What is Foot Pain?
Foot pain explained by Denver, Golden, Aurora, Boulder, Broomfield, Jefferson, and Littleton Colorado’s top pain doctors
Foot pain can result from a number of causes, including injury, arthritis, and age. Injuries to the tissues that make up the structure of the foot—i.e. the bones, muscles, and joints—can also be a source of pain. Our feet undoubtedly play an important role in our lives. Pain in these extremities can have a considerable impact on independent movement, productivity, and function. Pain can affect the ability to move the feet or toes, or to walk.
Causes of Foot Pain
Sensory signals in the feet or toes are controlled by nerves in the lumbar or sacral spine. Damage or inflammation to these nerves can result in pain in the hips, legs, or feet. This can be caused by many factors, including injury to the lower back, hip region, or lower extremities. Complex regional pain syndrome is a condition that involves chronic pain in some or all of these areas, including the feet.
Some cancers or cancer treatments can damage the relevant spinal nerves, resulting in foot pain. Nerve damage can also be caused by errors in back surgery, which can also result in chronic pain experienced in the feet.
Other sources of foot pain are direct damage to the feet, caused by activities such as extended periods of standing, lifting and carrying heavy weights, and wearing ill-fitting or high-heeled shoes. High levels of athletic or sporting activity can also result in a painful foot injury. Foot deformities, which can be caused by certain genetic disorders, can also result in chronic, debilitating pain. Arthritis, a condition in which inflammatory molecules invade joints, such as the ankle, is also associated with foot pain.
Treatments for Foot Pain
Over-the-counter analgesics (painkillers) such as acetominaphen and non-steroidal anti-inflammatory drugs (NSAIDs) are often recommended to treat foot pain. If the foot pain is a result of cancer, cancer treatment, or failed back surgery, opioids are often prescribed. Opioids bind to and inhibit pain receptors. There are risks associated with opioid administration though, including a high potential for addiction. Opioid alternatives are increasing in popularity and efficiency, due to their ability to inhibit pain signaling without these drawbacks.
It is possible to do this by delivering local anesthetics and/or steroids (to treat inflammation) to the sacral or lumbar nerves that conduct painful signals from the feet. These nerve blocks are associated with short- to medium-term relief from foot pain. They do however carry slight risks of damage (resulting in a loss of sensory or motor control) to the nerves. There is also a low incidence of blood vessels or other areas of the spine being injected inadvertently, which can cause paralysis or difficulty breathing. More common, and less serious, drawbacks associated with nerve blocks are transient neurological events, such as headaches.
Radiofrequency ablation (RFA) is another procedure that can be utilized to relieve foot pain. In this procedure, a probe is inserted into the vicinity of the relevant spinal nerve under local anesthetic. The probe then delivers electro-thermal impulses to the specific parts of the nerve that transmit pain signals, thus lysing (or destroying) them. This procedure is safe, effective, and accurate, though there is a low incidence of error resulting in motor problems or numbness. There are other risks of RFA, including infection, irritation, and bleeding at the injection site, and absence of the expected pain-blocking effect. RFA is associated with effective medium-term (i.e. a number of months) foot pain relief.
Spinal cord stimulation (SCS) is another option for treating foot pain. This is a minor surgical procedure in which a device that reduces pain signals by overriding them with electrical impulses is placed near the relevant spinal nerve. SCS can cause scar tissue to form on or near the spinal cord, which can be a source of pain. As with RFA, there are also risks of infection, discomfort, and bleeding. If SCS fails, it can magnify the pain signals instead of reducing them as intended. The majority of device implantations are effective and safe, and are associated with medium- to long-term treatment of pain.
Foot pain is caused by either nerve, mechanical, or chemical (i.e. inflammatory) damage. It can adversely affect normal function and motion. Many cases of foot pain can be treated by conventional analgesics or biofeedback training, but these may not be effective. In these cases, treatments that inhibit pain signals from lumbar or sacral nerves may be necessary. Well-regarded examples of these are nerve blocks, radiofrequency ablation (RFA), or spinal cord stimulation (SCS).
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