Zeljko Kojadinovic, MD- Neurosurgeon and Pain Specialist
In cases of persistent pain in the foot, it is important to determine by examination and imaging (ultrasound, X-ray, and possibly foot MRI) which of many structures the pain originates in (joints, tendons, fascia, muscles, bursae, nerves). The places where pain is most common are shown in the picture. These include heel pain, heel spur, Morton’s neuroma, Achilles tendon pain, Tarsal Canal Syndrome, joint pain, plantar fasciitis, metatarsalgia. Initially, treatment involves the use of analgesics, physical treatment, and ordering special shoe adjustments. Only in the case of severe problems that are resistant to other treatment is surgical treatment indicated, and it is mostly minimally invasive operations.
It is necessary to know specific examination techniques in order to establish which anatomical structures the pain corresponds to and which pathological processes are occurring in them (inflammation, degeneration, injury).
Once the cause of the foot pain has been determined, specific treatment can be given. Unfortunately, the cause of the pain is often not determined, so treatment is unsuccessful. In that case other causes are usually blamed for the persistent foot pain: flat feet, the patient’s age, obesity, poor posture, mental condition, other chronic diseases, etc. All this cannot serve as an excuse for unsuccessful treatment.