Foot & Toes Pain

When we lift our foot and take a step, the extensor retinaculum, a robust tissue, plays a crucial role in maintaining the proper function and alignment of tendons. However, this tissue can become irritated and inflamed due to factors like ankle twists, overuse injuries, or physical trauma to the top of the foot. Ankle pain typically manifests on the top of the foot and may extend down to the toes. Pain is often triggered by activities such as walking or standing on tiptoes, and it typically has a mechanical nature.

Physiotherapy can be instrumental in pinpointing the specific problematic structure. To alleviate symptoms, we can employ targeted techniques like soft tissue release and mobilisation, sometimes aided by ultrasonography. Additionally, we will investigate the root causes of the issue, addressing any abnormalities related to walking, foot placement, movement control, and balance to prevent its recurrence.

This injury often occurs during high-impact activities in athletes, especially after an awkward fall, or in older adults with reduced bone density. Following the triggering event, pain typically starts suddenly and can become severe to the point where walking and bearing weight become very challenging. If the injury is the result of repetitive high-impact activities like jogging, symptoms may initially develop gradually but can worsen rapidly if the activity continues.

Physiotherapy can be highly effective in treating this condition. You will receive guidance on maintaining your fitness level during a period of “active rest” that doesn’t place undue strain on your healing fracture. If a foot and ankle specialist has prescribed an aircast boot or support, your physiotherapist can assist you in gradually transitioning away from it. We can ensure the restoration of full flexibility in the surrounding joints, as well as regain foot strength and normal walking/running patterns. With training and rehabilitation tailored to your specific sport, we are well-equipped to help you successfully return to competitive sports.

The extensor muscles constitute a muscle group that spans the top of the foot and runs along the front of the lower leg, responsible for bending the toes and foot upward. Sometimes, overuse of these muscles can lead to tendon pain.

Physiotherapy can be beneficial in several ways. It can guide you through a progressive exercise regimen to strengthen and rehabilitate these muscles while addressing any underlying causes of their overuse. Additionally, physiotherapy can help alleviate inflammation and soreness associated with these muscles.

Osteoarthritis of the talus, which is the primary bone that supports the foot and ankle during activities like walking, climbing stairs, or bending down, often leads to pain in the front of the ankle joint. This pain typically develops gradually, worsens with changes in weather, can be bothersome and painful, and may occasionally be accompanied by swelling. The root cause of this condition is the deterioration of the joint surfaces and cartilage in the ankle.

There is compelling evidence that physiotherapy can effectively address ankle osteoarthritis by focusing on strengthening the muscles that stabilise the ankle and improving balance. This approach aims to alleviate stress on the joint surfaces, reduce loading, and consequently alleviate associated discomfort. Additionally, other effective treatments for managing the pain and restricted range of motion associated with osteoarthritis may include mobilisations, acupuncture, recommendations for appropriate footwear and insoles, as well as taping techniques.

Pain at the top of the foot can sometimes be referred from the spinal nerves and the lumbar spine. This occurs when these nerves become irritated or compressed, leading to the sensation of pain in the area they supply. The brain may misinterpret these signals, causing pain to be felt in the region served by the affected nerve. This type of pain is typically described as widespread and searing, and it may also be accompanied by numbness or a pins and needles sensation in the affected area.

Your physiotherapist will assess the condition and mobility of your nerves and work to rule out any local structures as the source of your pain. If this diagnosis is confirmed, effective treatment options may include addressing issues in the lower back if necessary, releasing tissues that impede normal nerve movement, and providing specialised exercises aimed at improving nerve mobility.

The ankle joint is formed by the dome-shaped talus bone, which connects to the lower part of your leg. Avascular necrosis is a serious condition for which prompt detection and treatment are crucial for a successful outcome. If a comprehensive assessment by a physiotherapist reveals that you have high-risk factors for this condition, we can provide you with appropriate guidance and recommend a consultation with a renowned foot and ankle specialist in London. Avascular necrosis occurs when a portion of the joint surface dies due to a lack of blood flow.

Treatment will encompass advice and symptom management, which may include acupuncture, the use of supports, and taping. We will guide you through mobilisation techniques to regain any lost range of motion, along with stretches and strengthening exercises to enhance the area around your ankle.

Continuous pressure applied to the top of the foot can lead to the accumulation of excess skin, and this direct pressure often causes discomfort. In such cases, it is typically advisable to consult a chiropodist to remove the excess skin.

Physiotherapy can also be beneficial by assessing whether adjustments to your walking pattern (gait) can help alleviate pressure in that area and by offering guidance on selecting more suitable footwear.

Rheumatoid arthritis is a condition where inflammation in the muscular tendons and joint lining occurs due to the immune system mistakenly attacking the body instead of protecting it. This type of arthritis causes swelling, pain, and stiffness in the affected joints. Morning stiffness is a common symptom, and as people age, the muscles that support the joints tend to weaken, making everyday tasks more challenging.

We can arrange for experienced physiotherapists to visit your home and work closely with you to help manage your condition. During the initial assessment, our physiotherapists will conduct a comprehensive evaluation, assessing your muscle strength, joint mobility, posture, functionality, and any mobility aids you may be using. Following the assessment, the physiotherapist will discuss recommended treatments with you and assist in setting achievable goals to enhance your overall well-being at home, at work, and in your social life. Treatment options may include advice on using ice, tailored exercise routines, massage, taping, acupuncture, and mobility programs, among others.

Furthermore, we can also arrange for occupational therapists to visit your home. They specialise in helping individuals regain the ability to engage in meaningful activities and maintain or attain their highest level of independence. Some of the services they offer include:

• Home assessments including modifications such as rearranging furniture, building ramps, widening doorways, grab bars, special toilet seats etc
• Wheelchair assessments
• Splinting

Acute pain refers to the immediate pain experienced after an injury and during the healing process, while chronic pain is characterised by persistent pain that persists even after the healing process is complete. It is not uncommon for there to be no apparent connection between the original injury, which may have healed long ago, and the ongoing pain. Chemical changes in the brain and spinal cord redirect pain signals to pain centres in the brain, allowing pain to be perceived in response to various sensations, including movement, touch, pressure, stretching, and more. Changes in weather, mood, thoughts, or even the absence of any physical stimulus can sometimes trigger the pain system.

In the treatment of chronic pain, physiotherapy must address not only the pain itself but also a range of associated issues. In addition to providing pain relief, physiotherapists assist in managing chronic pain through goal setting, gradual exercise plans, and guidance on coping with flare-ups and negative emotions. Their objective is to help you regain your previous level of engagement in work, sports, and leisure activities as it was before the onset of chronic pain.

Complex Regional Pain Syndrome, as the name suggests, is a challenging condition. Often, it involves intense and persistent pain. The affected area of the body is frequently highly sensitive to touch, and even the slightest contact can be excruciating. Changes in the warmth and colour of the affected body part may occur, and swelling and excessive hair growth are also possible. This syndrome can lead to symptoms that radiate up the leg and impair the foot. Its exact cause is unknown and may develop spontaneously or in response to a previous event, such as a fracture. It has been shown that the sympathetic nervous system, which regulates skin temperature and blood flow, plays a role in this condition.

Physiotherapy can be beneficial in managing this condition by preventing the affected body area from becoming stiff and maintaining its mobility. In certain cases, acupuncture may provide relief from the discomfort, and techniques to desensitise the affected area can also be employed. Your physiotherapist can also recommend a reliable pain consultant in London who can address your pain by blocking the firing of the sympathetic nervous system and prescribing appropriate medication.

Before conducting a thorough physical examination, the physiotherapist will first gather a detailed history of your symptoms and past medical conditions. It’s important to recognise that your symptoms may have various underlying causes, some of which may fall outside the scope of physiotherapy or require medical evaluation in conjunction with physiotherapy treatment. In such cases, the physiotherapist will refer you to your general practitioner (GP) or an appropriate specialist physician or consultant. Some potential reasons for referral may include:

• Cardiovascular Symptoms
• Respiratory (breathing) Symptoms
• Gynaecological Symptoms
• Urinary or Genital Symptoms
• Digestive Symptoms
• Immune System Symptoms
• Lymph System Symptoms
• Hormonal Symptoms
• Neurological Symptoms
• Dermatological (skin) Symptoms
• Medication Side-effects
• Virus
• Infection
• Cancer
• Disease Process
• Psychological Problem i.e. Depression, Anxiety

This condition involves inflammation of the tissue beneath the foot, typically occurring under the inner arch or heel. The pain associated with this condition is often more pronounced in the mornings and can be accompanied by stiffness during initial steps. While the pain is typically described as achy, it can also become intense. Common causes include engaging in unaccustomed activity, sudden changes in exercise intensity, or modifications in footwear.

Physiotherapy can play a crucial role in addressing this condition by assessing and treating biomechanical issues. This involves modifying the load on the affected tissue through techniques aimed at improving strength, movement control, and posture. Specifically designed exercises to enhance balance and control are recommended, as they are known to be essential in reducing strain on the plantar fascia. Other methods for pain relief may include soft tissue massage, acupuncture, orthotics, and taping.

Osteoarthritis is characterised by the gradual “wear and tear” of joint surfaces and the deterioration of the cartilage that lines them. This condition can affect any joint in the foot or the joints connecting the front of the foot to the big toe. In addition to causing pain and stiffness in the affected joints, it may occasionally lead to swelling or redness.

Physiotherapy can be beneficial for managing this condition. It involves teaching stability and proprioceptive exercises to enhance stability around the affected joint and strengthening the muscles in the foot and toes. Manual therapy, which includes addressing the stiffness in the affected joints and massaging the tight surrounding tissues, can also help improve the problem. Physiotherapists can provide recommendations on reducing inflammation and finding more comfortable footwear. Additionally, acupuncture is another method that can be used to treat pain associated with osteoarthritis.

This condition is usually caused by the irritation or compression of small nerves between the bones of the toes. It can result in a burning pain or numbness in the affected area when the nerve becomes irritated. The third and fourth metatarsals (foot bones) are the most common locations for this condition to occur. Tight footwear or an improper walking or running gait may be contributing factors, although other factors could also be involved.

Your physiotherapist can assess whether this condition is the cause of your foot pain. They can provide guidance on appropriate footwear for your condition and use techniques such as taping to alleviate tension in the affected tissue or acupuncture to manage pain. In some cases, symptoms can be relieved through specific stretches and strengthening exercises aimed at improving your biomechanics. If a medical evaluation is deemed necessary, we can recommend reputable foot and ankle consultants in London.

This condition is characterised by pain in the long bones of the foot, typically resulting from conditions such as hallux rigidus or valgus in the big toe (explained above). When the position and movement of the big toe’s joint are altered, it can affect the movement and position of the other toes, leading to joint pain and inflammation. This often impacts the second and third toes and can occasionally result in noticeable changes in their position.

Physiotherapy can offer pain relief methods, including techniques like acupuncture and taping, along with advice on selecting appropriate footwear and managing activity levels. If there have been significant changes in biomechanics, physiotherapists can also provide guidance on strengthening exercises, which may help alleviate metatarsalgia pain. If your physiotherapist determines that a medical evaluation is necessary, we can recommend reputable foot and ankle consultants in London.

Fractures in the foot can occur in the smaller bones within each toe or in the long bones (metatarsals) of the foot due to trauma, overuse, or significant impact. In some cases, ankle and heel fractures can also lead to pain radiating to the sole of the foot. Weaker bones resulting from conditions like osteoporosis can increase the risk of such fractures. If this type of pain is not promptly identified and treated, it can become severe and chronic. Stress fractures in the foot bones can also develop over time.

Following an injury, your physiotherapist can conduct a comprehensive assessment to determine your risk of fracture and provide guidance on the most appropriate course of action. If a fracture is suspected, they may recommend consulting a reliable foot and ankle specialist in London. This specialist can offer recommendations such as wearing supportive footwear or a plaster cast to stabilise the fracture site during the healing process. Fractures can lead to stiffness and limited range of motion over time.

Physiotherapists can assist in your recovery from such injuries using techniques such as mobilisation, massage, and specialised stretching exercises. They will collaborate with you to progress your personalised training program, ensuring that your recovery is tailored to your unique needs and sports-related activities.

Pain can originate from spinal nerves and the lumbar spine and be referred to the base of the foot. This happens when the area supplied by these nerves experiences discomfort due to inflammation or nerve compression. Additionally, pain in the supplied area may result from the brain misinterpreting these signals. This type of pain is typically characterised by widespread and severe discomfort and can sometimes include sensations like numbness or pins and needles in the affected area.

Your physiotherapist will conduct a thorough examination of your nerves to assess their health and range of motion. This assessment helps rule out any local structures as the source of your pain. If this diagnosis is confirmed, effective treatment options may include addressing tissues that impede normal nerve movement, addressing lower back issues if necessary, and implementing specialised exercises designed to improve nerve mobility.

The build-up of excess skin on the underside of the foot, often caused by continuous pressure, can lead to discomfort, especially when direct pressure is applied. In such cases, it is typically recommended to have a chiropodist remove the excess skin.

Physiotherapy can also play a role in alleviating pressure on the affected area. Physiotherapists can assess whether modifications to your stride or walking pattern can help reduce pressure. Additionally, they can offer guidance on selecting appropriate footwear to address the issue and prevent further discomfort.

Rheumatoid arthritis is characterised by an overactive immune system that mistakenly targets the body, leading to inflammation of the muscular tendons and joint linings. Individuals with arthritis often suffer from pain, swelling, and stiffness in their affected joints, with morning stiffness being a common occurrence. Another common challenge is the weakening of muscles around the joints, which can hinder daily activities.

Our skilled physiotherapists can visit you at your home to work closely with you in managing your condition. During the initial comprehensive assessment, the physiotherapist will evaluate your mobility, muscle strength, joint mobility, posture, and overall function. Following the assessment, the physiotherapist will discuss recommended treatments with you and assist you in setting goals to improve your overall function and mobility. This will enable you to maximise your potential at work, home, and in social settings. Treatment options may include mobility programs, massage, taping, acupuncture, exercise routines, and guidance on using ice.

Additionally, we can arrange visits from occupational therapists at a time that suits your schedule. They specialise in helping individuals regain the ability to engage in meaningful activities and achieve and maintain their highest level of independence. Occupational therapy services may include:

• Home assessments including modifications such as rearranging furniture, building ramps, widening doorways, grab bars, special toilet seats etc
• Wheelchair assessments
• Splinting

Acute pain is the type of pain that is experienced immediately following an injury and during the healing process. In contrast, chronic pain is characterised by persistent discomfort that continues even after the healing process is complete. Often, it is challenging to establish a direct connection between the ongoing pain and the initial injury, which may have already healed. Chemical changes in the brain and spinal cord redirect pain signals to the brain’s pain centres. Consequently, pain can be triggered by various sensations, including pressure, movement, touch, stretching, and more. Chronic pain can also be prompted by changes in weather, mood, thoughts, or even without any physical stimuli.

When addressing chronic pain, physiotherapy goes beyond pain management to address various factors. Physiotherapists work with patients to manage their pain, establish goals, implement gradual exercise programs, and provide guidance on coping with pain flare-ups and negative attitudes. The primary objective is to help patients regain their quality of life before the onset of chronic pain, enabling them to return to their previous levels of engagement in work, sports, and leisure activities. Additionally, we can recommend reputable pain specialists in London who specialise in treating chronic pain to further assist you.

Complex Regional Pain Syndrome (CRPS) lives up to its name as a multifaceted condition often marked by relentless and severe pain. The afflicted area’s heightened sensitivity means that even the slightest touch can trigger discomfort. Potential symptoms associated with this ailment encompass the development of swelling, increased hair growth, and alterations in the skin’s colour and temperature within the affected region. Furthermore, the pain stemming from CRPS can radiate upwards from the foot, affecting the leg. Although the precise origins of CRPS remain elusive, it can manifest spontaneously or emerge as a response to prior injuries such as fractures. This condition has been linked to the sympathetic nervous system, which governs skin temperature and blood flow regulation.

Physiotherapy has been proven to be highly valuable in the management of CRPS by enhancing mobility and mitigating stiffness in the affected bodily area. Pain alleviation techniques, including desensitisation methods and acupuncture, are occasionally employed. Your physiotherapist may also recommend consulting with a certified pain specialist in London. An expert can assist you in pain management by addressing hyperactivity in the sympathetic nervous system and prescribing appropriate medications.

The physiotherapist will gather comprehensive information about your symptoms and take a detailed medical history before conducting a thorough physical assessment. It’s important to keep in mind that your symptoms may have various underlying causes, some of which may require medical evaluation and treatment in addition to physiotherapy. In such cases, your physiotherapist will recommend that you consult with either an appropriate specialist or consultant, or your general practitioner (GP). Some potential reasons for referral may include:

• Cardiovascular Symptoms
• Respiratory (breathing) Symptoms
• Gynaecological Symptoms
• Urinary or Genital Symptoms
• Digestive Symptoms
• Immune System Symptoms
• Lymph System Symptoms
• Hormonal Symptoms
• Neurological Symptoms
• Dermatological (skin) Symptoms
• Medication Side-effects
• Virus
• Infection
• Cancer
• Disease Process
• Psychological Problem i.e. Depression, Anxiety

Inflammation of the tissue beneath the foot, typically under the inner arch or heel, is one of the primary characteristics of this condition. Pain associated with this ailment is often most severe in the mornings and may be accompanied by stiffness during the initial steps. It is typically described as a persistent, dull discomfort that can be triggered by sudden changes in activity levels, shoe choices, or the initiation of new exercise routines.

Identifying and addressing biomechanical problems is crucial in managing this condition. This involves improving strength, posture, and motor control to reduce strain on the affected tissue. Customised exercises aimed at enhancing balance and control are highly effective in relieving stress on the plantar fascia. In addition to these measures, other techniques like massage therapy, acupuncture, orthotic interventions, and taping may be used to alleviate pain and provide essential support.

This condition involves degenerative changes in the tibialis posterior tendon, which connects the inner foot bones to the deep calf muscle known as the tibialis posterior muscle. As a result, pain is experienced in the inner shin and the inner arch of the foot. In severe cases, the tendon may weaken, leading to the collapse of the inner arch and the development of a deformed foot and altered walking pattern.

Physiotherapy is valuable for managing this condition at all stages. Early detection allows us to modify risk factors for tendon rupture using orthotics, strength and control exercises. Physiotherapy can also alleviate pain through techniques such as taping, soft tissue release methods, and acupuncture. Our rehabilitation programs often include eccentric strengthening exercises, which gradually stress the injured tendon and promote its healing.

Engaging in sports that involve frequent foot landings can lead to stress fractures in the navicular bone, located on the inner side of the foot. Typically, this condition begins with a dull ache and improves with rest.

If there is suspicion of a stress fracture, it’s important to seek a medical referral. However, physiotherapy can play a crucial role in maintaining leg, ankle, and foot strength and mobility during the healing process. If needed, we can recommend a reputable ankle and foot consultant in London.

Spinal nerves and the lumbar spine have the potential to refer pain to the inner arch of the foot. This occurs when these nerves become irritated or compressed, resulting in pain being felt in the area they supply. Additionally, the brain’s misinterpretation of these signals can lead to pain in the serviced nerve area. This type of pain is typically widespread, searing, and may be accompanied by numbness or a pins and needles sensation in the affected area.

Your physiotherapist will assess the health and mobility of your nerves and can rule out any local structures as the source of your pain. If this diagnosis is confirmed, effective treatment options may include addressing lower back issues if necessary, releasing tissues that impede normal nerve movement, and implementing specialised exercises aimed at improving nerve mobility.

Osteoarthritis is a condition that can affect any joint in the body. It is characterised by a “wear and tear” process in which the protective cartilage covering the joint surfaces gradually deteriorates over time. On the other hand, rheumatoid arthritis is an autoimmune disorder where the immune system mistakenly attacks the body, leading to inflammation of the tendons and joint linings. In both cases, arthritic joints can become painful, stiff, and sometimes inflamed. Morning stiffness is a common occurrence. With age, the muscles supporting the joints often weaken, making it more challenging to perform daily activities.

We can arrange for experienced physiotherapists to visit your home and work with you to help manage your condition. During your initial assessment with the physiotherapist, they will conduct a thorough evaluation that includes assessing your muscle strength, joint mobility, posture, function, and mobility aids. Following the assessment, the physiotherapist will discuss recommended treatments with you and assist you in setting goals to maximise your potential in various aspects of life, including at home, work, and socially. Some of these treatments may include advice on using ice, exercise routines, massage, taping, acupuncture, and mobility programs.

Additionally, we can arrange for occupational therapists to visit your home. They specialise in helping individuals regain the ability to engage in meaningful activities and achieve or maintain their highest level of independence. Some of the services they can offer include:

• We provide home assessments that encompass modifications such as repositioning furniture, installing ramps, widening doors, fitting grab bars, adding adapted toilet seats, etc.
• Wheelchair assessments
• Splinting

The immediate pain experienced following an injury and during the healing process is known as acute pain. While chronic pain is characterised by persistent discomfort that persists even after the healing process is complete. Often, there is no apparent connection between the ongoing pain and the initial injury, which may have healed long ago. Chemical changes in the brain and spinal cord occur to redirect pain signals to the brain’s pain centres. Consequently, pain can manifest in response to a variety of sensations, including pressure, movement, touch, and stretching. Interestingly, changes in mood, thoughts, or even the absence of any physical stimuli can trigger chronic pain.

When using physiotherapy to address chronic pain, the objective extends beyond mere pain relief. Physiotherapists collaborate with patients to assist them in managing their pain by establishing goals, implementing gradual exercise plans, and providing guidance on coping with negative emotions and flare-ups. The ultimate aim is to empower individuals to return to their previous levels of engagement in work, sports, and leisure activities they enjoyed before the onset of chronic pain. Additionally, we can connect you with some of London’s leading pain specialists to further assist you in managing your condition.

As the name suggests, this condition is intricate and often accompanied by intense and persistent pain. The affected area is typically extremely sensitive to touch, with even slight contact causing significant discomfort. Variations in the affected body part’s temperature and colour can occur, along with possible swelling and excessive hair growth. This syndrome can also affect the foot and may manifest spontaneously or as a result of a previous incident, such as a fracture. It has been observed that the sympathetic nervous system, which regulates skin temperature and blood flow, plays a role in this condition.

Physiotherapy can play a role in managing this condition by preventing the affected body part from becoming stiff and promoting mobility. In some cases, acupuncture may provide relief from the discomfort, and desensitisation techniques can also be employed. Additionally, your physiotherapist can recommend a reliable pain specialist in London who can address your pain by interrupting the firing of the sympathetic nervous system and prescribing appropriate medication.

Your physiotherapist will take a detailed history of your symptoms and past medical history before performing a full physical examination. There are a number of other possible causes of your symptoms which are not appropriate for a physiotherapist to treat in any way or that need a medical opinion alongside physiotherapy treatment. In this case they will recommend you to your GP or an appropriate specialist doctor or specialist consultant. These possible causes include:

• Cardiovascular Symptoms
• Respiratory (breathing) Symptoms
• Gynaecological Symptoms
• Urinary or Genital Symptoms
• Digestive Symptoms
• Immune System Symptoms
• Lymph System Symptoms
• Hormonal Symptoms
• Neurological Symptoms
• Dermatological (skin) Symptoms
• Medication Side-Effects
• Virus
• Infection
• Cancer
• Disease Process
• Psychological Problem i.e. Depression, Anxiety