Pain on Outside of Foot – Causes, Treatment & Prevention | Pain Care

Pain on Outside of Foot – Causes, Treatment & Prevention

Lateral Foot pain – One of the most common pain that many people have to endure every day. It is too disturbing to ignore. Our feet carry us daily from one place to another and once it hurts, you want a treatment to keep on track in your life.

The feet are integrated network of muscles, ligaments, bones, and tendons. They should be strong enough to bear your body weight, however, they are susceptible to injury, pain, overuse, and strains.

To address the cause of your foot pain, You need to know the exact location of your pain. Pain on the outside of your foot is called ” Lateral foot pain“, While the one on the inner side is called ” medial foot pain“. Some might experience pain on top of foot.

The onset pattern of the pain is very important as well to determine the cause of the foot pain. It might come suddenly (acute) or gradually (chronic). It can be mild or severe. Until you know the exact cause of the pain, it is best to rest and avoid further injuries.

What Causes the Pain on Outside of Foot?

There are many common causes for the pain on the outside of the foot.

We are going to cover a list of the common causes, how they present, and the symptoms and signs for each one.

Stress Fracture

The most important and dangerous cause that needs to be excluded first. Stress fracture also called hairline fracture, occurs when repetitive small fractures are implied on foot bones.

Those are microfractures and painless in the beginning until you put some stress such as running or vigorous exercise. At that time, it gets worse and starts to hurt.

Lateral foot pain from stress fracture happens in the calcaneus or navicular bone. Metatarsals are the most commonly affected on either side of the foot either medial or lateral depending on the affected side.

Diagnosis: It can be easily diagnosed in the physical examination; The doctor will try to apply some pressure on the outside of the foot and ask you if it hurts. If yes, you will need to rest for 6-8 weeks. Imaging can be also very helpful such as CT, MRI scan, and X-ray.

Treatment: It usually includes many steps

  • Rest: The most important step to recover quickly. Try to avoid any intense exercise such as running or apply any pressure on your feet. Failure to do so will lead to delayed healing and complications.
  • Ice Packs: They are helpful to reduce the inflammation and pain.
  • Leg Elevation: It will help if it is swollen.
  • Braces and crutches: It might be helpful to decrease the pressure on your foot.
  • Medications: Your physician might prescribe painkiller medications such as Tylenol(acetaminophen) or Paracetamol.
  • Surgeries: Very rare in the stress fracture. And only applied if you failed to heal.

 Cuboid Syndrome

Cuboid is one of the tarsal bones on the outside foot. If there is too much pressure on it, It might lead to dislocation, and subsequently cuboid syndrome.

The pain usually spread down to the toes, much worse in the morning and better with rest. It affects 7% of the ankle sprain patients. Overuse is the most common cause, however, other possible causes such as wearing tight shoes and spraining near the cuboid region.

Please consider the cuboid syndrome, especially if you have ongoing outside foot pain for more than 3 months following an ankle sprain.

Diagnosis: Usually through a physical examination which reveals red and tender area and radiological imaging such as MRI scans, CT scans, and  X-rays.

Treatment: Rest for 6-8 Weeks, wearing comfortable shoes, and physical therapy if needed, especially when the joints are dislocated. It usually resolves in few weeks after the treatment.

Ankle Sprain

An ankle sprain is one of the most common causes of lateral foot pain. It represents 85% of people with lateral foot pain.

Ankle inversion or sprain might lead to foot instability. Given that 35% of the people with foot instability might get recurrent sprains, Physical rehabilitation is essential to prevent such complication.

Ankle sprains affect any ligaments but Anterior Talofibular Ligament (ATFL) is the most commonly affected one. Possible causes are high heels, sports, or trauma.

Diagnosis: Physical examination reveals pain, swelling, tenderness, bruising around the ankle. X-rays might be helpful to exclude any broken bones.

Treatment: Usually varies according to the severity and grade of the sprain.

  • Rest for 6-8 weeks.
  • Surgery is not done even in the severe forms unless the ligament is torn.
  • Physical Rehabilitation to prevent recurrence and further injuries.
  • Medications such as NSAIDs to relieve the pain.

Peroneal Tendonitis

Peroneal tendon runs from the back of calf, the heels, edge of your ankle, up to the bottom of the big toe.

Peroneal tendonitis is caused by repetitive pressure on the peroneal tendon by running, inversion of the ankle, and abnormal foot position. It is associated with inflammation and degeneration.

Diagnosis: Physical examination reveals pain, swelling, weakness, warmth, and popping sensation around the ankle.

Treatment: It depends if the tendons are just inflamed or torn.

  • Medication such as NSAIDs to decrease the pain.
  • Surgery in cases of torn ligaments to repair them.
  • Physical therapy to increase the foot range of motion.
  • Exercise such as stretching might help to strengthen peroneal muscles.

Corns and Calluses

Corns and calluses could happen anywhere on the foot.

They develop as a result of repetitive friction to the skin on the side of the foot, leading to the growth of extra layers of skin to protect the foot. They usually do not cause pain unless it affects deeper layers of the skin.

Diagnosis: Usually by History and physical examination.

Treatment

  • Change the types of footwear
  • Shoe inserts and pumice stone: to reduce the pressure and soften the skin
  • Creams and chemicals to break down the hard skin and peel any dead skin away

Bunions

When the big toe goes inward and points to the other toes, the base of the toe will be outwards producing a lump of the big toe.

Little toe is less commonly affected and called ” bunionette”. Causes include the improper footwear, high heels, and some diseases such as gout and rheumatoid arthritis in patients with a genetic predisposition.

Diagnosis: Physical examination reveals inflammation, redness, and malposition of the big toe.

Treatment: Changing the footwear is the best strategy, however, treatment might include surgical and non-surgical options such as orthotics to correct the position of the big toe.

Tarsal Coalition

This is a congenital disease that causes improper connection between the tarsal bones at the back of feet. Those people do not have any symptoms till the teenage.

It is not very common compared to other causes of outside foot pain. The symptoms include pain in the back of feet, stiffness, gait imbalance especially after a long period of exercise, and flat feet.

Diagnosis: Physical examination and Imaging.

Treatment:

  • Foot inserts to support your feet
  • Physical rehabilitation to strengthen feet.
  • Medications such as NSAIDs to relieve pain
  • Temporary casts and boots to stabilize tarsal bones

 Arthritis

One of the leading of lateral foot pain worldwide. It comes in two forms–inflammatory (rheumatoid arthritis) and degenerative (osteoarthritis). It varies in severity and any joint in the foot might be affected.

Diagnosis: Physical examination shows pain, swelling, stiffness, and cracking sound especially in Osteoarthritis. Radiological imaging might be helpful to differentiate the cause.

Treatment

  • Medications such as NSAIDs and Corticosteroid to relieve the pain and swelling.
  • Physical therapy is helpful, especially in osteoarthritis to relieve the stiffness.
  • Surgery: very rare and if needed, it will be joint repair.

Posterior Tibial Tendonitis

Posterior tibial tendonitis is a common cause of medial foot pain. The pain is usually worse with exercise, better with rest. Flat feet patients are commonly affected group.

Common causes include overuse, injury, medical conditions such as gout and rheumatoid arthritis.

Diagnosis: Physical examination shows painful, swollen and stiffness on the inner side of the foot.

Treatment: Includes rest for few weeks, ice packs, leg elevation, and pain medications if needed.

Lateral Foot Pain Prevention & Exercises

 After discussing the specific treatment for each cause of outside foot pain. There are few tips that are helpful to reduce the pain regardless of its cause.

The most common approach is RICE method:

  • Rest.
  • Ice Packs.
  • Compression of the foot by an elastic bandage.
  • Elevation of your foot.

Other tips for relieving pain on the outside of your foot include:

  • wearing comfortable and well-fitting shoes.
  • stretching your feet for at least 10-15 minutes before exercising
  • Avoid daily and vigorous exercises to give your feet a break
  • Try to maintain a healthy body weight.

The Take-Home Message!

Outside foot pain is a very common condition. If you started to feel such pain, try to rest for few days. If it did not go away, It is the best to see a doctor and know what is causing that.

Dr. Sachin
 

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