Lateral Foot Pain: A Comprehensive Guide to Relief

Last updated on February 14th, 2024 at 02:18 pm

Lateral foot pain refers to discomfort or pain along the outer edge of the foot. This type of pain can range from mild to severe. In some cases, it can significantly impact an individual’s daily life. Walking, standing, or engaging in physical activities may become increasingly difficult, decreasing the overall quality of life. As such, understanding the nature of lateral foot pain is crucial to ensure proper diagnosis and effective treatment.

Despite its less conspicuous nature, lateral foot pain is more prevalent than one might assume. It affects individuals from all walks of life, including athletes, office workers, and those with physically demanding jobs. The pain may stem from various factors such as injuries, underlying medical conditions, or even ill-fitting footwear. The far-reaching consequences of untreated lateral foot pain can extend beyond physical discomfort, potentially leading to emotional distress and social isolation.

Given the potential impact on daily life, it is crucial to prioritise proper diagnosis and treatment for lateral foot pain. A thorough understanding of the condition, its causes, and available treatment options empowers individuals to seek the appropriate care and regain control of their lives. Accurate diagnosis paves the way for effective treatment plans and helps prevent further complications or unnecessary interventions. Keep reading for more!

Common Causes of Lateral Foot Pain

Cuboid Syndrome

Symptoms: Cuboid syndrome occurs when the cuboid bone on the foot’s outer side becomes dislocated or misaligned. This condition often causes pain, tenderness, and swelling on the lateral aspect of the foot. Additionally, patients may experience difficulty walking and a reduced range of motion.
Causes and risk factors: Common risk factors for cuboid syndrome include overuse, acute ankle sprains, and poorly fitting shoes. Athletes, particularly those involved in sports requiring repetitive jumping or side-to-side movement, are at an increased risk.

Peroneal Tendonitis

Symptoms: Peroneal tendonitis is the inflammation of the peroneal tendons, which run along the outer side of the ankle and foot. Symptoms include pain, swelling, tenderness in the affected area, and potential instability in the ankle joint.
Causes and risk factors: Overuse, repetitive stress, and ankle sprains are typical causes of peroneal tendonitis. Runners and athletes engaging in high-impact sports are especially susceptible.

Stress Fractures

Symptoms: Stress fractures are small cracks or severe bruising within a bone, often affecting the metatarsal bones of the foot. Symptoms include localised pain, swelling, and tenderness, which may intensify during weight-bearing activities. You may also experience pain at night, which may wake you up. Also, the fracture may only show on an X-Ray once it starts healing.
Causes and risk factors: Stress fractures are usually caused by repetitive stress or overuse, inadequate footwear, and osteoporosis. Athletes and military recruits have a higher risk of developing this condition. See also Iselin Disease. Especially if the patient is a young person. Iselin’s disease in adults is very rare.

Tailor’s Bunion

Symptoms: A tailor’s bunion, or bunionette, is a bony bump that develops on the foot’s outer side near the base of the fifth metatarsal. Symptoms include pain, redness, and swelling in the affected area, which may worsen with pressure from tight shoes.
Causes and risk factors: Factors contributing to a tailor’s bunion include hereditary factors, foot structure abnormalities, and ill-fitting footwear.

Base of the 5th Metatarsal Fracture

Symptoms: A fracture at the fifth metatarsal base is a bone break that connects the little toe to the midfoot. This injury is characterised by sudden, sharp pain, swelling, night pain and bruising on the outer side of the foot.
Causes and risk factors: Common causes include direct impact, twisting injuries, or repetitive stress. Athletes and individuals with osteoporosis are at an increased risk.

Lateral Ankle Sprain

Symptoms: A lateral ankle sprain involves stretching or tearing the ligaments on the outer side of the ankle. Symptoms include pain, swelling, and bruising, with potential difficulty bearing weight on the affected foot.
Causes and risk factors: Lateral ankle sprains typically result from rolling the foot inward during physical activity. Factors increasing the risk of sprains include previous ankle injuries, weak muscles, and poor proprioception.

Sinus Tarsi Syndrome

Description and symptoms: Sinus tarsi syndrome is a condition that causes pain and tenderness in the sinus tarsi, a small bony canal located on the outer side of the foot. Symptoms include pain during weight-bearing activities, reduced range of motion, and ankle instability.
Causes and risk factors: This condition often results from an ankle sprain or chronic instability. Individuals with flat feet or participating in activities that place excessive strain on the ankle may also be at risk for sinus tarsi syndrome.

Distal Fibula Fracture

Symptoms: A distal fibula fracture is a break in the lower part of the fibula, the thinner bone of the lower leg that runs parallel to the tibia. Symptoms include pain, swelling, and bruising on the outer side of the ankle, as well as difficulty bearing weight on the affected leg.
Causes and risk factors: Common causes of distal fibula fractures include direct impact, twisting injuries, and falls. Osteoporosis, participation in high-impact sports, and a history of previous fractures can increase the risk of this injury.

Corns

Symptoms: Corns are hardened areas of skin that develop on the foot due to pressure and friction. They may cause discomfort and tenderness, especially when walking or wearing tight shoes. Corns typically have a central core, which can be painful when pressed.
Causes and risk factors: Ill-fitting footwear, foot deformities, and improper gait can contribute to the development of corns. Individuals with bony prominences or frequently wearing high-heeled shoes may be more prone to corn.

Other possible causes

Nerve entrapment: Compression or irritation of nerves in the foot can lead to pain and discomfort along the lateral side of the foot. Common nerve entrapment syndromes include the sural nerve and Baxter’s nerve entrapment.
Arthritis: Inflammatory joint diseases, such as rheumatoid arthritis or osteoarthritis, can affect the joints in the foot, causing pain, stiffness, and swelling.
Infections: Infections, including cellulitis or osteomyelitis, may cause pain and swelling in the lateral foot area. These infections may occur due to skin injuries, surgery, or other underlying health conditions.

Diagnosing Lateral Foot Pain

Medical history and physical examination

The first step in diagnosing lateral foot pain involves a thorough medical history and physical examination. A healthcare professional will ask about the pain’s onset, duration, intensity, and any relevant past injuries or health conditions. The physical examination may include palpation of the affected area, assessment of the range of motion, gait analysis, and evaluation of muscle strength and function.

Imaging tests

Imaging tests play a crucial role in accurately diagnosing lateral foot pain. These tests can help identify underlying structural issues or injuries contributing to the discomfort. X-rays are often the first imaging test performed to identify fractures, dislocations, or signs of arthritis. They provide a two-dimensional view of the bones and joints in the foot, allowing healthcare professionals to visualise any abnormalities. Magnetic resonance imaging (MRI) offers a more detailed overview of the foot’s soft tissues, such as ligaments, tendons, and muscles. This imaging test can be valuable in diagnosing conditions like peroneal tendonitis, stress fractures, and nerve entrapment. Ultrasound uses sound waves to create images of the foot’s structures, making it a valuable tool for assessing soft tissue injuries and inflammation. It is particularly beneficial in the evaluation of tendon and ligament disorders. I have used it to look at the Achilles tendon and plantar fascia to aid in diagnosis.

Lab tests

Sometimes, laboratory tests may be ordered to rule out infections or systemic inflammatory conditions. Blood tests can help determine the presence of infection or inflammation. At the same time, a joint fluid analysis may identify specific types of arthritis or infections.

Differential diagnosis

The differential diagnosis process is essential in determining the specific cause of lateral foot pain. Given the variety of potential underlying issues, clinicians must carefully consider each patient’s symptoms, physical examination findings, and imaging results to arrive at an accurate diagnosis. In some cases, additional diagnostic tests or consultations with specialists may be necessary to confirm the cause of the pain and develop an appropriate treatment plan.

Treatment Options for Lateral Foot Pain

Conservative treatments

Most cases of lateral foot pain can be effectively managed with conservative, non-invasive treatments. These methods aim to reduce pain and inflammation, promote healing, and address underlying biomechanical issues.

Rest, ice, compression, and elevation (RICE): The RICE protocol is a fundamental component of initial treatment for many foot and ankle injuries. Rest helps prevent further damage, ice reduces inflammation and numbs pain, compression minimises swelling, and elevation aids fluid drainage from the affected area.
Over-the-counter pain relievers: Non-prescription pain medications such as paracetamol, ibuprofen or naproxen can help alleviate pain and inflammation associated with lateral foot pain.
Physical therapy: A physical therapist can develop a customised exercise and stretching program to strengthen the muscles, improve flexibility, and correct any imbalances contributing to lateral foot pain. Manual therapy techniques may also be employed to alleviate pain and improve joint mobility.
Orthotics and shoe modifications: Supportive footwear, cushioned insoles, or custom orthotics can help redistribute pressure, correct alignment issues, and alleviate lateral foot pain. Shoe modifications such as wider toe boxes or cushioned heel counters are also beneficial.

Advanced treatments

Doctors may recommend more advanced interventions if conservative treatments are ineffective in managing lateral foot pain. These may include:

Corticosteroid injections: Corticosteroid injections can temporarily relieve pain and inflammation in persistent lateral foot pain cases. However, they should be used judiciously, as overuse may weaken the surrounding tissues.
Extracorporeal shockwave therapy (ESWT): ESWT uses high-energy sound waves to stimulate healing in injured or inflamed tissues. This treatment has shown promise in managing chronic plantar fasciitis, peroneal tendonitis, and other soft tissue disorders.
Platelet-rich plasma (PRP) therapy: PRP therapy involves injecting a concentrated solution of the patient’s platelets into the affected area, promoting tissue regeneration and healing. Research has shown potential benefits in treating various foot and ankle conditions, including tendon and ligament injuries.
Surgical treatments: In rare cases where conservative and advanced therapies fail to provide relief, surgery may be necessary to address the underlying cause of lateral foot pain. The specific surgical procedure will depend on the diagnosed condition. Examples include tendon repair or reconstruction for peroneal tendonitis, osteotomy or arthrodesis for arthritis-related deformities, or fracture fixation for severe bone injuries. Depending on the procedure’s nature, rest and immobilisation are typically required following surgery. A comprehensive rehabilitation program, including physical therapy, will be essential in regaining strength, flexibility, and function in the affected foot.

Prevention Strategies for Lateral Foot Pain

Preventing lateral foot pain involves addressing the factors that contribute to its development. By adopting the following strategies, individuals can reduce their risk of experiencing lateral foot pain and maintain overall foot health.

Proper footwear

Wearing appropriate, well-fitting shoes is crucial in preventing lateral foot pain. Supportive footwear with a wide toe box, cushioned sole, proper arch support, a rocker bottom and ideally a fastener can help distribute pressure evenly and minimise the risk of injury. Replacing worn-out shoes is essential, as they may lose their supportive properties over time.

Gradual increase in physical activity

Sudden increases in physical activity can place excessive stress on the feet, leading to injuries and pain. To prevent this, individuals should gradually increase the intensity and duration of their workouts, allowing their bodies to adapt to the increased demand. Incorporating rest days and varying activities can also help prevent overuse injuries.

Strength and flexibility exercises

Regular strength and flexibility exercises can help maintain proper foot function and reduce the risk of lateral foot pain. Exercises targeting the foot and ankle muscles and tendons can improve stability, support, and overall foot health. Additionally, stretching exercises focused on the calf muscles, and plantar fascia can help maintain flexibility and prevent tightness that may contribute to foot pain.

Maintaining a healthy weight

Carrying excess weight places additional stress on the feet, increasing the risk of developing lateral foot pain. By maintaining a healthy weight through a balanced diet and regular physical activity, individuals can reduce the strain on their feet and lower the likelihood of experiencing pain.

Living with Lateral Foot Pain

Managing and adapting to life with lateral foot pain can be challenging. However, by implementing effective coping strategies, modifying daily activities, and seeking support, individuals can improve their quality of life and mitigate the impact of foot pain on their daily routines.

Coping strategies for pain management

Effective pain management is essential for individuals living with lateral foot pain. In addition to medical treatments, individuals can explore alternative pain relief methods such as heat or cold therapy, relaxation techniques, and mindfulness practices. Experimenting with various coping strategies can help identify the most effective ways for individual needs.

Adapting daily activities

Modifying daily activities can reduce pain and minimise the risk of further injury. This may include breaking tasks into smaller, manageable steps or using adaptive equipment to reduce strain on the foot. For example, using a stool to rest the affected foot while standing for extended periods or choosing low-impact exercises like swimming or cycling can help alleviate pressure on the foot.

Seeking support from healthcare professionals and support groups

Living with lateral foot pain can be an isolating experience. Regularly consulting with healthcare professionals can help ensure proper treatment and pain management. Additionally, connecting with others with similar experiences through support groups or online forums can provide emotional support and practical advice. Sharing experiences, discussing coping strategies, and learning from others can help individuals feel less alone and better equipped to manage their lateral foot pain.

Conclusion

Addressing lateral foot pain as soon as it arises is crucial in preventing the development of chronic issues or complications such as swollen feet. Early intervention allows for more effective treatment and can significantly improve the long-term prognosis for individuals experiencing foot pain. Seeking professional help at the first signs of discomfort can help prevent more severe problems down the road.

Since lateral foot pain can have various causes, working closely with healthcare professionals to develop a personalised treatment plan tailored to individual needs is essential. This approach ensures that the most appropriate interventions address the underlying issues contributing to the pain, leading to a more successful recovery.

Living with lateral foot pain can be challenging, but relief is possible with the proper support and resources. By proactively seeking help, implementing prevention strategies, and committing to a personalised treatment plan, individuals can improve their quality of life and overcome the challenges associated with foot pain. Stay persistent and remain hopeful in your journey towards pain-free living. Remember, your health is your wealth!