What are the main causes of metatarsalgia. How is metatarsalgia diagnosed and treated effectively. What lifestyle changes can help alleviate ball of foot pain. How can proper footwear choices impact metatarsalgia symptoms.

Understanding Metatarsalgia: An Overview of Ball of Foot Pain

Metatarsalgia is a common foot condition characterized by pain and inflammation in the ball of the foot, specifically in the area between the arches and toes. This discomfort centers under the five metatarsal bones at the bases of the toes. While metatarsalgia can affect anyone, certain factors increase the risk of developing this condition.

Who is most susceptible to metatarsalgia? Individuals who participate in high-impact sports, especially runners, are more prone to experiencing ball of foot pain. Additionally, people with high arches, those with a second toe longer than their big toe, and individuals with foot deformities like hammertoes and bunions are at higher risk.

Key Risk Factors for Metatarsalgia

• Participation in high-impact sports
• Having high arches
• Foot deformities (hammertoes, bunions)
• Longer second toe
• Wearing ill-fitting shoes or high heels
• Excess body weight
• Presence of rheumatoid arthritis, osteoarthritis, or gout

Understanding these risk factors can help individuals take preventive measures and seek appropriate treatment when necessary.

Recognizing the Symptoms of Metatarsalgia

Identifying the symptoms of metatarsalgia is crucial for early diagnosis and effective treatment. The primary symptom is pain in the metatarsal area under the ball of the foot. This discomfort can manifest in various ways and may be accompanied by other signs.

How does metatarsalgia pain typically present itself? The pain can be sharp, aching, or burning in nature. It often worsens when standing, running, or walking. Some individuals may also experience numbness or tingling in their toes or feel as if there’s a pebble in their shoe.

Common Symptoms of Metatarsalgia

• Pain in the ball of the foot (sharp, aching, or burning)
• Increased discomfort during weight-bearing activities
• Numbness or tingling in the toes
• Sensation of having a pebble in the shoe
• Possible bruising and swelling in the affected area

It’s important to note that symptoms can develop gradually over time or appear suddenly. If these symptoms persist, seeking medical attention is advisable to prevent potential complications.

Diagnosing Metatarsalgia: Medical Approaches and Tests

Proper diagnosis of metatarsalgia is essential for developing an effective treatment plan. Healthcare professionals employ various methods to accurately identify this condition and rule out other potential causes of foot pain.

What steps do doctors typically take to diagnose metatarsalgia? The diagnostic process usually begins with a thorough discussion of the patient’s symptoms and medical history. This is followed by a physical examination of the foot, focusing on the affected area.

Diagnostic Methods for Metatarsalgia

1. Patient history and symptom assessment
2. Physical examination of the foot
3. X-rays to rule out stress fractures or other bone-related issues
4. Ultrasound or MRI scans to evaluate soft tissues around the metatarsophalangeal joints

These diagnostic tools help healthcare providers determine the underlying cause of the pain and develop a tailored treatment approach.

Effective Treatment Strategies for Metatarsalgia

Treating metatarsalgia often involves a combination of conservative measures and, in some cases, medical interventions. The goal is to alleviate pain, reduce inflammation, and address any underlying factors contributing to the condition.

How can metatarsalgia be effectively managed without surgery? Many cases of metatarsalgia respond well to non-surgical treatments. These may include the use of metatarsal pads, orthotic inserts, or specialized footwear to redistribute pressure away from the painful area.

Non-Surgical Treatment Options

• Use of metatarsal pads or shoe inserts
• Wearing appropriate footwear (athletic shoes or rocker-soled shoes)
• Avoiding barefoot walking
• Regular foot care, including callus management
• Rest and elevation of the affected foot
• Application of ice packs to reduce inflammation
• Over-the-counter pain medications

In cases where conservative treatments don’t provide sufficient relief, medical interventions such as corticosteroid injections or, in rare cases, surgery may be considered to address the underlying cause of pain.

Lifestyle Modifications and Prevention Strategies

Preventing metatarsalgia and managing its symptoms often involves making lifestyle changes and adopting preventive measures. These strategies can significantly reduce the risk of developing ball of foot pain or experiencing recurrent symptoms.

What lifestyle changes can help prevent or manage metatarsalgia? Key modifications include choosing appropriate footwear, maintaining a healthy weight, and modifying high-impact activities. Additionally, incorporating foot-strengthening exercises and stretches can improve foot health and resilience.

Preventive Measures for Metatarsalgia

• Selecting shoes with good soles, wide toe boxes, and lower heels
• Maintaining a healthy body weight to reduce pressure on the feet
• Gradually increasing intensity in physical activities to avoid overload
• Regular foot exercises and stretches
• Using supportive insoles or custom orthotics
• Avoiding prolonged periods of standing or walking barefoot

By implementing these preventive strategies, individuals can significantly reduce their risk of developing metatarsalgia and improve overall foot health.

The Impact of Proper Footwear on Metatarsalgia

Choosing the right footwear plays a crucial role in both preventing and managing metatarsalgia. Proper shoes can help distribute pressure evenly across the foot, reducing strain on the metatarsal area.

How does footwear choice affect metatarsalgia symptoms? Shoes that provide adequate support, cushioning, and a wide toe box can significantly alleviate pressure on the ball of the foot. Conversely, ill-fitting shoes, high heels, or shoes with minimal support can exacerbate symptoms.

Characteristics of Foot-Friendly Shoes

• Wide toe box to allow natural toe spread
• Adequate arch support
• Cushioned soles for shock absorption
• Low to moderate heel height
• Proper fit with enough room for orthotics if needed
• Breathable materials to reduce moisture and friction

Investing in quality, supportive footwear can make a significant difference in managing metatarsalgia symptoms and promoting overall foot health.

Exercise and Physical Therapy for Metatarsalgia Relief

Incorporating specific exercises and physical therapy techniques can be beneficial in managing metatarsalgia and improving overall foot function. These activities aim to strengthen the muscles supporting the foot, increase flexibility, and reduce pressure on the metatarsal area.

What types of exercises are most effective for metatarsalgia relief? Gentle stretching exercises, toe and foot strengthening activities, and balance exercises can all contribute to better foot health. It’s important to start slowly and gradually increase intensity under the guidance of a healthcare professional.

Beneficial Exercises for Metatarsalgia

1. Toe stretches and flexes
2. Arch stretches
3. Calf stretches
4. Towel scrunches with toes
5. Marble or small object pickups with toes
6. Gentle foot rolls using a tennis ball or foam roller
7. Balance exercises on one foot

Regular practice of these exercises can help alleviate pain, improve foot strength and flexibility, and reduce the risk of recurrent metatarsalgia symptoms.

When to Seek Medical Attention for Metatarsalgia

While many cases of metatarsalgia can be managed with self-care and lifestyle modifications, there are instances where professional medical attention is necessary. Recognizing when to consult a healthcare provider is crucial for preventing complications and ensuring proper treatment.

Under what circumstances should one seek medical help for ball of foot pain? Persistent pain that doesn’t improve with rest and home remedies, severe pain that limits daily activities, or symptoms accompanied by swelling, redness, or fever warrant a medical evaluation.

Signs Indicating Need for Medical Consultation

• Pain persisting for more than a few weeks despite self-care measures
• Severe pain interfering with normal activities
• Sudden onset of intense pain in the ball of the foot
• Visible deformity or changes in foot shape
• Signs of infection (redness, warmth, swelling)
• Numbness or tingling that doesn’t resolve
• Pain accompanied by systemic symptoms like fever

Timely medical intervention can prevent the progression of metatarsalgia and address any underlying conditions contributing to foot pain.

Long-Term Management and Outlook for Metatarsalgia

Understanding the long-term outlook for metatarsalgia and implementing effective management strategies is essential for individuals dealing with this condition. While metatarsalgia can be a chronic issue for some, many people experience significant improvement with proper care and lifestyle adjustments.

Can metatarsalgia be completely cured? While complete cure may not always be possible, especially in cases with underlying structural issues, most individuals can achieve substantial pain relief and improved foot function through a combination of treatments and preventive measures.

Keys to Long-Term Metatarsalgia Management

• Consistent use of appropriate footwear and orthotics
• Regular foot care and hygiene practices
• Maintaining a healthy body weight
• Modifying activities to reduce foot stress
• Ongoing foot-strengthening exercises
• Periodic check-ups with a podiatrist or orthopedic specialist
• Prompt attention to any recurring symptoms

By adopting these long-term management strategies, individuals with metatarsalgia can often lead active, pain-free lives and minimize the risk of recurrent symptoms.

Innovative Treatments and Future Directions in Metatarsalgia Care

As medical science advances, new and innovative treatments for metatarsalgia are emerging, offering hope for improved management and potentially better outcomes for those affected by this condition. Researchers and healthcare professionals continue to explore novel approaches to address ball of foot pain more effectively.

What cutting-edge treatments are being developed for metatarsalgia? Some of the innovative approaches currently being researched or implemented include advanced biomechanical analysis, customized 3D-printed orthotics, regenerative medicine techniques, and minimally invasive surgical procedures.

Emerging Treatments and Research Areas

• High-tech gait analysis for personalized treatment plans
• Advanced imaging techniques for more precise diagnosis
• Platelet-rich plasma (PRP) therapy for tissue regeneration
• Shockwave therapy for pain relief and healing promotion
• Minimally invasive surgical techniques for severe cases
• Smart insoles with pressure-sensing technology
• Gene therapy research for underlying genetic factors

While many of these treatments are still in developmental stages or limited clinical use, they represent promising avenues for improving metatarsalgia care in the future. As research progresses, individuals with metatarsalgia may have access to more targeted and effective treatment options, potentially leading to better long-term outcomes and quality of life.

Metatarsalgia (Pain in the Ball of Your Foot): Causes & Treatment

Overview

What is metatarsalgia?

Metatarsalgia refers to pain and inflammation in the ball of the foot. This is the area between the arches and toes on the bottom of the foot. Metatarsalgia centers under the five bones at the bases of the toes, the metatarsals.

The pain of metatarsalgia can be caused by a number of conditions and can have varied treatments.

Who gets metatarsalgia?

Anyone can get metatarsalgia, although runners and others who take part in high impact sports or spend more time on their forefoot have the condition more frequently than others.

People with high arches also have metatarsalgia more than others. High arches put extra pressure on the metatarsals and heels. People with a second toe longer than their big toe may also experience metatarsalgia more frequently.

People with foot deformities such as hammertoes and bunions may also experience more metatarsalgia.

Symptoms and Causes

What causes metatarsalgia?

Not all of the causes of metatarsalgia are known. In addition to being a frequent runner, wearing ill-fitting shoes or high heels can cause metatarsalgia.

Excess weight can also contribute to metatarsalgia.

Having rheumatoid arthritis, osteoarthritis or gout can also contribute to metatarsalgia.

What are the symptoms of metatarsalgia?

The main symptom of metatarsalgia is pain in the metatarsal area under the ball of the foot. Metatarsalgia may or may not be accompanied by bruising and swelling or inflammation. Symptoms can come on quickly or develop over time. They include:

• Pain in the ball of the foot: this can be sharp, aching or burning. The pain may get worse when you stand, run or walk.
• Numbness or tingling in your toes
• The feeling of a pebble in your shoe

If you have any of these ongoing symptoms, you should see your doctor. Untreated metatarsalgia can lead to hammertoes, can cause you to limp and cause pain in other parts of the body, including the lower back and hip when you compensate and begin to walk abnormally.

Diagnosis and Tests

How is metatarsalgia diagnosed?

Your doctor will begin an exam for metatarsalgia by asking about your symptoms. He or she will also examine your foot manually. You may need an X-ray to rule out stress fractures or other problems that could be causing your pain. Other times an ultrasound or MRI may be ordered to assess the soft tissues surrounding your metatarsophalangeal joints.

Management and Treatment

How is metatarsalgia treated?

Metatarsalgia is usually easily treated without surgery. Your doctor may recommend that you use a metatarsal pad, a surgical shoe, or a shoe insert to offload the painful part of your foot. Athletic shoes or rocker soled shoes may be recommended. Other helpful tips include:

• Picking shoes with good soles, a wide toe box and a lower heel
• Avoiding walking barefoot
• Soaking and using pumice stone on your feet to help remove calluses. Removing these calluses can help relieve pressure. People with diabetes should consult their physician first before doing this.

If these measures do not help relieve your metatarsalgia, an injection or surgery may be necessary to resolve the underlying cause of your pain.

Pain in the bottom of the foot

Pain in the bottom of your foot (ball, arch or sole) will often get better in a few weeks. See a GP if it does not improve.

How you can ease pain under the foot

If you see a GP, they’ll usually suggest trying these things:

Do

• rest and raise your foot when you can

• put an ice pack (or bag of frozen peas) in a towel on the painful area for up to 20 minutes every 2 to 3 hours

• wear wide comfortable shoes with a low heel and soft sole

• use soft insoles or pads you put in your shoes

• try to lose weight if you’re overweight

• try regular gentle stretching exercises

• take paracetamol

Don’t

• do not take ibuprofen for the first 48 hours after an injury

• do not walk or stand for long periods

• do not wear high heels or tight pointy shoes

Video: exercises to reduce pain in the bottom of the foot

This video demonstrates exercises that can help reduce pain in the bottom of the foot.

Media last reviewed: 17 April 2019
Media review due: 17 April 2022

See exercise video safety information

This exercise video is suitable for most people, but is not tailored to any specific condition, characteristic or person.

Get advice from a GP or health professional before trying it, especially if:

• you have any concerns about your health
• you are not sure if the exercises are suitable
• you have any pre-existing health problems or injuries, or any current symptoms

Stop the exercise immediately and get medical help if you feel any pain or feel unwell.

You can ask a pharmacist about:

• the best painkiller to take
• insoles and pads for your shoes
• treatments for common skin problems
• if you need to see a GP

Non-urgent advice: See a GP if:

• the pain is severe or stopping you doing normal activities
• the pain is getting worse or keeps coming back
• the pain has not improved after treating it at home for 2 weeks
• you have any tingling or loss of sensation in your foot
• you have diabetes – foot problems can be more serious if you have diabetes

What we mean by severe pain

Severe pain:

• always there and so bad it’s hard to think or talk
• you cannot sleep
• it’s very hard to move, get out of bed, go to the bathroom, wash or dress

Moderate pain:

• always there
• makes it hard to concentrate or sleep
• you can manage to get up, wash or dress

Mild pain:

• comes and goes
• is annoying but does not stop you doing things like going to work

Information:

Coronavirus (COVID-19) update: how to contact a GP

It’s still important to get help from a GP if you need it. To contact your GP surgery:

• visit their website
• use the NHS App
• call them

Find out about using the NHS during COVID-19

Common causes of pain under the foot

Pain in the bottom of your foot is often caused by exercising too much or wearing shoes that are too tight.

Your symptoms might also give you an idea of what’s causing your pain.

Information:

Do not worry if you’re not sure what the problem is.

Follow the advice on this page and see a GP if the pain does not get better in 2 weeks.

You can also read about pain in other areas of your foot.

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Page last reviewed: 1 April 2019
Next review due: 1 April 2022

Pain in the top of the foot

Pain in the top of your foot will often get better in a few weeks. See a GP if it does not improve.

How you can ease pain in the top of your foot

If you see a GP, they’ll usually suggest trying these things:

Do

• rest and raise your foot when you can

• put an ice pack (or bag of frozen peas) in a towel on the painful area for up to 20 minutes every 2 to 3 hours

• wear wide comfortable shoes with a low heel and soft sole

• use soft insoles or pads you put in your shoes

• try to lose weight if you’re overweight

• try regular gentle stretching exercises

• take paracetamol

Video: an exercise to reduce pain in the top of the foot

This video demonstrates an exercise that can help reduce pain in the top of foot.

Media last reviewed: 17 April 2019
Media review due: 17 April 2022

See exercise video safety information

This exercise video is suitable for most people, but is not tailored to any specific condition, characteristic or person.

Get advice from a GP or health professional before trying it, especially if:

• you have any concerns about your health
• you are not sure if the exercises are suitable
• you have any pre-existing health problems or injuries, or any current symptoms

Stop the exercise immediately and get medical help if you feel any pain or feel unwell.

You can ask a pharmacist about:

• the best painkiller to take
• insoles and pads for your shoes
• treatments for common skin and nail problems
• if you need to see a GP

Non-urgent advice: See a GP if:

• the pain is severe or stopping you doing normal activities
• the pain is getting worse or keeps coming back
• the pain has not improved after treating it at home for 2 weeks
• you have any tingling or loss of sensation in your foot
• you have diabetes – foot problems can be more serious if you have diabetes

What we mean by severe pain

Severe pain:

• always there and so bad it’s hard to think or talk
• you cannot sleep
• it’s very hard to move, get out of bed, go to the bathroom, wash or dress

Moderate pain:

• always there
• makes it hard to concentrate or sleep
• you can manage to get up, wash or dress

Mild pain:

• comes and goes
• is annoying but does not stop you doing things like going to work

Information:

Coronavirus (COVID-19) update: how to contact a GP

It’s still important to get help from a GP if you need it. To contact your GP surgery:

• visit their website
• use the NHS App
• call them

Find out about using the NHS during COVID-19

Common causes of pain in the top of the foot

Pain in the top of your foot is often caused by exercising too much or wearing shoes that are too tight.

Your symptoms might also give you an idea of what’s causing your pain.

Information:

Do not worry if you’re not sure what the problem is.

Follow the advice on this page and see a GP if the pain does not get better in 2 weeks.

You can also read about pain in other areas of your foot.

Page last reviewed: 1 April 2019
Next review due: 1 April 2022

Arch Pain | Symptoms, Causes & Treatment by Sydney Heel Pain

Arch pain can be the result of one or a combination of conditions that develop in the sole of the foot. Patients will often describe a tightness, pulling, strain, burning or ripping sensation through the mid arch of the foot, in front of the heel but behind the ball of the foot.

The pain in the arch can come on suddenly as in a one off day of increased walking or a sporting event, or progressively over a period of time as in walking in inappropriate shoes. Arch pain can be present every day and can be consistently present, in that it interferes with day to day activity. It will often feel worse in bare feet or thongs or flat and flimsy shoes such as ballet flats.

In extreme cases the pain can be excruciating and can cause burning and throbbing in bed at night. The soft tissue in the arch can be torn and this can be detected via ultra sound or MRI.

CONDITIONS CAUSING ARCH PAIN

ARCH PAIN TREATMENT

It is important to assess and diagnose which part of the foot is affected and causing the pain. Physical examination is usually sufficient but in complex cases the patient can be referred for ultra sound imaging. An MRI is not usually necessary.

It is also important to determine whether or not the ligament, fascia or tendon has been torn as this will determine which treatment path to take. If the tissue is not torn, then it is important to determine what has caused the condition so that these contributing factors can be resolved. Factors such as footwear, exercise or even stretching techniques are common contributing factors.

If there are bio mechanical issues affecting the patients foot then these need to be addressed also. Orthotics can be arranged and shoes can be changed. Strapping can be applied to the foot and in extreme cases an immobilisation boot can be used.

Shock wave therapy can applied to the foot which can stimulate blood flow and accelerate healing in addition to relieving pain. Correct stretching techniques must be instructed and followed.

ARCH PAIN TREATMENT OPTIONS

• Strapping
• Orthotics where necessary
• Footwear changes
• Shock wave therapy
• Stretching
• Immobilisation boot

CASE STUDY – ARCH PAIN WITH WEIGHT GAIN BY KARL LOCKETT, SPORTS PODIATRIST

HISTORY – ARCH PAIN

A 44-year-old lady presents to the clinic with arch pain in her right foot which came on gradually. She reports an increase in body weight, gaining 14 kilo’s in approximately 6 months. The arch pain started 3months ago, around the time she was starting to feel her body weight was becoming a problem. Mrs X had been through an extremely stressful period at work and this meant she stopped visiting the gym. Her eating habits also became an issue and this compounded the weight gain problem. As her body weight increased she became aware of a mild arch pain and some general fatigue in her foot muscles. She would release the stiffness in her feet with a spiky ball at home and this provided temporary relief. In addition to the onset of arch pain and fatigue, she felt her calf muscles tightening and she would occasionally experience cramps, particularly in the evenings. Mrs X described the pain as a burning sensation under the sole of her foot and a sharp pulling sensation. She would often stop mid stride, and stand still, as the stabbing pain was extreme and she felt like her arch was tearing. One week ago, she went to see her regular physiotherapist who applied some rigid sports tape to her foot, and this provided short term relief.

HER ARCH PAIN WAS WORSE IN FLAT SHOES

Mrs X brought a large selection of shoes to her consultation and wondered if her arch pain and general foot fatigue was due to her choice of footwear. Amongst the collection were 3 pairs of ballet flats, a pair of Merrell street shoes, and some flat and flexible office shoes. Not one pair of her shoes had mid sole support or a small heel. The uppers were soft and flexible and also lacked support.

Mrs X did have a pair of Asics sports shoes too, although she did not bring these along to the consultation, as she had not worn them for some 6 months at the gym. On the odd occasion that she did wear the Asics running shoes she explained that her arch pain would subside and she could spend longer on her feet. This allowed her to carry out some household chores and go for an occasional walk without too much discomfort.

HER ARCH PAIN WAS DUE TO PLANTAR FASCIITIS

Mrs X was referred to the imaging centre for an Ultra sound scan of her painful foot. She was relieved when the report explained the cause of her arch pain, describing inflamed Plantar Fascia – a condition commonly known as Plantar Fasciitis. Plantar Fasciitis can cause pain in the heel and the arch of the foot and is common in people carrying extra body weight. The Sports Podiatrist reassured Mrs X that Plantar Fasciitis was a common condition that was treatable, and that she would make a full recovery within a month or 2, once treatment commenced.

PHYSICAL EXAMINATION OF ARCH PAIN

The medical report from the imaging centre had already described Plantar Fasciitis as the cause of this lady’s arch pain and the physical examination revealed typical findings. There was pain on palpation of the Plantar Fascia, distal to the heel and along the medial slip. Her peroneal tendons were unremarkable and there was no heel pain. Mrs X was able to walk in her bare feet without limping, but was unable to perform a single leg heel raise without pain. This is typical in patients with arch pain as the exercise loads the Plantar Fascia and pulls through the arch.

FACTORS CAUSING THE ARCH PAIN IN MRS X

The increase in body weight was clearly a contributing factor in the onset of Mrs X’s arch pain. The weight gain adds load to the feet and causes stress and strain on muscles and tendons. When the weight gain occurs quickly, the feet don’t always cope with the extra stress and the Plantar Fascia can become overloaded. This leads to the micro tearing and inflammation of the Plantar Fascial fibres.

In addition to this, the extra body weight leads to an increase in calf muscle bulk and tightness. This muscle group works harder during stance and push-off in heavier patient’s. The stiffness in these muscles, which are attached to the back of the heel, causes a stronger pulling action on the back of the foot. This in turn causes a stronger pull through the sole of the foot, which can lead to strain in the Plantar Fascia and result in arch pain.

There’s a fairly good case that would suggest Mrs X would not have developed this acute arch pain had she worn more supportive shoes. Ballet flats, and any shoes that are flat and flexible are likely to cause problems in heavier patient’s, if used for longer periods.

TREATMENT OF MRS X ARCH PAIN

It was explained to Mrs X that she needed to lose weight in order to help her fatigued feet and reduce this chronic and acute arch pain. She was already aware of this and explained she can’t walk for exercise, to burn the calories. She was advised to swim and perform resistance training for her upper body. Mrs X enquired about the use of prescription orthotics. She felt her feet were more unstable since gaining weight. The Sports Podiatrist
explained to Mrs X that the orthotics were a valid treatment option, and that the Carbon Fibre material would be the preferred choice. These are a firm material but are streamlined and less bulky, and so fit into more shoes more easily. They would have slow release poron to provide cushioning and the support from these orthotics would reduce the strain on the whole foot, particularly the arch. This would allow the arch pain to resolve over time, as the micro tears and inflammation subsided.

FOOTWEAR CHANGES

A comprehensive list of appropriate shoes that would offer support and accommodate the orthotics was given to Mrs X. These were tailored to her foot type and body weight. Work shoes, casual shoes and trainers were all recommended.
OTHER

As a temporary measure, rigid sports tape was applied to both feet and this would be used until the orthotics were ready for fitting. Calf massage was also recommended and a comprehensive stretching programme was applied.

2 WEEKS ON

After 2 weeks, Mrs X returned to be fitted with her orthotics. Her pain level had not changed when the arches were palpated. However, she did feel more stable and slightly more comfortable with the strapping in place, and the new shoes on her feet.

6 WEEKS ON

Calf range had improved and pain had reduced by 40%. Mrs X was compliant with stretching but was not applying ice packs to her feet on a daily basis. Her orthotics were very comfortable and were helping. She wore them every day. She had lost 2.5 Ks in weight, partly due to dietary changes and partly due to swimming.

10 WEEKS ON – MINIMAL ARCH PAIN

Mrs X reported that her arch pain had virtually gone. There was some mild discomfort if she was standing still, without walking, for extended periods, as she had recently done at a work conference. However, she was very comfortable and free from pain at all other times. When palpating her arches, she did not flinch and reported mild tenderness but to pain.

Mrs X was asked to continue her change in eating habits but to now introduce walking. 3 k’s to commence and only twice a week. Her stretching must continue and her training programme would be modified in due course, increasing gradually.

PLEASE NOTE: The information in this case study is specific to one individual patient and should not be taken as general advice. If you have arch pain or a condition causing discomfort in your feet, you should seek the help of a Sports Podiatrist.

For more information, click here: Plantar Fasciitis

Written by Karl Lockett

Top of Foot Pain Causes, Symptoms and Treatment

It might sound ridiculous to say, but it’s certainly true: our feet carry us wherever we go. Depending on our age, our feet have walked or run hundreds and hundreds, if not thousands of miles over the years. Rarely do we think about the complex structure of bones, tendons and muscles until there’s an injury or we experience intermittent sharp pain on top of the foot.

There are few things as uncomfortable and debilitating as foot pain. For athletes, it may mean poor game-time performance or an inability to keep up with their training regimen while they wait for the issue to heal.

However, healthy feet are just as important for everyone else too. A lack of pain-free mobility can cause serious quality of life issues and even disability if a person’s job requires them to be on their feet all the time.

Obviously, top foot pain can be the result of an injury, such as a sprain or strain, or even dropping a heavy object on the foot by accident. But it can also arise when there’s seemingly been no injury at all.

Understanding what some of these conditions are can be a useful foot pain identifier.

What Conditions Can Cause Top of Foot Pain?

It’s important to note that some health issues, such as diabetes or Gout, can cause pain in the feet. These are special types of health conditions, so it’s important to always consult with your doctor about overall health and wellbeing when you experience pain in the feet.

Some types of stress fractures of the bones in the feet can cause painful symptoms and these should be examined by a podiatrist to perform an assessment and diagnosis.

There are a number of conditions that will cause pain in the top of the foot that are not strictly the result of an injury.

Arthritis

Arthritis is an issue that can cause sharp pain on top of the foot when walking or even without any activity.

Arthritis in the foot is not uncommon. There are 30 joints in the foot where this condition can take hold. Here, the most affected place on top of the foot is the area located at the base of each toe in the metatarsophalangeal joints.

Sinus Tarsi Syndrome

Sinus Tarsi Syndrome occurs when the channel located between the heel and the bone of the ankle becomes inflamed. This can cause intense pain on the outside of the ankle, as well as on the top of the foot.

Sinus Tarsi Syndrome is often caused after a series of ankle sprains or from over-pronation when running.

Bone Spurs

Bone Spurs are bony projections that can develop along the edges of bones. They typically form in the joint where bones are rubbing against each other.

It should be noted that bone spurs can form in many places in the body, although the feet are a common location.

If bone spurs are present in the joints of the feet, especially near the toes, they can cause severe top of foot pain.

Peripheral Neuropathy

Peripheral Neuropathy is a disorder that causes a breakdown in the peripheral nervous system, which is responsible for sending signals about physical sensations to many parts of the body, including the feet.

This condition can be caused by an infection, a chronic illness, an injury or be a genetically inherited disorder. Top of foot pain associated with this condition is likely to be a prickling sensation or numbness.

Extensor Tendonitis

Extensor Tendonitis can occur when the extensor tendons on the top of the foot become inflamed either by overuse, shoes that are not a proper fit (especially if they’re too tight), or even from frequently running uphill.

The extensor tendons are responsible for enabling the foot to flex and raise the toes and can impact running or jumping.

How Do You Relieve Pain on the Top of Your Foot?

It’s important to seek treatment for pain in the top of the foot. Feet carry the body’s weight and any issue causing pain can worsen if it’s not addressed by a physician.

Treatment approaches for foot pain will vary depending on what the underlying diagnosis turns out to be, but there are several methods that are effective.

Treatment for top of foot pain can include some of the following:

The RICE Method

RICE stands for Rest, Ice, Compression, and Elevation and this method is generally a smart thing to do when pain first appears, even if you plan to see your doctor.

It’s necessary to rest the injury and stop any activities that may have caused the pain so the injury has time to heal properly.

Periodic icing and compression can help with both inflammation and pain.

Whenever possible, elevate the foot so it is above the heart.

Anti-Inflammatory Pain Medications

Nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen found in Advil or Motrin are effective over-the-counter medications to help in easing the symptoms of inflammation and pain.

Steroid injections, such as a cortisone shot, can also reduce pain or swelling in the foot, as well as decrease any stiffness resulting from certain conditions.

EPAT Shockwave Therapy

EPAT Therapy, also known as Shockwave Therapy, is a noninvasive method for speeding recovery and healing that is a popular treatment method used by podiatrists and sport medicine professionals.

EPAT Therapy Treatment helps muscles and tendons heal faster by sending impulse pressure waves deep within injured soft tissue.

The acoustic pressure waves will reduce inflammation and increase blood flow to the affected area resulting in decreased pain and faster recovery.

EPAT is extremely effective for treating many types of foot injuries such as plantar fasciitis or even heel and ankle conditions.

Physical Therapy

Physical therapy is effective for increasing flexibility and strengthening muscles and tendons as they continue to recover.

A good physical therapy program can also help develop exercises to prevent additional injuries from occurring after recovery.

Caring for the Feet

Taking care of our feet is necessary for preventing injuries or other health issues that might limit mobility.

Pain and swelling on top of the foot, as well as pain just beneath the surface of the skin that may feel like a bruise should never be ignored.

Wearing properly-fitted shoes can protect the feet and lessen the chances of an injury in the future.

Cotton socks can help keep moisture away from the feet better than nylon ones, and feet should always be dry before putting on socks.

It’s important to exercise every day for optimal health, and clean socks should be worn before every new workout. If possible, alternate shoes as well so they have a chance to air out and dry to prevent infection or athlete’s foot.

Keeping our feet healthy is crucial for good mobility and makes it possible for athletes and amateurs alike to perform at their best.

Foot Pain in the Morning

Why Do the Balls of My Feet Hurt in the Morning?

Sharp and achy pains in the bottom of the foot early in the morning are signs of possible inflammation or arthritis. A common diagnosis related to these symptoms is plantar fasciitis, which is an overuse injury of the band of ligament that connects your heel to your toes and supports the arch of your foot.  When you sleep at night, your feet are in a relaxed or plantarflexed position.  This position causes the plantar fascia to shorten while you sleep.  When you first step on your foot it hurts because the tendon is tight!  Please watch this video by orthopedic surgeon Dr. Turner Vosseller on why you should not wait to see a doctor if you have foot pain.

Arches of the Foot

Why do the Balls of My Feet Hurt? Is it my Plantar Fascia? 

Common causes of developing plantar fasciitis include daily activities that require prolonged standing or walking which can cause repetitive strain to the ligament, poor footwear, and tight muscles, and or excessive pronation – which is the inward roll of your foot with walking. Each of these causes can be treated and may provide you with the relief you need to get rid of the discomfort early in the morning. If you think you may be experiencing symptoms of plantar fasciitis, which include foot pain in the morning, click here to read moreor watch this VIDEO.

Ball of Foot Sore

Treatment of Foot Pain and Pain in Arches in the Morning

Orthotics can provide you with sufficient arch support if you have flat feet or can help prevent excessive pronation when you walk. Stretching of proper muscles which include gastrocnemius/soleus can reduce stress through the foot in weight-bearing positions and can reduce foot pain in the morning. Depending on how long you may have been experiencing these symptoms whether it is a chronic issue or acute can determine the length of recovery. 

Exercises for When Ball of Foot Sore

A few excellent ways of helping deal with foot pain in the morning are by performing these specific exercises: towel/sitting/kneeling stretches or rolling a frozen water bottle or ball underneath the foot which helps reduce ligament restriction/tightness and increase circulation to the involved areas. Changing or modifying how you perform certain activities can help result in a speedier recovery process; if you begin to experience discomfort or irritation in the foot make sure you stop that activity before you exacerbate your symptoms. Wearing a stretching sock or night splint may also help while you are sleeping.  Stretching your calf is definitely recommended to increase flexibility and the shortening of the plantar fascia.  

If you are experiencing foot pain in the morning that you can pinpoint the pain to the heel area of your foot, be sure to read more here about heel pain.  You may also want to read about home remedies for foot pain. JOI Rehab clinicians can also help with sesamoiditis treatment and Achilles tendonitis. 

Calf Stretch for Foot Pain in the Morning.

When to See a Doctor When You Have Pain in Feet

To schedule an in-person or Telehealth appointment, please call 904-JOI-2000 or click below.  JOI MD’s also have ASAP appointments available for acute injuries and fractures.

Whether you are suffering from foot issues or injuries resulting from any type of activity, JOI has 12 physical therapy clinics conveniently located in Jacksonville and Northeast FL that specialize in orthopedic rehab.

If you are interested in scheduling an appointment at JOI Rehab for physical therapy, call (904) 858-7045. Come see us!

Jacksonville Orthopaedic Institute is Here for You!

The Jacksonville Orthopaedic Institute will continue to monitor the latest developments of coronavirus disease (COVID-19), we are committed to protecting the health and safety of our patients, families and caregivers. To read more about our safety measures go to JOI4U. JOI & JOI Rehab, encourages all patients to wear a mask to their appointment. Anyone with COVID-19 symptoms, including fever, cough or shortness of breath, should contact 904-JOI-2000 prior to your scheduled appointment. In an effort to adhere to the national social distancing request, please do not bring family members to your appointment unless they are needed for translation or transportation.  You can also complete all of your new patient paperwork from home. To request registration paperwork electronically click HERE.

By: Genesis Villanueva, PT

Foot Pain symptoms and treatment

Plantar fasciitis is a very common foot condition that causes pain in the heel, across the sole of the foot and sometimes into the arch area of the foot.  Foot pain is a normal part of life but if you are suffering it can be worrying and bring daily duties to a standstill. But it can be treated, and in most cases you can do this yourself at home or at work with the right advice.

The pain is caused by swelling of the plantar fascia which is a form of connective tissue that is very important to the biomechanics of the foot.  This tissue connects the heel to the ball of the foot and supports the arch of the foot and takes considerable strain when standing, walking and running.

This condition can affect anyone but is more common in people over the age of 40. Overuse is the most common cause, as well as being overweight, or having altered biomechanics e.g. flat feet, high arches or tight calf muscles.

Plantar Fasciitis symptoms

Pain in the heel, across the sole of the foot (the part in contact with the ground) and possibly spreading to the arch of the foot.  The pain is usually described as sharp, burning and aching and usually develops slowly and doesn’t go away.  It is often at its worst when you first put weight through your foot, so more noticeable in the morning.
Pain can worsen as the day progresses or after long periods of standing and may feel as if the more you do the worse it becomes.

Why does it develop?

It can affect anyone but is more common over the age of 40.  There are a number of theories as to why it develops, and includes factors such as overuse (prolonged standing or walking), being overweight and/or altered biomechanics.  Occupation can also influence its development, ie completing a shift whereby you are stood for 8 hours.

How do I manage my Plantar Fasciitis?

As with many foot and ankle pains it can be treated yourself at home or work without having to see a Physiotherapist or Podiatrist.

Rest and modified activity – for most people keeping off your feet isn’t an option. For this reason alone the pain may take some time to fully resolve, but by trying to reduce activity levels in the first instance, and then gradually increasing them as the pain improves, will aid your recover.  You should use your pain to monitor your progress, for instance if your pain is worse in the  morning, reduces quickly after taking a few steps, and is absent for the remainder of the day you know you are on the road to recovery.  If you have increased your activity and the pain then takes longer to decrease the next day you can be confident that you have over done it and make changes accordingly.

ICE (Cryo-therapy) and massage – it may be tender initially but try massaging the heel and arch area of the foot.   This should become comfortable over time as the areas around the plantar fascia spasm less the tenderness will reduce.  You can simply use your fingers to do this, or ask someone else, or even use something like a rolling pin or golf/tennis ball over the area.

Do this a couple of times a day for approx 5 minutes. Afterwards the heel may feel tender and now would be a good time to consider using ice on the area for 5 -10 minutes in order to get maximum affect. You ,may choose to combine the two by using a frozen water bottle.

Stretching – stretching the foot and ankle has also been proven to be effective in treating the condition.  Stretching should not be painful and you should hold the stretch for at least 30 seconds. As you stretch the resistance will begin to ease as the tissues in the foot start to give.  You should repeat the stretches approx 5 times and aim to repeat all stretches a couple of times a day at least.  Example stretches can be seen below

Poor footwear – can be a contributing factor so it is important to consider the appropriateness and condition of your current footwear and make changes as necessary.   Footwear should;

• Fit well
• Not excessively compress the feet
• Have a cushioned sole
• Be supportive

For more information please see our footwear information.

Insoles or Orthotics – these can be useful in aiding your recovery and can be purchased from a range of pharmacies and sport shops. Over the counter insoles will primarily aim to cushion your heel and support your arches.  You may, in the first instance, choose to try some felt or similar material to see if additional support provides any relieve or increased comfort.

Remember if your symptoms continue without improvement or are getting worse as your GP to refer to PhysioHey and we will provide you with advice, reassurance that you’re doing the right thing, or invite you in to review the situation and help get you back on track.  If you do need to attend for treatment you will still need to complete your exercises at home and it is this combined approach that will be key to resolving your foot pain.

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90,000 Lameness and leg pain

Published: 13.12.2017 Updated: 14.04.2021 Views: 14356 90 003

At the age of 30-40, a man is still full of energy, so he often ignores unpleasant symptoms, for example, pain in the legs.

But in vain, because it is at a young age that physical discomfort may indicate the development of a serious illness.For example, such as chronic obliterating endarteritis, in which there is a violation of blood circulation in the peripheral vessels of the legs. The disease is inherent in men, not women.

How to understand that the disease makes itself felt, and it is necessary to start prevention and / or treatment? It is important to recognize the symptoms in time.

Symptoms of chronic endarteritis

• At the initial stage: sensory disturbance, numbness of the legs.
• Stage of intermittent claudication: the appearance of pain when moving, lameness.Dry skin appears, the nail plate changes.
• Pain occurs at rest. At the same time, erosion is clearly visible on the skin, and a fungal infection may appear on the nails.
• The latest stage, when it is difficult to walk even 10-50 meters without pain in the legs. The shins and feet are “captured” by a necrotic lesion.

In addition, alarming symptoms are a decrease in the amount of hair on the shins, slow growth of nails, long-term non-healing wounds, and scratches on the legs.

Symptoms of the progression of chronic obliterating endarteritis are sad – if prevention and treatment are not started in time, the disease can lead to gangrene, amputation of the lower limb and complete disability.

Endarteritis also increases the risk of coronary and carotid atherosclerosis. This means that the risk of myocardial infarction and ischemic stroke increases.

Diagnostics and prevention of endarteritis

Among young men aged 30-40 years, smokers are most susceptible to endarteritis.Nicotine triples the risk of developing the disease. If a man is sick with diabetes mellitus, suffers from arterial hypertension, had frostbite or serious leg injuries in the past – such a patient needs to be careful!

In order to differentiate endarteritis from atherosclerosis, since the symptoms in the initial stages may be somewhat similar, CITILAB conducts a number of special studies:

To restrain the development of the disease, it is necessary to eliminate provoking factors, regularly conduct courses of drug therapy and be monitored by a doctor.

Be healthy!

Author:
Baktyshev Alexey Ilyich, General practitioner (family doctor), ultrasound diagnostics doctor, chief physician

90,000 German cardiologists named the symptoms of heart attack

Cardiologists in Germany have listed symptoms that can indicate heart problems and warn of the risk of a heart attack.

According to experts, you should immediately consult a doctor if extrasystole – one of the types of arrhythmia – is repeated several times during the day and lasts longer than 30 seconds.

In addition, arrhythmias during dizziness, pain and burning in the chest, and shortness of breath are also considered serious signals. It is worth making an appointment with a specialist even with a sudden increase in heart rate for no apparent reason, for example, in the absence of physical activity.

Pain in the legs can indicate heart problems. So, the pain that occurs in the calf area when walking and subside after stopping is a symptom of atherosclerosis of the vessels of the lower extremities. It is worth paying attention to the pain around the toes, which appears when lying down and disappears when a person stands up.

In addition, according to cardiologists, people who have had the flu are at risk. If, after recovery, a person still feels weak and cannot return to his usual way of life, then this may indicate inflammation of the muscular middle layer of the heart – myocarditis. Other symptoms are swelling of the legs, a feeling of pressure in the chest, an irregular pulse and shortness of breath with low physical exertion, Izvestia writes.

Most people know the symptoms of a heart attack: sharp chest pain, a sharp increase in pressure, dizziness, difficulty breathing, and cold sweats. However, an acute heart attack is not the only threat to the heart. There is also the so-called “silent heart attack”, which can be experienced and not understand it.

A Harvard University study found that incidences of an imperceptible heart attack are almost as common as an acute one.Co-author of the scientific work, Professor George Platzky , said that the symptoms of a silent heart attack are mild and do not last long, so they are often mistaken for a common malaise and ignored.

As a result, scars appear on the heart, it starts to work worse, and the risk of a second attack greatly increases.

A heart attack can easily be confused with a disease of the digestive system, since the symptoms of angina, a condition preceding a heart attack, often resemble stomach pain or heartburn. How to distinguish between these two states.

Restless legs syndrome

Restless legs syndrome (RLS) is a neurological disease manifested by paresthesias in the lower extremities and their excessive motor activity, mainly at rest or during sleep.

Restless Legs Syndrome was first described by Thomas Willis in 1672: “Some people, when they are going to sleep and go to bed, immediately after that there is a movement of tendons, arms and legs, accompanied by colic and such anxiety that the patient cannot sleep, as if he is under torture. “The modern definition of this syndrome was proposed by the Swedish scientist K. Ekbom in 1945:

Restless legs syndrome can be primary (idiopathic) and secondary.

One of the most probable causes of the development of primary restless legs syndrome is considered to be the insufficiency of the dopaminergic systems in the subcortical structures of the brain involved in inhibitory processes.

Secondary restless legs syndrome can develop during pregnancy and various pathological conditions.

The main causes of secondary restless legs syndrome are:

1. Iron deficiency. Iron deficiency disrupts the production of dopamine in the brain, which in turn provokes the development of secondary RLS. A patient’s iron stores may be depleted even without clinically significant anemia. Studies have shown that a decrease in iron stores, as measured by a decrease in ferritin levels below 50 mcg / L, can cause or worsen RLS symptoms.
2. Neurological disorders.Secondary RLS is often observed in spinal cord and peripheral nervous system injuries, as well as peripheral neuropathies of various origins (diabetic, alcoholic, toxic).
3. Pregnancy. RLS occurs in 15-20% of women during pregnancy. Symptoms can be severe, but usually resolve completely within a few weeks after delivery. It is assumed that the causes of RLS during pregnancy can be iron deficiency anemia, folate deficiency, hormonal changes and venous congestion in the lower extremities.
4. Uremia. Up to 50% of patients with end-stage renal disease have RLS. RLS incidence was shown to correlate with blood urea levels, anemia, peripheral neuropathy, and a decrease in parathyroid hormone levels in this category of patients. Particularly severe symptoms are noted directly during dialysis, when the patient is forced to lie still for several hours. RLS symptoms have been shown to decrease or disappear after kidney transplantation.
5. The use of medicines.RLS symptoms can develop or worsen with the use of various medications, such as tricyclic antidepressants (amitriptyline, azafen, etc.), selective serotonin reuptake inhibitors (trazodone, Prozac), lithium preparations, metoclopramide (raglan), calcium channel blockers (corinfen finoptin). Caffeine also makes RLS symptoms worse.

Clinical manifestations of RLS can be grouped into several main symptom complexes:

Unpleasant sensations in the legs. They are commonly described as creeping, shivering, tingling, burning, twitching, electric shock, wiggling under the skin, etc. About 30% of patients describe these sensations as painful. Sometimes patients cannot accurately describe the nature of the sensations, but they are always extremely unpleasant. These sensations are localized in the thighs, legs, feet and arise in waves every 5-30 seconds. There are significant fluctuations in the severity of these symptoms. In some patients, symptoms may occur only at the beginning of the night, in others, it may be disturbing continuously throughout the day.

Symptoms are worse at rest. The most characteristic and unusual manifestation of RLS is an increase in sensory or motor symptoms at rest. Patients usually report worsening while sitting or lying down, and especially when falling asleep. It usually takes from a few minutes to an hour before symptoms appear when the patient is calm.

Symptoms are better with motion. Symptoms greatly improve or disappear with movement. Walking is most often the case.Stretching, bending over, exercise on a stationary bike, or just standing up can help in some cases.

Symptoms are circadian. Symptoms are significantly worse in the evening and in the first half of the night (between 6 pm and 4 am). Before dawn, symptoms subside and may disappear altogether in the first half of the day.

It should be noted, however, that sometimes there may be diagnostic difficulties in the differential diagnosis of primary and secondary restless legs syndrome.Since there are no precise biochemical markers for primary RLS, it is not possible to say with certainty whether the above condition is the cause of secondary RLS, or whether it only triggered the clinical manifestations of primary RLS.

Valuable diagnostic information to confirm the presence of restless legs syndrome can be obtained from polysomnography, a method of long-term recording of various physiological parameters during sleep.

If you or your relatives want to fully rest during sleep, we are waiting for you in the sleep department of the Medical and Diagnostic Center of the International Institute of Biological Systems named after S. M. Berezina.

Give yourself a healthy sleep!

90,000 diagnostics and treatment in the clinic of Krasnoyarsk

Sensory impairment in the toes may be accompanied by tingling or burning sensation, and difficulty walking is common. The reason for going to the clinic of Dr. Savyak is chronic numbness in the lower limb. This condition is dangerous with injuries and wounds that cannot be felt due to a decrease or complete loss of sensitivity. Mobility problems increase, which means that the risk of falling increases.

Causes of numbness of toes

The body contains a complex network of nerves responsible for sensitivity.If the nerve is damaged, compressed, or irritated, the connection is cut off and no signals are received. Because of this, temporary or chronic paresthesia occurs. It is caused by a number of reasons:

• protrusion of the intervertebral disc and its complication – hernia ;
• spinal cord injury ;
• sciatica – back pain due to damage to the sciatic nerve;
• osteochondrosis of the lumbar spine;
• tunnel syndrome due to prolonged uncomfortable posture or the same type of work;
• arthritis .

Sensation loss in fingers is sometimes felt after fitness or sports. In these cases, there is no need to worry: it happens that the nerves are pinched during physical exertion, but this is a short-term condition.

You should immediately seek the help of doctors if the numbness of the foot is accompanied by muscle weakness, impaired coordination, loss of sensitivity in any other part of the body, facial asymmetry and slurred speech.

The most effective treatment for numbness in toes

Correction of the condition of patients in the clinic of vertebrology of Dr. Oleg Savyak depends on the nature of the disease of the spinal column or joints, which caused numbness of the foot.Typically, therapy includes manual manipulation and traction of the spine , aimed at relaxing the pinched nerve roots. Also used arthrotherapy – the author’s soft technique without discomfort, jerks or blows.

manual massage, physiotherapy, remedial gymnastics and the intake of safe supporting drugs help to consolidate the beneficial result.

Take care of your health on time: if you repeatedly notice that your toes become numb, contact the spine rehabilitation clinic of Dr. Savyak for an examination!

90,000 what can these symptoms indicate?

Pain in the leg can be of various shades and be as mild, which is tolerated by the patient and disappears over time, or debilitating so much that it interferes with sleeping, walking, or participating in simple daily activities.The pain can take many forms – some patients describe the pain as a burning, throbbing pain, or one that causes a burning sensation. It can also be accompanied by other symptoms, such as feeling like needles are being stuck in a certain place and / or accompanied by numbness and weakness in the limbs.

Leg pain can occur due to problems with the lower extremities, but quite often such radiating pain can be caused by problems with the lumbar spine, where the sciatic nerve originates.This pain along the path of the sciatic nerve is called sciatica.

Among the possible causes of pain in the lower extremities, one should not exclude the option of pinching the sciatic nerve, especially if the pain is concentrated in the area of ​​the thigh and / or ankle or foot.

Symptoms and clinical picture of leg pain

Leg pain associated with lesions of the lumbar spine does not always have the same symptomatology in all patients. Leg pain caused by osteochondrosis of the spine can present with additional symptoms and vary widely.

Some of the most common manifestations of leg pain and accompanying symptoms:

• Burning pain. Some patients may experience burning pain in the leg that starts from the lower back and runs through the buttocks down the leg, while others complain of intermittent shooting pain that “pulses” from the lower back and down the leg. At the same time, the words that can describe such pain, patients use the following – radiating, electric or shooting, which literally feels like a throbbing pain. Unlike many forms of low back pain, which can often be dull, for many, leg pain can be excruciating and almost unbearable. This type of pain often manifests itself as a burning sensation when the nerve root is pinched and irritated. This phenomenon in medicine is called “radiculitis”.
• Numbness or tingling in the leg. Anyone who has sat up or fell asleep at least once in a bent leg position knows how it feels when the leg starts to move again and normal blood circulation is restored in it.Against the background of such numbness, a person becomes unable to feel pressure, temperature, etc. Unlike the temporary numbness described earlier, the numbness caused by neurological disorders is permanent and can significantly worsen the patient’s life. For example, it can cause difficulties in driving a car, getting around, etc. Typical symptoms can range from a slight tingling sensation radiating down the leg to the foot.
• Weakness (unsteadiness in gait) or heaviness in the legs. Basically, patients complain of weakness or heaviness in the legs, which interferes with movement. Patients, describing this condition, say that the legs do not obey, it is necessary to make significant efforts to move or climb stairs. Patients who experience weakness in the legs cannot walk on the heels or perform heel-to-toe rolls.
• Constant pain. This type of pain is usually felt in the buttocks. Quite often, pain can arise and radiate along the lower limb.This type of pain is commonly described as “neuralgia,” as opposed to throbbing pain, this pain is usually present on only one side, and is commonly referred to as sciatica or radiculopathy lumbar. This pain can be relieved by relieving stress on the spine and relaxing movements.
• Pain in the leg in a certain position. If leg pain worsens sharply while sitting, standing, or while walking, it may indicate a problem in a specific part of the lumbar spine.Finding a more comfortable position can usually ease the pain. For example, leaning forward can relieve pain associated with spinal stenosis.

Exercises to reduce the symptoms of intermittent claudication

Relevance

Intermittent claudication is a cramping leg pain that occurs when walking and resolves with rest. It is caused by insufficient blood supply to the leg muscles due to atherosclerosis (fatty deposits that restrict blood flow through the arteries).People with mild to moderate lameness are encouraged to keep moving, quit smoking, and address risk factors for cardiovascular disease. Other treatment options include antiplatelet therapy, pentoxifylline or cilostazol, angioplasty (inserting a balloon into an artery to open it), and bypass surgery.

Research and Key Findings

The review authors found 32 controlled trials in which 1,835 adult participants with stable leg pain were randomized to exercise, routine care, placebo, or other interventions (as of November 2016). Researchers assessed outcomes over periods ranging from two weeks to two years. The types of exercise ranged from strength training to walking with poles and exercises for the upper or lower extremities; in general, supervised sessions were held at least twice a week. The quality of the included trials was moderate, mainly due to a lack of relevant information. Ten trials reported that in the exercise groups, the pain-free walking distance and the participants’ maximum walking time were increased.Improvements have been observed for up to two years. Exercise did not improve the ankle-brachial blood pressure index. There is no evidence of an effect of exercise on mortality or the need for amputation as data were limited. The researchers assessed quality of life using the SF-36 questionnaire at three and six months. After three months, quality of life scores – “physical function”, “vitality” and “physical role” – improved with exercise, but the data are limited as this was reported in only two trials. Five studies reported improvements in “overall physical score” and four reported improvements in “mental health scores” after 6 months of exercise. Two trials also reported improvements in “physical function” and “overall health.” All other indicators did not improve at 6 months after exercise.

Comparisons of exercise with antiplatelet therapy, pentoxifylline, iloprost, vitamin E, and pneumatic foot and calf compression were limited because the number of trials and participants found was small.

Quality of evidence

This review shows that exercise programs improve walking distance in people who are suited to exercise regimens. This beneficial effect lasts for two years. The quality of the evidence presented in this review ranged from moderate to high. While the differences between trials were clear, the populations and outcomes were broadly comparable, and the results were relevant for people with intermittent claudication. Pooled results were obtained from large populations — over 300 participants for most outcomes — using reproducible methods.