Foot Pain: Causes and Remedies for Painful Steps - Rehabilitation

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Pain on the dorsum of the foot, especially during the first few steps while walking?


Hello, doctor.
I have been experiencing intermittent pain on the dorsum of my right foot for about three weeks.
The pain is located approximately on the outer midsection of the dorsum, extending to a concave area near the ankle bone.
It does not hurt when I am sitting, but I feel pain when I stand up and walk.
However, after taking a few steps, the pain significantly decreases, and I almost feel no pain afterward.
The pain only occurs during the moments when I stand up and walk after sitting for a while.
What could be the possible cause? Should I go to the hospital for an examination? I find that massaging the ankle bone can alleviate the pain when I stand up and walk; is this advisable? Thank you.

Changlin, 30~39 year old female. Ask Date: 2019/05/13

Dr. Li Yanheng reply Rehabilitation


It could be gout or ligament/tendon inflammation, and blood tests and ultrasound examinations are acceptable.

Reply Date: 2019/05/13

More Info


Foot pain can be a common yet complex issue, and understanding its causes and potential remedies is essential for effective management. Based on your description, the pain you are experiencing in your right foot, particularly around the mid-outer side of the foot and the ankle, could be attributed to several factors.


Possible Causes of Foot Pain
1. Tendonitis: Inflammation of the tendons around the ankle or foot can cause pain, especially when transitioning from a seated to a standing position. This is often exacerbated by activities that involve repetitive motion or strain.

2. Plantar Fasciitis: Although this condition typically presents with heel pain, it can also cause discomfort in the arch and the midfoot area. The pain is usually worse after periods of inactivity, such as sitting.

3. Nerve Compression: Conditions like tarsal tunnel syndrome, where the posterior tibial nerve is compressed, can lead to pain and discomfort in the foot, particularly when standing or walking after sitting for a while.

4. Stress Fractures: If you have recently increased your activity level or changed your footwear, stress fractures in the metatarsal bones could be a possibility. These often present with localized pain that worsens with weight-bearing activities.

5. Arthritis: Conditions such as osteoarthritis can lead to joint pain, particularly in the midfoot and ankle. This pain may be more pronounced after periods of inactivity.


Recommendations for Management
1. Rest and Ice: If the pain is due to inflammation, resting the foot and applying ice can help reduce swelling and discomfort.

2. Footwear: Ensure that you are wearing supportive shoes that fit well. Shoes with inadequate support can exacerbate foot pain.

3. Stretching and Strengthening: Gentle stretching of the calf muscles and the Achilles tendon can help alleviate tension on the foot. Strengthening exercises for the foot and ankle can also improve stability and reduce pain.

4. Massage: As you mentioned, self-massage around the ankle and foot can provide temporary relief. Focus on the areas that feel tight or painful, but be cautious not to apply excessive pressure that could worsen the pain.

5. Gradual Activity Increase: If you have recently increased your activity level, consider scaling back and gradually increasing your activity to allow your foot to adapt.

6. Consult a Specialist: If the pain persists or worsens, it is advisable to consult a healthcare professional, such as a podiatrist or orthopedic specialist. They can perform a thorough examination, possibly including imaging studies, to determine the exact cause of your pain and recommend appropriate treatment.


When to Seek Medical Attention
If you experience any of the following symptoms, it is crucial to seek medical attention promptly:
- Severe pain that does not improve with rest or home remedies.

- Swelling or bruising that develops around the painful area.

- Difficulty bearing weight on the affected foot.

- Any signs of infection, such as redness, warmth, or fever.

In conclusion, while self-care measures can often alleviate foot pain, understanding the underlying cause is essential for long-term relief. If your symptoms persist, do not hesitate to seek professional medical advice to ensure proper diagnosis and treatment.

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