, the slightest movement becomes a problem. “When the discomfort is significant, the pain becomes disabling: it limits us in our daily, professional, physical and sporting activities.notes the specialist.
What causes pain in the arch of the foot?
These pains can be multiple, benign or more severe, and the sign of numerous pathologies, depending on their location.
Pain in the skin:
Wet area, often trapped in shoes, feet can become infected quickly. “Many people develop fungal (fungal) infections between the toes which will initially be painless but can progress and cause pain. Bacterial infections are also possible, superinfecting a wound: diabetic people must be particularly vigilant.underlines Dr Maurice Demol.
Pain in bones and joints:
- Fractures: They most often occur following trauma;
- Stress fractures: Linked to excess constraints, they develop without there being any trauma;
- Sesamoiditis: This is an inflammation which affects two small bones located in the soft tissues, under the end of the first metatarsal, towards the toe;
- Rheumatism: The feet are sometimes affected by certain rheumatic diseases, such as rheumatoid arthritis. This disease progresses through inflammatory attacks and results in deformities and stiffness of the feet;
- Osteoarthritis: Osteoarthritis is a common cause of pain, linked to the loss of joint mobility that it causes. “Osteoarthritis of the big toe (hallux rigidus) is more frequently observed, but it is frequently found at the site of an old fracture.notes the specialist;
- Deformations: Hallux valgus is the most common. “Initially, it does not cause pain but when the deformation progresses, pain is often felt at the base of the big toe, then under the foot when the deformation is significant and weakens the arch of the foot.
- Metatarsalgia: These pains include numerous conditions such as Freiberg’s disease, Morton’s neuroma, sesamoiditis, etc. ;
- Freiberg’s disease: This necrosis of the head of the 2nd or 3rd metatarsal mainly affects young girls at puberty. It manifests itself as pain in the front of the foot and gives the impression of walking on a stone;
- Müller-Weiss syndrome: This is a rare condition but one that has been talked about a lot in recent years, since tennis player Rafael Nadal has it. This necrosis of the navicular bone results from an anatomical malformation (flat feet) or excess mechanical stress (such as practicing high-level sport);
- The exostoses: This bony growth, often benign, most often goes unnoticed. But it can sometimes cause pain through compression of adjacent tissues;
- Capsulitis: We usually observe them at the shoulder, but they can also affect the foot and in particular the metatarsophalangeal joints, usually after long immobilization;
- Subluxations: They are located at the level of the cuboid bone, on the outside of the foot (we speak of “cuboid syndrome”) and refer to hypermobility of the bone, due to microtrauma. Pain (on the outer side of the foot) is often accompanied by swelling and tenderness of the soles of the feet. Dancers and joggers are more concerned;
- A Lenoir thorn or heel spur: This is a particular bone deformation, where the calcaneus bone has a more pointed part which can attack the plantar fascia and cause pain;
- Pain in the ligaments: Most often, this pain follows a sprain.
Pain in the fascia
- Plantar fasciitis or plantar fasciitis: Located under the foot, the plantar aponeurosis connects the heel to the metatarsals. Sometimes there can be an injury or inflammation of the fibrous tissue on the bottom of the foot (at the junction between the heel and the arch of the foot). The pain worsens with weight-bearing and walking. “Plantar fasciitis is one of the main causes of pain under the foot (cause of heel pain or “talalgia”).specifies Dr Maurice Demol;
- Plantar fibromatosis: This is a non-cancerous (benign) enlargement of the connective tissue of the sole of the foot, which forms painful growths on the soles of the feet.
Pain in muscles and tendons
- Tendinopathy: It frequently concerns the flexor hallucis tendon, this muscle that allows the big toe to flex. The injury or inflammation causes pain on the inside and middle of the soles of the feet. When the origin is inflammatory, the pain is more present in the morning when getting up. “Achilles tendinopathy is a common cause of plantar pain because when the tendon hurts or becomes stiff, plantar fasciitis can develop.adds the specialist;
- Muscle contractures;
- Inflammation of the fatty pad of the heel, often due to repeated jumping (for example in gymnasts);
- Bursitis, or inflammation of the periarticular bursae.
Pain in the nerves
- Morton syndrome or neuroma: This is the compression of the interdigital nerve in the space between two metatarsals, mainly between the 3rd and 4th. Over time, the nerve will thicken and take on a ball-like appearance, becoming sensitive to the slightest compression. Morton’s neuroma is a pathology that causes fairly intense pain, such as burning or electric shock, under the base and between the toes. They may be associated with numbness. This syndrome occurs in adults, mainly in women over 50: tight shoes and wearing high heels would favor the appearance of the pathology;
- Sciatica: The pain from sciatica can radiate into the calf, heel and under the sole of the foot;
- Neurological diseases: Peripheral neuropathies (such as diabetic neuropathy) can cause pain in the feet, associated with sensory disorders.
Pain in the vessels
- Phlebitis or venous thrombosis: It is due to the presence of a clot in a vein, which blocks the circulation of blood. The entire foot may become hot, red, painful. Phlebitis is a medical emergency;
- Arteriopathies: This is a partial or total obstruction of the arteries of the lower limbs. The feet are cold, white and painful. Pain appears when walking;
- Raynaud’s syndrome: Temporary blood circulation disorder, it affects the hands and feet during exposure to cold or stress. During attacks, they become white and insensitive, even blue and swollen, then red.
- Flat foot:…