What could be the cause for soreness at the top and sole of my feet?

Thanks for your question - sounds like the foot pain is quite troubling, particularly if it has been going on for some time!

Dr Sean has asked some important questions, particularly regarding an overuse injury; often overuse injuries are on a spectrum from normal tissue on one end to a overuse/stress changes in the middle and stress fractures at the other extreme.

As he says, assessment clinically and is important to determine if your pain is due to this or another problem, such as a morton's neuroma, synovitis of a meta-tarsophalangeal joint, foot OA or others.

Imaging can take the form of an X-ray, or in most sport clinics you can undergo a quick ultrasound scan to look for soft tissue injuries.

In this situation, it might be an idea to consult:

1. An MSK/Sports Physician

2. A Sports Podiatrist

3. An Orthopaedic surgeon

Each will have their own take on the symptoms and look into it from various aspects. Perhaps you can start with number 2 - a Sports Podiatrist - in some hospitals they are available either as a direct referral from GPs or within a multidisciplinary Sports/MSK Medicine Centre.

Hope this help and good luck with your symptoms.

BW

Dr Dinesh

Thank you for your email. Have u been doing anything strenuous/ more than usual physical activity before the pain/ soreness started?

A lot of times it can be due to an overuse injury. Sometimes there are some other less common reasons like malalignment, or even a hypersensitive nerve. I would need to take a look at your foot and examine it, and we may also need further radiological imaging. Then we will know what we are dealing with, and can then institute the correct treatment for the problem.

If the foot is still persistently symptomatic, it would be prudent to contact an Orthopaedic surgeon, especially someone that manages a lot of foot and ankle problems.

Do let me know if there is something else I may be of help for.

Best regards

Dr Sean Ng

Thank you for your email. This persistent foot pain is definitely not normal, typical "sprain/ strain" should resolve within a week or two.

Before we start, we need to ask you a few more questions about your symptoms:

1. Was there any injuries involved? (it means that we might have to suspect fractures or ligaments tear)

2. Does this pain radiates from somewhere? Is there any associated symptoms such as numbness/ paraesthesia (ant biting sensation)/ weakness? (it means that the pain maybe referred from the spine and could be nerve related)

3. Will the pain be bad enough that keeps you awake at night? (it means that we might have to suspect something more sinister such as some kind of abnormal growths)

Sometimes fractures can occur without major fall/ injury, they can occur with repeated loading/ strenuous exercises, the classic example is stress fracures in the metatarsal bones in soldiers who are required to do long distance marching.

Another uncommon cause of foot pain would be a Morton's neuroma, typically felt as a persistent "pebble in the shoe". It's a benign growth of one of the nerves in the foot which may get impinged or irritated from the movements of the foot.

To clinch the diagnosis, we would need to perform careful physical examination and advanced imaging (X rays can rule out fractures, but MRI would be able to pick up more information about where there are ligaments tear or any abnormal growths).

I would definitely recommend you to get check out by an Orthopaedic Surgeon or a Sports Physician. Only after the cause of your symptoms had been established, then we can initiate appropriate treatments.

Hope it clarifies some of your doubts.

Cheers,

Dr. Henry Chan