Bilateral foot pain

Moderators: kwyss, Sillevis

Bilateral foot pain

Postby baevans » Tue Sep 13, 2011 1:14 pm

We are currently treating a female patient who has complaints of bilateral foot pain during exercise. Patient reports a burning sensation on the bottom of her foot that extends from her heel to the middle of her foot and a feeling of "tightness" when she exercises. Patient reports these sensations stop shortly after the exercise ends. Could these sensations be referred pain from tight calf muscles?
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Re: Bilateral foot pain

Postby kwyss » Tue Sep 13, 2011 10:53 pm

What is the patients actual diagnosis? What exercises trigger the symptoms? I am not aware of referred pain from the calf in the form of burning in the foot. Is there dysfunction at the ankle joint?
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Re: Bilateral foot pain

Postby baevans » Wed Sep 14, 2011 8:07 am

This patient's diagnosis is LBP, R lumbar radiculopathy, cervical myofascial pain syndrome. The exercises which trigger the sensations in her feet are marching and walking for extended periods of time. I do not recall any ankle dysfunction for this patient.
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Re: Bilateral foot pain

Postby kwyss » Wed Sep 14, 2011 11:49 am

assesment of the footplacement during her exercises and shoeware. It appears to be a local issue, possible tarsal tunnel, navicular dysfunction. Discuss if the therapist agrees to set patient up with a 1/8 heel lift bilateral to alter wt bearing. Another option is taping of the navicular into internal rotation.
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Re: Bilateral foot pain

Postby Maddox » Wed Sep 14, 2011 2:18 pm

If her pain is bilateral, aggrevated by exercise, reduces with rest, and she is diagnosed with lumber radiculopathy, i would check for lumbar instability, glute and piriformis tightness, iliopsoas tightness, as well as for excessive lordosis.. How are her legs and knees and feet aligned while standing?
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Re: Bilateral foot pain

Postby Sillevis » Wed Sep 14, 2011 5:56 pm

What about spinal stenosis (lumbar or cervical)? Can we test for that and rule this out as source?
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Re: Bilateral foot pain

Postby matt » Thu Sep 15, 2011 8:29 am

How are her arches? My wife has similar pain in her feet when running, and she has very flat feet. She has gotten good relief with medial arch taping, but she has no lumbar issues to compound the problem.
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Re: Bilateral foot pain

Postby Sillevis » Thu Sep 15, 2011 9:36 pm

Matt,
So if taping wworks, why not get prefabricated arch supports? The research indicates that these achieve the same outcome as orthotics.
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Re: Bilateral foot pain

Postby cpendo » Thu Sep 29, 2011 2:41 pm

I have tarsal tunnel syndrome and wear orthotics due to falling arches, if I do not wear them then I have severe pain in the bottoms of my feet. I have never experienced burning, however my tarsal tunnel is in the very early stages. In my experience with patients that experience burning in the bottoms of their feet, doing glides for the talonavicular joint seems to help.
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Re: Bilateral foot pain

Postby Sillevis » Wed Oct 12, 2011 4:31 pm

Maybe we should be looking a the TP muscle and see if there is dysfunction there. Weakness will obvioulsy contribute to the arch issue. An eccentric program might be benficial.
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