FOOT PAIN

BONES OF THE FOOT

There are amazingly 26 bones in the foot, each and every one capable of causing foot pain! In between are almost as many joints, likewise a rich source of pain.

The foot is extremely richly endowed with nerves that send information to the brain, telling the brain exactly where the body is poised in space. When one is kicking a ball, for example, even walking, it is extremely important that the brain has exact information about the position of each part of the body, in order to precisely coordinate movement.

Little wonder that the foot, with so many bones, joints, ligaments, nerves and muscles, all extremely pain sensitive, can cause so much discomfort.

Look for the Metatarsal-phalangeal joints in the forefoot - the source of so-called Metatars-algia (algia = pain)

METATARSALGIA

Metarsarsalgia, or ball of the foot pain, is a very common and sometimes extremely distressing problem. It can be acute, often recurs, and in many people becomes a chronic source of pain. A limp often develops with a negative knock-on effect at the knees, hips and spine.

It is usually, but not always associated with a dropped transverse arch, in which case the toes often jut upwards, and thick calluses form under the metatarsal heads (or met heads, for short) due to increased pressure on the second, third and fourth met head. The solution is NOT to scrape the callus away.

The arrow points clearly to the the callus.

Improper fitting and too-tight shoes are often the cause, especially women�s dress shoes with a high heel, which force more weight onto the forefoot. Pointed shoes squeeze the ball-of-foot into a restricted space, forcing the met heads against each other, irritating the nerves that run between them. This causes a Morton�s neuroma, a benign painful swelling of the nerve, leading to extreme discomfort in the forefoot.

Associated with the Meta-tarsalgia we often find a generalised "Plantar myofascitis", with pain running under the foot, down towards the heel.

FROM THE COAL FACE

Instead of an anecdote, I would simply to state that there are few conditions that I like to treat more than metatarsalgia. Except in extremely deformed feet, and the very elderly this condition responds brilliantly to chiropractic treatment of the foot, without arch supports, bandages and the like.

The stretching and longitudinal frictioning of the muscles between the metatarsals may be very painful, but I can almost give a guarantee ... something no wise doctor ever does!

For more interesting cases from the Chiropractic Clinic, click here.

HOT TIP

Ever think of sending a card to your doctor, chiropractor, dentist? Tell him/her how much you appreciate their efforts, how much you are improving. When you know he or she has really gone the extra mile, a bottle of wine wouldn't go amiss! Perhaps at Christmas. We in the healing professions can also do with a little encouragement from time to time.

I got this letter from an English lady who crossed the North Sea to consult me in Holland for pain in the foot. It turned out to be Metatarsalgia of two years duration. Only three treatments: "I can walk without pain, yes!"

Chiropractic Care

As in all conditions the first step in treating metatarsalgia is to determine the cause of the pain. Proper fitting footwear is obviously the start.

Mobilising the metatarsals, adjusting the toes, and deep stretching and soft tissue therapy of the muscles between and under the metatarsals is extremely effective.

Checking for fixations in other parts of the foot are important. They can be adjusted with the help of a Thuli drop board.

Shoe inners may be very helpful, particularly if pronation of the foot exists. A common chiropractic brand is made by Foot Levelers. Foot Levelers are one of the foremost manufacturers of shoe inserts

SPRAINED ANKLE TREATMENT

The foot and ankle obviously functionally go together. Ankle joint injuries are certainly worthy of a page of their own. Whilst I don't have the research to back it up, my opinion is that many foot problems begin after an improperly sprained ankle, in which the subluxated talus (or other bone) was never corrected.

EXERCISES

Finally, exercises for the foot are are important in the treatment of foot pain. However, they are specialised and difficult to teach over the internet.

One simple option is the so-called alphabet exercises: sitting on a chair, well back, with the shoes off, move each foot tracing out say about 5 letters of the alphabet. Flex your toes and foot as high as you can (called dorsi-flexion), then drop them down, tracing out an A. Try and move all parts of the foot including the toes. The knee shouldn't move.

More exercises for the foot and ankle can be found here.

Podiatrists us a variety of orthotics to unload the pressure on the ball of the foot. Various pads, cushions and bandages each have a place in the care of foot pain.

MORE ABOUT FOOT PAIN

Plantar myofascitis

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