Introduction
As a much-used organ of human movement, the feet are exposed to constant stress. Pain in the back of the foot is usually caused by pathological changes in the tarsal or tarsometatarsal joints, which are held in place by numerous ligaments and vision. However, stiffening of the metatarsophalangeal joints of the toes can also cause pain in the back of the foot. Urgent clarification by an orthopedic specialist is required if the complaints persist for more than three days or occur in conjunction with other diseases. If signs of inflammation such as overheating, swelling and redness are present and lead to a significant restriction of movement, a specialist should be consulted urgently.
Symptoms and possible causes
Depending on the underlying cause, the severity of the pain may vary. Pain on the back of the foot is often felt through stinging, which is often intensified depending on the load. Pain is rarely the only symptom.
For example, if there is an inflammation, the foot is swollen, overheated, reddened and painful under pressure. Symptoms such as tingling and numbness occur when there is strong pressure or injury to a nerve. Broken bones in the area of the metatarsal bones can cause severe pain when rolling or make it impossible for the foot to roll.
Often a traumatic event, such as twisting or strong impact with the foot, precedes the fracture. In the treatment of metatarsal fractures, surgery is sometimes necessary. Pain when rolling is also a typical symptom of hallux rigidus.
These are arthrotic changes in the metatarsophalangeal joint of the big toe. The increasing stiffness of the joint causes discomfort, especially when the foot rolls. Chronic wear and tear processes are often caused by incorrect and excessive strain.
The basic disease gout can also lead to arthrosis. Besides pain when rolling, the metatarsophalangeal joint of the big toe often feels swollen and warm. Increasing problems arise when putting on shoes.
In many cases, the symptoms worsen in cold temperatures. In the therapy of hallux rigidus, conservative measures such as physical treatments, shoe insoles and anti-inflammatory drugs are prescribed (see insoles for hallux rigidus). The surgical therapy includes joint-preserving and non-joint preserving operations.
Stinging pain is often observed in conjunction with swelling and redness on the back of the foot. These are inflammatory changes in the tarsal joints. There are several possible causes.
As a result of unaccustomed physical exertion, a so-called bursitis can develop. Due to the strong pressure and the high strain, the bursae become inflamed, which normally ensure that the surfaces between the joints slide smoothly. To prevent chronic bursitis, the joints should be spared until the symptoms have subsided completely.
Not only the bursae are a possible source of pain after overloading, but also the tendon sheaths. When a bulging occurs, one speaks of a so-called ganglion, which is colloquially known as the “overbone”. A bulging of the tendon sheaths on the back of the foot is one of the rare variants of a ganglion.
Besides protecting the foot, cooling measures and anti-inflammatory drugs are used in the treatment. This topic might also be of interest to you: Pain on the inside of the footDeviations in the shape of the arch of the foot also cause pain when walking. The healthy foot is a stable structure consisting of a longitudinal and transverse arch, which distributes the body weight evenly.
This construction is held in shape by ligaments and tendons. The tibialis posterior tendon in particular makes a significant contribution to this. In adults, a flat-foot kink often occurs when the tension of this tendon decreases (see flat foot).
The following instability of the arch of the foot causes pain when walking, which preferably occurs at the inner edge of the foot and extends to the inner ankle. Pain also occurs on the outer edge of the back of the foot. In most cases, a flat-foot is treated conservatively with shoe insoles and physical measures.
Osteoarthritis of the tarsal is also known as arthrosis of the Lisfranc joint and causes load-dependent pain on the back of the foot. A possible cause of arthrosis is a previous fracture of the tarsal bone.Only when conservative treatment measures fail, a tarsal arthrodesis is performed. The joints are surgically stiffened.
Anterior tarsal tunnel syndrome can occur in conjunction with pain on the back of the foot. Strong pressure on the anatomical tunnel through which nerves and vessels pass can cause pain that is both load-dependent and load-independent. It is important to clarify the exact cause.
The therapy can be performed conservatively and surgically. Pain on the back of the foot rarely occurs in isolation after a twisting trauma. The painful symptoms usually show a greater spread.
The foot swells due to the tissue injury. In some cases the ankles are also affected. Areas that turn blue indicate bleeding from torn vessels.
The traumatic event can result in a stretching, tearing or even a complete rupture of the ligaments of the foot. Fractures in the metatarsal area are also possible and should be urgently excluded. If the symptoms are severe and persistent, a doctor should be consulted urgently for further clarification.
In the acute situation, it is recommended to put the foot up, cool it and apply pressure with the help of a compression bandage. Persistent sharp, stabbing pain is observed in connection with gout, rheumatism and other metabolic diseases. The pressing of a nerve, on the other hand, is accompanied by a burning, sometimes dull pain, often accompanied by numbness and tingling.
This is the case with tarsal tunnel syndrome, for example. Inflammation, for example of the bursa, is primarily noticeable with a stabbing sensation. The pain often occurs when the affected person begins to walk.
Inflammations of tendons also show a similar symptom. The so-called tarnishing pain does not only occur in acute inflammations, but also in connection with arthritic changes in the small ankles. Sudden sharp and stabbing pain is characteristic for the complaints after a bone injury due to a traumatic event, such as twisting.
A skin rash on the back of the foot can also cause pain in this area. Gout is a metabolic disease in which uric acid crystals are initially deposited in the joints and later lead to kidney damage. The metatarsophalangeal joint of the big toe is often affected.
In the acute state, typical signs of inflammation such as swelling, redness and pain when touching the foot are evident. Subsequently, a hallux rigidus develops, an increasing joint stiffening due to arthrosis. Those affected complain of discomfort when the foot rolls and pain in the back of the foot. In the treatment of chronic gout, attempts are made to reduce the elevated uric acid level through a balanced diet. At the same time, so-called uricosurics and uricosstatics are used to reduce the uric acid level.
