shooting pain of unknown origin

by Sean
(blackburn)

Hi my name is sean and I have a problem with my foot..to look at it its normal no swelling or redness or anything like that but it's a sharp shooting pain every time I put pressure on my foot it hurts on the inner side or the incove of my foot..and once I sit down and leave it for a bit the pain goes until I put pressure back on it..but with it being rested once I walk again it seems to hurt twice as bad until I get use to walking on it again were it's just still a shooting pain but not as bad..I have had this problem for about a month now and have been struggling to walk proper at work and it's becoming very annoying and sore

If you can think of anything i will leave my email if that's ok with you


Thankyou

Sean

RESPONSE

Hi Sean,
We do not like people leaving their email addresses on this sight because they can be scraped by people and then your email address ends up on every marketing list out there. So, it has been removed and your answer appears here.

You do not mention any history of trauma, nor do I know whether you are athletic or overweight. Since I essentially know nothing about you, I will assume this pain came about insidiously. One day you noticed it and now it has been with you for a while and apparently not getting better.

Since it occurs on the inside of your foot and since there was no history of trauma (that I am aware of), the first thing I would look at would be damage to the tibialis posterior tendon that attaches into the inside portion of the foot. The purpose of this muscle/tendon is to help maintain the congruity of your arch.

For those who do a lot of walking, particularly on hard surfaces and for those you may be overweight as well as those that tend to have flat feet, a great deal of strain is placed on this tendon and it can begin to hurt where it attaches into the navicular bone.

In this scenario, the foot will not hurt all that much when you are off the foot, but as soon as you step on the foot, you put tremendous strain on the tendon and the pain ensues. It would not be impossible for the foot to actually feel a little bit better after walking for a period of time, as the more walking you do, the more you "loosen" up the tendon and therefore, the less strain there is and the less pain.

The bigger problems becomes one of actually tearing the tendon particularly where it attaches into the bone. Continued strain on the tendon could cause it to start to tear away from the bone. Pressing on that area will also be very painful.

The affected area may appear normal in color and appearance, so that does not help one way or the other.

Sometimes this part of the foot will have what is known as an accessory navicular, which is an extra bone that is surrounded by the tendon. This is not an abnormal finding, but it can exacerbate the problem. In addition, sometimes the navicular bone will just happen to be larger then it should and this too will add to the problem.

This is the most common cause of pain on the inside of the foot, particularly when there is no history of trauma, but keep in mind, it is not the only possibility.

If you have been suffering from this problem for over a month, it probably time to see a doctor in your area. After four weeks, it is probably safe to say, it is not going to disappear on its own.

Assuming this ends up being the diagnosis, the first thing to do is to use an arch support in an effort to keep your foot from over flattening out. This will remove the strain on the tibialis posterior tendon and will allow it to heal.

Other measures such as anti-inflammatory medication as well as physical therapy may also allow the foot to heal quicker.

So, get yourself to a doctor, who is familiar with foot pathology, get a proper diagnosis and get started with treatment.

Marc Mitnick DPM
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