Why do I have pain on the outside of my foot?

Pain localized to the outside of the foot is a common complaint in our offices.  It often occurs after an injury, such as after turning your ankle, but often presents with no history of any injury at all.  Let’s discuss some of the more common causes of pain on the outside of your foot that is not the result of an injury.

Tailor’s Bunions

Tailor’s Bunions are bumps on the outside of your foot, just behind your little toe.  It is usually the result of a life-long instability in the way your foot works.  This instability causes a muscle imbalance, as your muscles may be working in ways that they shouldn’t.  This eventually causes the toes and bones to move into a bad position.  In the case of the Tailor’s Bunion, the little toe starts to curve toward the fourth toe, and the metatarsal bone behind it moves the other way.  The fifth metatarsal head is then prominent on the outside of the foot and can become irritated from shoe pressure.

Treatment for painful Tailor’s Bunions includes comfortable shoes, Tailor’s Bunion pads, orthotics to address the instability, topical and oral anti-inflammatory medications, cortisone injections and sometimes therapy to reduce the inflammation and pain.  When conservative care isn’t enough to keep you comfortable, surgery may be necessary to remove the bump.

If you have pain directly over the shaft of the fifth metatarsal that occurs with every step you take, you may be experiencing a stress fracture or stress reactionStress fractures or stress reactions can occur if you’ve imparted stresses to the bone that it’s not ready to accept.  For example, starting to exercise too quickly, or changing your activities, such as doing more walking than usual (like when you’ve just taken a vacation and did a lot of walking), are common causes of stress injuries.  Stress injuries are not the result of an acute injury such as falling or twisting your ankle.  Symptoms of stress injuries usually include pain with standing and walking, and usually is accompanied by swelling.  A stress fracture is an actual crack in the bone, although it may not show up on x-rays for a couple weeks after the onset of symptoms.  Stress reactions cause the same symptoms but without an actual fracture.   An MRI can usually identify the edema within the bone when x-rays can’t.

Treating stress fractures and stress reactions is the same, however, and is to simply to immobilize the foot, reduce or completely eliminate the stresses imparted to the foot, and give it time to heal.  These conditions heal very well when the foot is immobilized in a walking boot for four to six weeks.

Another very common condition we see is peroneal tendonitis.  The peroneal tendon courses around the outside of the ankle and attaches to the fifth metatarsal base on the outside of your foot about midway between your heel and your toes.  There is a bump there where the bone flares out.  This is where the tendon attaches.  The tendon can become inflamed as a result of an injury, such as turning your foot or ankle inward but commonly occurs as a result of compensation from another painful condition or a general foot instability.  If the inside of your heel, arch or ankle is painful, then it is natural for people to walk on the outside of their foot.  This causes excessive tension to the peroneal tendon and often leads to inflammation and pain where the tendon attaches, and often up to the course of the tendon to, and sometimes around, the ankle.

Treatment for peroneal tendonitis can include anti-inflammatory medications, cortisone injections, physical therapy modalities, immobilization, and orthotics.

Pain on the outside of your foot is not normal and is easily treatable.  If you have pain on the outside of your foot, see one of our doctors at Kansas City Foot and Ankle.  We have in-office diagnostic modalities such as digital x-rays and ultrasound in order to help properly diagnose your condition right away, and the expertise to get you back on your feet quickly and comfortably. Call 816-943-1111 to schedule an appointment at one of our offices.