Question: I have severe pain at the back of my heel that flares up whenever I start running. I am young, and trying to keep fit, and this constantly prevents my running.
Running puts a great deal of stress on the attachment of the large Achilles tendon into the back of the heel bone. With the constant jarring and pushing on this point, th§ tendon may tear and separate slightly from the bone, leading to acute pain and tenderness at the site. Treatment is by rest, and anti-inflammatory tablets. Occasionally, an injection is given into the sore point to settle the inflammation, and very rarely surgery is required. If you do not rest for long enough, or start running too hard too soon, the problem rapidly recurs.
Running is not the best form of exercise to keep fit because of the excess stress it places on feet, ankles and knees. Swimming and cycling are far more effective, and it is probably better to keep fit with these for a season until the heel has completely healed rather than run.
Question: What can cause pain in the front half of the foot? I cannot recall injuring it in anyway.
Gout is a severe and obvious cause of foot pain, but there are several other common causes.
Metatarsalgia is a condition common in athletes. It is an inflammation of the bones that form the ball of the foot, and is due to prolonged running, jumping or walking, usually on hard surfaces. Soldiers on route marches may develop the condition. Severe pain may develop in the ball of the foot, and the treatment is primarily rest, and anti-inflammatory medications. A ‘march fracture’ of the fore foot bones, due to the stress of continued walking or running on the foot may be another cause. There are minimal changes on x-ray, but excruciating pain on attempting to walk. Six weeks rest heals these fractures. In the elderly, foot pain may be the first sign of poor circulation, diabetes, rheumatoid arthritis or neuralgia.
Because these conditions can be serious, the cause of the pain must be investigated by a doctor and the correct treatment started.