Deep pain in the soles of both feet?
Hello, Doctor.
I would like to ask you: A few days ago, I started experiencing mild pain in the soles of both feet, which has progressed to localized pain today.
The affected area includes the five toes (with the big toe experiencing more stabbing pain), and the pain is more pronounced in my right foot compared to my left.
Occasionally, I also feel a slight stabbing sensation, but there are no visible issues on the surface.
I noticed that the pain is most noticeable in the morning when I first get out of bed, and my entire foot feels sharp and numb.
During normal activities, I only feel deep pain in the soles when walking; when I'm not walking, I don't feel anything.
As a result, I tend to walk on my heels.
Additionally, I've been feeling down lately, experiencing headaches and a desire to sleep, and I'm not sure if this is related to my foot pain causing me distress.
I've never felt this way before, and I'm quite worried.
Over the past few days, I've also moved a lot of heavy items, including lifting a 30-kilogram table by myself a few days ago.
I wonder if this could be related...
Thank you for your response, Doctor! Thank you.
Xia Zhi, 20~29 year old female. Ask Date: 2018/02/20
Dr. Jiang Junyi reply Neurology
Hello: Your symptoms may suggest Tarsal Tunnel Syndrome, as the posterior tibial nerve is compressed while passing through the tarsal tunnel behind the medial malleolus.
Common clinical symptoms include numbness, burning sensations, tingling, and other abnormal sensations in the heel area.
Initially, there may be a decrease in sensation, which can progress over time.
Symptoms tend to worsen after prolonged walking and are relieved by rest.
Causes of Tarsal Tunnel Syndrome include calcaneal fractures, ganglion cysts, flatfoot deformities, neuromas, and excessive thickening of the flexor retinaculum, all of which can increase pressure in the tarsal tunnel.
Diagnosis is based not only on clinical complaints but also on the finding that percussion along the tunnel can exacerbate pain.
Electromyography can assist in differential diagnosis, and X-rays can determine if there are any bony protrusions in the tarsal tunnel.
Treatment principles vary depending on the underlying cause, typically involving the use of splints, oral non-steroidal anti-inflammatory drugs, local steroid injections, restriction of excessive activities, and appropriate physical therapy.
It is advisable for you to consult with a neurologist or a rehabilitation specialist for discussion and treatment.
Wishing you good health and peace.
Dr.
Tao, Neurology, cares for you.
Reply Date: 2018/02/20
More Info
Understanding deep foot pain can be complex, especially when it arises suddenly and is accompanied by various symptoms. Based on the description provided, it appears that you are experiencing pain in the soles of your feet, particularly around the toes, with a notable difference in intensity between your right and left foot. The pain is exacerbated in the morning when you first get out of bed and seems to improve somewhat with rest. Additionally, you mentioned a recent history of lifting heavy objects, which could indeed be a contributing factor to your symptoms.
The symptoms you describe could potentially be linked to several underlying conditions. One possibility is Tarsal Tunnel Syndrome, which occurs when the posterior tibial nerve is compressed as it passes through the tarsal tunnel near the ankle. This condition can lead to sensations of tingling, burning, or sharp pain in the foot, particularly in the heel and arch areas. The fact that your pain is more pronounced in the morning and improves with movement may suggest that the nerve is being compressed or irritated, leading to discomfort during initial activity.
Another potential cause of your symptoms could be plantar fasciitis, which is characterized by inflammation of the plantar fascia, the thick band of tissue that runs across the bottom of your foot. This condition often presents with sharp pain in the heel or arch of the foot, especially after periods of inactivity, such as sleeping. The pain typically decreases with movement but can return after prolonged activity.
Your recent heavy lifting could also have contributed to muscle strain or overuse injuries, particularly if you are not accustomed to such physical exertion. Straining the muscles and ligaments in your feet can lead to localized pain and discomfort, especially if proper lifting techniques were not employed.
In terms of management, there are several strategies you can consider to alleviate your symptoms:
1. Rest and Ice: Allow your feet to rest and apply ice to the affected areas to reduce inflammation and pain. Avoid activities that exacerbate your symptoms, especially heavy lifting or prolonged standing.
2. Footwear: Ensure that you are wearing supportive footwear that provides adequate cushioning and arch support. Avoid high heels or shoes with inadequate support, as these can exacerbate foot pain.
3. Stretching and Strengthening: Engage in gentle stretching exercises for your calves and feet to improve flexibility and reduce tension. Strengthening exercises for the foot and ankle can also help support the structures of the foot.
4. Orthotics: Consider using orthotic inserts in your shoes to provide additional support and cushioning. Custom orthotics can be particularly beneficial if you have specific foot mechanics that contribute to your pain.
5. Physical Therapy: If your symptoms persist, consulting a physical therapist may be beneficial. They can provide tailored exercises and treatments to address your specific issues.
6. Medical Evaluation: If the pain continues or worsens, it is important to seek a medical evaluation. A healthcare professional can perform a thorough examination, potentially including imaging studies, to rule out any serious underlying conditions.
Lastly, it is important to address the emotional aspects of dealing with chronic pain. Pain can significantly impact your mood and overall well-being, leading to feelings of frustration or depression. Engaging in stress-reducing activities, such as mindfulness or gentle yoga, may help improve your mental health while you manage your physical symptoms.
In summary, while your symptoms may be related to recent physical activity, it is essential to consider various potential causes and seek appropriate management strategies. If your pain persists or worsens, do not hesitate to consult a healthcare professional for further evaluation and treatment.
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