Sunday, March 03, 2024
FOOT PAIN Outside of Foot Pain

Outside of Foot Pain- Causes & Treatment for Side of Foot Pain

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Outside of foot pain can be caused by many different conditions. These conditions include ankle sprains, stress fractures, corns/calluses, tarsal coalitions, tendonitis, bunions, arthritis, cuboid syndrome, and sinus tarsi syndrome. 

In this article, you will learn about all the major conditions that could be causing the outer foot to hurt, as well as how they are treated. 

What Is the Outside of the Foot Called?

The outer portion of the foot is called the “lateral” side of the foot. 

This includes the 4th/5th toes, the 4th/5th metatarsals (the long bones in the foot that connect your midfoot and toes), the cuboid bone, and your heel bone. 

This also includes the tendons, ligaments, nerves, and joints that are present along the lateral foot.  

Causes of Pain on the Outside of the Foot

cuboid syndrome

Cuboid Syndrome

The cuboid bone is one of the foot bones on the outside of the midfoot. When a joint or ligament near the cuboid becomes injured, it can cause the cuboid to slightly shift out of place, causing “cuboid syndrome”. 

This usually occurs from an ankle sprain or due to repetitive pressure on the cuboid bone from physical activity. 

Symptoms include pain and swelling around the cuboid bone. It can be difficult to walk due to instability and pain. 

Treatment

If you experience pain, make sure to rest and ice the foot.

You can wrap the foot using an ACE bandage to reduce pain and swelling. Elevate the foot to reduce swelling as well. 

You will need to see your foot doctor if you suspect you may have cuboid syndrome.

If the cuboid bone is shifted, your foot doctor will be able to reduce the cuboid bone back into its proper position.  This can be done in the office fairly quickly.  

If pain persists, your doctor may suggest custom orthotics with a cuboid pad incorporated into the orthotic. 

This is a wedge-shaped pad that can be applied directly onto the orthotic. The pad raises the cuboid bone and thus will provide pain relief when walking. 

lateral ankle sprain

Ankle Sprain 

There are three main ankle ligaments on the outer foot/ankle. If you twist your ankle, you may sprain or even tear one or more of the ligaments. 

This will cause immediate pain, bruising, and swelling in the outer foot. You may find it difficult to walk, and may even feel instability when you try to walk.

Treatment

Most mild ankle sprains will resolve with RICE therapy, an ankle brace, and physical therapy. 

It’s important to rest and take care of the ankle after an ankle sprain.  Rest will help reduce ankle swelling. 

Once the swelling reduces, you can wear an ankle brace to provide the ankle with support. The Zenith ankle brace works well for ankle sprains. 

However, if there is extensive damage to one or more ligaments, your doctor may choose to surgically repair the ligaments. 

After surgery, you will need to stay off of your foot for a minimum of 6 weeks. Recovery can take 3 months or longer. 

peroneal tendons

Peroneal Tendonitis Could Cause Outside of Foot Pain

The peroneus longus and brevis tendons start on the outer leg and course into the outer ankle and foot. These tendons are responsible for “eversion” motion. This means “outward” motion. 

Inflammation of the peroneal tendons can occur due to repetitive injury. If you have high-arched feet, you may strain these tendons more easily. 

Activities like running and dancing can aggravate the tendons further. 

If you sustain an ankle sprain, you may even tear the peroneal tendons. This can cause significant ankle pain with swelling. 

You may have a hard time walking due to the discomfort. 

Treatment

Start RICE therapy and limit your activities. 

For peroneal tendonitis, stabilization of the ankle and foot is needed. If you have significant instability with swelling, your doctor may suggest you walk in a cast boot. You can obtain a short cast boot on Amazon. 

If you have mild swelling, your doctor may suggest an ankle brace (Zenith ankle brace) to provide your ankle with stability. 

Orthotics can be beneficial to help stabilize the foot. You should obtain the Powerstep ProTech orthotic for arch support and stability. 

If your doctor suspects that you may have torn your peroneal tendons, he/she may order an MRI to evaluate the tear. 

If the tear is significant, surgery may be needed to repair the tear. After surgery, you will need to remain off your feet for 6 weeks until the tendon heals. 

Physical therapy can also be greatly beneficial in reducing pain associated with peroneal tendonitis. Physical therapy can help improve the strength of the tendon and reduce pain. 

fifth metatarsal base fracture

A Stress Fracture Could Cause Lateral Foot Pain

Repetitive stress on the outer foot can cause you to develop stress fractures. Stress fractures are commonly seen in athletes, and after activities that cause pressure to be placed on the outer foot. These activities include running, dancing, and walking. 

Some individuals are born with certain foot structures that naturally cause them to place more pressure on the outer foot. This can predispose them to developing stress fractures. 

Stress fractures on the outer foot are commonly seen in the fifth metatarsal. Fifth metatarsal base fractures are known as “Jones Fractures”. 

Treatment

If you develop a stress fracture in the fifth metatarsal, you will experience dull, achy pain in the outer foot. 

If x-rays confirm a stress fracture in the fifth metatarsal, you will need to remain non-weightbearing in a cast boot for 6-8 weeks until the fracture heals. If the fracture is shifted, your doctor will suggest surgery to repair it. 

A Tarsal Coalition Could Cause Pain in the Lateral Side of the Foot

A Tarsal Coalition could be causing pain on the lateral side of your foot. 

A tarsal coalition is when two bones on the back of your foot/ankle are connected. This is present at birth and discovered later in life on an x-ray. 

People who have tarsal coalitions may feel stiffness and pain in the areas where the bones are connected. This can cause lateral foot pain during activities.

Treatment

If the tarsal coalition is causing pain, NSAID therapy and orthotics can be beneficial. Steroid injections can also help to reduce pain. 

In some cases, surgery may be required. Depending on the location of the tarsal coalition, and whether arthritis may be involved in the joint, your doctor may choose to cut the fused bones to separate them or fuse the joint completely. 

sinus tarsi

Sinus Tarsi Syndrome

The sinus tarsi is the tunnel of space between your heel bone and your ankle bone. Inside the sinus tarsi, there is fatty tissue and ligaments present. 

When the structures inside the sinus tarsi get inflamed, it is called sinus tarsi syndrome. 

If you have very flat feet and roll inwards as you walk (pronate) the structures in the sinus tarsi can get inflamed. This can cause dull, achy pain in the outer foot/ankle.

Sinus tarsi syndrome can also occur due to ankle sprains. 

Treatment

Sinus tarsi symptoms can improve significantly with the use of orthotics. Orthotics raise the arch of the foot and thus decompress pressure from the joint.

It’s important to wear inserts that provide appropriate support and stability. 

Both orthotics help to elevate the arch and relieve pressure along the sinus tarsi. However, the Powerstep Maxx provides extra resistance against overpronation.

Physical therapy and steroid injections can also help to relieve pain along the sinus tarsi. In rare cases, surgical decompression may be required. 

Tailor's bunion

A Tailor’s Bunion Could Cause Foot Pain

A Tailor’s bunion or “bunionette” is a bone prominence at the 5th metatarsal head near the base of your baby toe. 

It is called a “Tailor’s bunion” because Tailors used to sit cross-legged on the floor and place pressure on the fifth metatarsal heads while working.  

Tailor’s bunions form due to the spreading apart of your fourth and fifth metatarsal bones that occur over time. This causes the bone at the fifth metatarsal head to stick out and cause pain. 

Tailor’s bunions usually occur due to genetics, but tight shoes can worsen symptoms. 

The 5th metatarsal bone is covered by a fluid-filled sac called a “bursa”. If your bunionette rubs against your shoes, you may notice redness due to bursitis (inflammation of the bursa). 

You may experience dull and achy pain while walking with and without shoes. 

Excessive pressure along the bottom of the Tailor bunion can cause a painful callus to form. 

Treatment

If you have a Tailor’s bunion, the best thing to do would be to wear the right shoes. Getting wider shoes is a simple way to completely alleviate pain. 

Another solution would be to purchase a Bunionette Gel Guard. You can obtain this from Amazon. By wearing a bunionette gel guard, you can prevent irritation to the bone while wearing shoes. 

If you have a callus on the bottom of your fifth metatarsal head in the area of your Tailor’s bunion, inserts can be beneficial because they can rebalance the feet and change the way you walk. 

Get the Powerstep Pinnacle Plus orthotic and place it in your shoes. This insert has a firm arch support with a deep heel cup. It also has a metatarsal pad incorporated into the insert to help offload calluses on the bottom of your feet. 

If you continue to experience pain, it’s best to contact your foot doctor to discuss surgical options for the Tailor’s bunion. 

Depending on the level of deformity, your doctor may suggest cutting and repositioning the bone to correct the deformity.

corn pinky toe

Foot Corns and Calluses Could Cause Outer Foot Pain

If you have pain in your fifth toe, you may have a corn. A corn is a hard layer of tissue that your body builds up to protect itself. 

If you have a bent toe (hammertoe) that is slightly rotated inwards, your 5th toe bone can rub against your shoes and cause a painful corn to develop. 

A corn usually develops from rubbing against shoe gear. It may sting and burn, and can feel especially uncomfortable when wearing shoes.

Treatment

Make sure you avoid shoes that feel narrow and have a shallow toe box. This may further irritate the skin overlying the fifth toe. 

For instance, certain shoes like high heels and dress shoes may rub uncomfortably against the fifth toe.

Find out more about How Bad Shoes Can Cause Foot Pain.

If you must wear certain shoes for work, the next best option would be to protect the toe itself. You can do this by applying Dr. Jill’s digital corn pads to the baby toe. This will offload the corn and can prevent irritation. 

You can also try applying a toe sleeve (toe fabric gel sleeve) on your pinky toe to cushion the toe when wearing shoes. This will help reduce pain. 

As far as how to get rid of the corn itself, soak your feet in warm water, and then once it’s dry, use a pumice stone to remove superficial dead tissue overlying the corn. Apply a thick moisturizer like Vaseline.

If your corn is too thick and painful, visit your local foot doctor to have the corn trimmed. This is a painless and effective procedure. 

arthritis

Arthritis Could Be Causing Your Foot to Hurt

If you suffer from rheumatoid or osteoarthritis, you may develop arthritic changes in your feet. 

The joints on the outer foot may be affected, causing dull and achy pain in the lateral foot. The pain may be worse in the morning and improve once you get moving. 

To read more about arthritis in detail, check out this supplemental guide “Simple Solutions To Manage Arthritis On The Foot”. 

Treatment

Rheumatoid arthritis is an autoimmune disease, whereas osteoarthritis is not. 

For Rheumatoid arthritis, your doctor may suggest immunosuppressant medications along with NSAID therapy to manage discomfort. 

If you have osteoarthritis, speak to your doctor about anti-inflammatory medications that you can take to help reduce symptoms.

You can also obtain Voltaren 1% Gel and apply it directly onto your foot. It is an NSAID gel that is effective in reducing pain and stiffness associated with arthritis. 

Orthotics can be beneficial for people who suffer from arthritis. Orthotics can help cushion and support the foot, thus relieving pain. 

Conclusion

As you can see, many different things could be causing lateral foot pain. It’s important to address lingering symptoms you may have so that you don’t develop a severe injury. 

It’s important to seek help from a medical health care provider at a nearby health center so that they can help diagnose and treat the condition. 

Proper foot care is important. The earlier patients diagnose and treat their medical foot injuries, the faster the recovery will be.

Related article: Outside of Ankle Pain- 5 Surprising Causes of Outer Ankle Pain

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References

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Vaishnavi Bawa
Dr. Vaishnavi Bawa is a Podiatrist who specializes in treating foot and ankle pathology. LifesLittleSteps mission is to educate the public about foot health in an easy-to-understand manner using evidence-based medicine.
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