Medial Foot Pain

Medial Foot PainThe ‘medial’ side of the foot is the inside of the foot – the part closest to the mid-line of the body. As well as playing an important role in foot function and being subjected to considerable force when walking or running, this part of the foot has a complicated structure, housing multiple large joints, ligaments and tendon insertions. Due to these factors, it is also a common site for aches, pains and injuries and the potential causes of this medial foot pain will be discussed in this article.

Essentially, medial foot pain (or inside of foot pain as it may be called) can occur at any site along the medial column of the foot running from the back of the heel to the tip of the big toe. Below is an overview of the most common conditions that can cause pain in this area. I have organised the conditions as ‘fore front’, ‘mid-foot’ and ‘rear foot’ to aid your understanding and skip to the section that is applicable to you.

Medial Foot Pain Causes

Fore Foot

Bunion (Hallux Abducto-Valgus)

The ‘bunion’ is a very common foot condition that is far more common in females than in men and this may be attributable to poor footwear choices, although the evidence to support this is contradictory. Generally, people think of a bunion as bump at the side of the big toe, but in actual fact the whole foot structure becomes altered, especially in established cases. The first toe drifts sideways away from the mid-line of the body and the first metatarsal (long bone on the medial side of the foot) drifts sideways towards the mid-line of the body. This creates an angle at the joint between the first metatarsal and first toe, greatly exposing the area.

The rubbing on this joint from footwear tends to be the primary cause of pain associated with a bunion as the over-lying skin becomes irritated and inflamed. Pain associated with this condition can also be associated with arthritis (see below) and may radiate across the top of the foot. Once a bunion is established it is not correctable, unless through surgical procedures. The best way to manage it is to avoid the trauma from the footwear through sensible footwear choices or cushioning foot protectors.

Arthritis Of The Big Toe Joint (Hallux Limitus)

The big toe joint is very prone to damage (such as the constant impact on footwear or kicking a football incorrectly) due to its prominence. Repeated damage to the joint through impact or faulty foot mechanics can eventually lead to arthritic changes can occur at this joint. This will manifest as a stiff joint that becomes very achy and painful. Although a common cause of medial foot pain, arthritis can also occur in any other joints of the foot and is not strictly limited to the forefoot.

Middle Foot

First Metatarsal Trauma

The first metatarsal is the long bone that runs down the inside side of the foot. Due to this area being exposed and unprotected by any of the surrounding structures it is liable to become bruised, fractured or even broken upon impact. Simple things like kicking a table leg by mistake or stumbling in to a solid object can cause such trauma. This is very common in sporting people and you often hear about footballers breaking their metatarsals. The first metatarsal is significantly thicker and stronger than the rest, so breaking this metatarsal is unlikely, and a fracture or bruise is far more likely.

Tarsal Coalition

This condition tends to manifest in both the mid-foot and heel of foot area. It describes the joining of two bones in these areas, resulting in pain in the area. This condition is not very common and usually presents during childhood or adolescence. There is no way to properly determine the presence of this condition other than expert examination or x-ray.

Rear Foot

Medial Ankle Sprains

This is a tear or partial tear of the ligaments that surround the inside of ankle, when the foot is subjected to a considerable eversion (inward rolling) motion. This type of ankle sprain is actually relatively rare in comparison to a lateral (outside) ankle sprain due to the strength of these ligaments. In actual fact, the ligaments are so strong that often a fracture/break will occur in the bones in this region before the ligaments tear. However, if you are affected by this, rest ice and compression therapy is recommended. Ankle supports may be used during the rehabilitation process.

Tarsal Tunnel Syndrome

This syndrome describes the compression of the posterior tibial nerve as it passes through the tarsal tunnel along with the tendons and blood vessels of the lower limb. As the nerve is compressed, feelings of numbness, tingling or even shooting pains can appear in the areas that this nerve supplies sensation to. This will typically be around the heel radiating down the medial foot to the big toe and first 3 toes.

Posterior Tibial Tendinitis

This is the inflammation of the tendon of the posterior tibial (or tibialis posterior) muscle. This muscle runs down the back of the lower leg and the tendon passes round the medial side of the ankle before entering the underside of the foot. The inflammation may occur when the muscle/tendon becomes irritated such as in overuse scenarios e.g. running further than you are used to or when you first start running. The pain will most likely be felt on the inside of the ankle. Rest is the best medicine for this condition!

These are among the most common causes of medial foot pain. I hope you now have a better understanding of what is causing your foot pain and the best treatment options. Please consult your Podiatrist or Physician for further information.