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FOOT PAIN Inside of Foot Pain

Stabbing Pain on Side of Foot: Causes & Treatments of Sharp Foot Pain

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Stabbing pain on the side of the foot can be painful, causing you to limit your activities. There are several different causes of stabbing foot pain on the side of the foot that include tarsal tunnel syndrome, plantar fasciitis, nerve pain, injuries, tendonitis, and sprains. 

In this article, you’ll learn about the conditions that cause stabbing foot pain, as well as how to treat them. 

Common Causes of Stabbing Pain on the Side of the Foot

tarsal tunnel

Tarsal Tunnel Syndrome can cause sharp foot pain

The tibial nerve, along with blood vessels sit in the tarsal tunnel region of your ankle. This region is a passageway in between your inner ankle bone and heel.

There is a nerve on the inside of your ankle that branches into your foot. This nerve is called the tibial nerve.

When the tibial nerve gets compressed or squeezed it can cause stabbing pain to occur that starts at the ankle and shoots towards your toes.

Tarsal tunnel can occur if something like a mass, arthritis, or varicose veins impinge on the nerve. 

People with flat feet are also prone to experiencing tarsal tunnel syndrome. If you are flat footed and roll inwards as you walk, the tibial nerve can become compressed. 

Treatment

Tarsal tunnel syndrome can often be treated conservatively. Usually wearing shoes with appropriate arch supports and orthotics can help significantly to alleviate pressure along the tarsal tunnel.

This is especially helpful if the compression and stabbing pain is occurring secondary to a flatfoot structure.

The Powerstep Protech Orthotic is great for tarsal tunnel syndrome. It has a firm arch and provides appropriate support. 

Make sure your shoes and especially boots are not too tight. Any compression to the ankle can aggravate the nerve further. 

Steroid injections for tarsal tunnel can also be very effective. Your doctor can inject the tibial nerve directly with an anesthetic and steroid, which can help reduce inflammation of the nerve. 

Your doctor may also suggest resting the foot for some time, followed by physical therapy to reduce pain. 

Compression stockings can also help to reduce swelling in the ankle, especially if you suffer from varicose veins. Make sure to go to a medical equipment store to get your ankles and legs measured to make sure you are getting the right size. 

If there is a soft tissue mass that is compressing the nerve, your doctor may choose to surgically excise the mass. 

In severe cases, your doctor may choose to perform tarsal tunnel surgery. This would involve decompressing the tibial nerve in the ankle. This is usually a last resort.

posterior tibial tendon

Posterior Tibial Tendonitis Can Cause Stabbing Pain in the Foot

Posterior tibial tendonitis can cause dull, achy pain along the inner ankle and foot.  The posterior tibial tendon is a tendon that courses behind the inside of your ankle and attaches to a bone on the inside of your foot.

If you have a flat foot structure, this tendon can become strained. The constant strain on the tendon can cause the tendon to become inflamed or even tear.

This can cause stabbing pain to occur on the inside of your foot. 

Treatment

Arch supports can be very effective in relieving tension along the tendon. NSAIDs can also help to reduce pain.

If the stabbing pain and inflammation are severe, your doctor may suggest wearing an ankle brace to help stabilize the entire ankle.

Physical Therapy can also help to strengthen the tendon and reduce the pain. You can perform stretching exercises at home.

Check out this article on how to perform proper stretching exercises for posterior tibial tendonitis. 

If the pain is severe, your doctor may have you walk in a cast boot for a few weeks until the inflammation reduces.

Wearing high-top boots and high-top tennis shoes can be helpful to wear if you suffer from posterior tibial tendonitis. 

The ankle support that comes from wearing high-top shoes can help improve stability. Make sure your shoes are rigid on the bottom and have appropriate arch support. 

Make sure when picking your shoes that you get recommendations from your foot doctor or your local shoe store. 

In some cases, surgery may be indicated. If you have a deep tear of the posterior tibial tendon, your doctor may choose to repair it.

If the tendon tear is occurring secondary to a flatfoot structure your doctor may choose to repair your flatfoot. This is an extensive surgery and it should only be done as a last resort. 

deltoid ligament sprain

Ankle Sprains  

There is a group of ligaments on the inside of the ankle that connects the ankle bone to the foot.

This is called the deltoid ligament. It keeps you from rolling your foot and ankle inward. If you sprain your ankle during an injury, you may sprain this ligament. This can cause stabbing pain on the inner ankle.

Luckily, deltoid ligament sprains are rare. When they do occur, you may feel pain and swelling in the inner ankle. You may also have a hard time bearing weight on the foot/ankle for a while. 

Ankle sprains along the outer ankle (lateral) can cause stabbing pain as well. Sprains of the lateral ankle ligaments can cause stabbing pain during ambulation. 

Treatment

RICE therapy can be effective for treating ankle sprains. You should rest the foot immediately and elevate your leg on pillows. You can ice the ankle/foot intermittently and wrap the ankle using an ACE bandage. 

You will need to walk in a cast boot for up to 4-6 weeks if you sustain a moderate to severe ankle sprain. 

This United Ortho short cast boot works great because it stabilizes the foot and ankle.

Your doctor may also suggest physical therapy to help reduce pain and also improve balance.

neuropathy

Nerve Pain

If you have stabbing foot pain on the side of your foot, you may be experiencing pain secondary to peripheral neuropathy. In this condition, the peripheral nerves are affected. You may feel shooting pain, tingling, and burning pain. The pain can be intermittent or persistent. 

A lot of conditions can cause neuropathy in the feet. Diabetes is the most common condition where neuropathy is seen.

Dr. Caitlin Hick’s article in Current Diabetes Reports reported that 50% of patients with diabetes will likely suffer from diabetic neuropathy in their lifetime4.

Other causes of neuropathy include alcohol abuse, trauma, and certain medications. Sometimes, the cause of neuropathy is unknown. This is called idiopathic neuropathy. 

Treatment

Although neuropathy is not reversible, you can treat the symptoms of neuropathy with medications. These medications can include numbing creams such as Lidocaine 4% cream, or prescription pills that help with neuropathy symptoms.

If you have neuropathy it’s also important to wear appropriate supportive shoes and avoid walking barefoot. You may also want to speak to your foot doctor about obtaining orthotics to help with balance.

To learn more about nerve pain in the foot, check out this supplemental article Ultimate Guide To Nerve Pain In the Foot.

Metatarsal Fractures

If you have stabbing foot pain on the side of your foot, you may have a metatarsal fracture. Acute metatarsal fractures occur from direct injury to the foot. Stress fractures occur due to repetitive pressure on a bone. 

Jones fractures are common fractures that occur at the fifth metatarsal base on the outer side of the foot. Since there are nerves that surround the bone, sustaining a fracture can irritate the nerves and cause sharp stabbing pain in the foot.

Treatment

Depending on the fracture, your doctor may suggest that you walk in a cast boot for a few weeks. If the fracture fragments are shifted, your doctor may suggest surgery. This would require you to be off your foot for a several weeks after surgery. 

inside foot pain sitting

Plantar Fasciitis

Plantar fasciitis is when the ligament called the plantar fascia on the bottom of the foot becomes inflamed and irritated. This can cause a sharp, stabbing pain on the side of the foot that occurs in the heel or arch of the foot. 

The pain may be worse in the morning or after prolonged periods of standing or walking. Plantar fasciitis can be caused by a variety of factors, including overuse, improper footwear, and tight calf muscles. 

Treatment

Treatment for plantar fasciitis includes plantar fascia stretches, rest, and wearing proper arch supports. Physical therapy can be beneficial in helping to improve flexibility and strength in the foot and lower leg muscles. In some cases, corticosteroid injections or surgery may be necessary. 

Other Causes of Stabbing Lateral Foot (Outer Foot) Pain

Other causes of stabbing foot pain on the outside of the foot include: 

Lateral Ankle Impingement

This occurs when the ligaments or soft tissues on the outer side of the ankle become compressed or pinched, causing ankle pain and swelling.

Peroneal Tendonitis

Peroneal tendonitis can cause stabbing foot pain on the outer foot because the peroneal tendons, located on the outer side of the ankle and foot, become inflamed or irritated, leading to pain, swelling, and tenderness. 

Peroneal tendonitis is caused by overuse or repetitive stress on the tendons, such as in sports that require frequent jumping, running, or sudden changes in direction.

Gout

Gout is a type of arthritis that can cause sudden, stabbing pain in the joints of the foot, including the lateral foot. Gout is caused by a buildup of uric acid crystals in the joints and is often associated with a diet high in purines, such as red meat and seafood.

The treatment for stabbing foot pain on the outside of the foot from lateral ankle impingement, peroneal tendonitis and gout will depend on how severe the symptoms are. 

Lateral ankle impingement may require physical therapy to stretch and strengthen the affected area or in some cases, surgery may be necessary to relieve pressure on the affected ligaments or soft tissues. 

For peroneal tendonitis, rest, ice, compression, and elevation of the affected foot, as well as physical therapy exercises to strengthen the muscles and improve flexibility can improve symptoms. 

For gout, medications such as nonsteroidal anti-inflammatory drugs (NSAIDs) or Colchicine may be prescribed to reduce pain and inflammation. 

Conclusion 

In conclusion, stabbing foot pain on the side of the foot can be caused by a variety of conditions. 

If you experience stabbing foot pain that is persisting for longer than a few weeks, it’s important to get evaluated by your foot doctor.

The faster you know what could be causing the stabbing pain on the inside of your foot, the quicker you can effectively treat it.

Related article: List of Foods to Avoid With Gout (And What to Eat Instead)

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References

  1. Hicks, C. W., & Selvin, E. (2019). Epidemiology of Peripheral Neuropathy and Lower Extremity Disease in Diabetes. Current diabetes reports, 19(10), 86. https://doi.org/10.1007/s11892-019-1212-8
  2. Kiel J, Kaiser K. Tarsal Tunnel Syndrome. [Updated 2022 May 13]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK513273/
  3. Bubra, P. S., Keighley, G., Rateesh, S., & Carmody, D. (2015). Posterior tibial tendon dysfunction: an overlooked cause of foot deformity. Journal of family medicine and primary care, 4(1), 26–29. https://doi.org/10.4103/2249-4863.152245
  4. Mayer, S. W., Joyner, P. W., Almekinders, L. C., & Parekh, S. G. (2014). Stress fractures of the foot and ankle in athletes. Sports Health, 6(6), 481–491. https://doi.org/10.1177/1941738113486588
  5. Shatto, Ben. (2018, October 28). How to Self-Treat Tarsal Tunnel Syndrome. Retrieved from https://www.marathontrainingacademy.com/tarsal-tunnel-syndrome

Photo Credit

http://www.scientificanimations.com/, CC BY-SA 4.0 https://creativecommons.org/licen

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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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