September 21, 2020: Why do I have pain in the arch and big toe?
What is the cause of my arch and big toe pain?
At Maidenhead Podiatry and Chiropractic Clinic, our Podiatrists are often asked about foot pain located in the inner long arch or inside of the foot. The pain often associated with pain in the large/big toe joint. It can also radiate up the leg.
When do I get the pain?
When exercising, the pain often doesn’t come on straight away, but can develop some time after starting. What can be happening, halfway through a round of golf or some miles into a walk, is that the small supporting muscles of the foot become fatigued. It may come on more rapidly with high impact exercise such as running. Inflammation may be involved meaning that the pain worsens the day following exertion.
Where do I get the pain?
Pain or discomfort can manifest along the inside of the foot or the inner longitudinal arch. It can also be associated with pain the base of the big toe and into the joint.
Because the discomfort of the foot is usually due to mechanical changes this can refer to compensation pain up the leg and into the knee, hip, or back.
Why do I get the pain?
If you ‘overpronate’ it causes medial or inward rotation of the lower leg, which can cause stress at the knee, misalignment of the hips, and resultant lower back pain. The degree of ‘pronation’ can vary from person to person and used to be known as ‘flat feet’ although the actual cause is more complex. As the muscle fatigue, this allows the arch to over-extend further stressing the support tissues and increasing discomfort.
Think of your feet as the ‘foundation’ for the rest of the body. Ensuring your feet are correctly aligned allows the rest of the kinetic chain or biomechanical relationship between the feet and the rest of the body to function efficiently. Big toe joint pain can be due to a number of reasons including inflammation, arthritis, and poorly fitting shoes.
What can I do about it?
What is most important with any foot pain is to ensure a correct diagnosis. This ensures targeted and appropriate treatment. This starts with a bio-mechanical assessment.
The assessment focuses on structure, alignment, strength, and starts with the foot. This includes pelvis, hips, knees, feet and their relationship, as pain in one area can result in or cause weakness or a structural problem somewhere else.
A biomechanical assessment is essential where there is a pain in the feet or lower limbs but no cause has so far been established. Sometimes simple recommendations on footwear can make a huge difference especially sports shoes. Simply tying shoelaces properly can dramatically increase the support offered to the foot by a shoe. There are many different ways to lace a shoe. For ideas and a bit of fun, click here for lacing ideas.
Pain in the large toe can be associated with this but can also be due to shoe pressure on the inner edge of the apex of the toe.
Buy shoes that have a square toe box to reduce this pressure.
What can we do about it?
Podiatrist Jeremy Ousey has a special interest in bio-mechanics There are numerous choices following a biomechanical assessment. The outcome of the assessment determines the appropriate treatment. If the mechanics of the foot are contributing to injury or pain, orthotics or custom made insoles are prescribed, moulded from a foam impression of the feet.
The orthotics are prescribed in conjunction with exercises and a carefully constructed rehabilitation plan. Footwear is also considered and recommendations made.
Topical treatments such as Shockwave can be very effective in the treatment of foot and lower limb pain.