Fibromyalgia and foot pain

Research tells us that 50 percent of people with fibromyalgia report pain in their feet. Here I will discuss some of the reasons, what can be done about them and share my own personal story with fibro and feet problems. 

Fibromyalgia is a long term pain disorder. This means that you live with pain each and everyday and it can be in any part of our body. Today I am talking about the feet. 

The foot has three areas; the ankle, the middle and the toes. They have many muscles, nerves and joints... actually there are 26 bones and 33 joints in each foot. 

The feet bear the weight of our body, so it’s not surprising that we get pain in this area. As well as pain in the feet pain can be referred to our ankles, knees, hips and back from problems in the feet.

If your foot pain is persistent, your doctor can help determine the best treatment.   

The feet are complex as can be seen in this illustration of the muscles.

There are many conditions that cause foot pain. These conditions may not be caused by fibromyalgia but fibro is what amplifies the pain. 

Osteoarthritis may cause episodes of pain and swelling in one or multiple joints. It can also cause bone enlargement and changes in the shape of feet, which may also cause pain. Between 10-15% of people with osteoarthritis also have fibromyalgia.

Treatment includes:

• Anti-inflammatory drugs.
• Taking over-the-counter pain relievers.
• Wearing pads or arch supports.
• A steroid injection into the foot.
• Using canes or braces to support the joints.
• Using an orthotic in the shoes.
• Physical therapy.
• Wearing custom shoes.

Plantar fasciitis causes pain in the heel. It is an inflammation of the band of connective tissue on the surface of the foot connecting your heel bone to your toes.

Usually, it hurts the worst in the morning when first getting out of bed. You feel it in your heel or the arch of your foot.

Treatment includes:

• Resting your foot.
• Specific heel and foot muscle stretches.
• Taking over-the-counter pain relievers.
• Wearing shoes with both an arch support and a cushioned heel.

Heel spurs are a growth of bone on the bottom of your heel. You can be caused by wearing ill-fitting shoes or from postural problems or from running. 

They hurt when you walk, run or stand. They are more common in people with flat feet or high arches.

Treatment includes: 

• Resting your foot.

• Wearing a horseshoe shaped pad.
• Using an orthotic in the shoe.
• Wearing shoes with shock-absorbing soles.
• Taking over-the-counter pain relievers.
• Trying physical therapy.

Morton's neuroma causes a thickening around the nerves between the base of the toes (usually between the third and fourth toes). You may` feel pain, or numbness on the ball of your foot. It can be a result of wearing high heels or tight shoes.

Treatment includes:

• Wearing shoe inserts to reduce pressure on the nerve.
• A steroid injection into the foot.
• Taking pain relievers.
• Don’t wear high-heeled shoes or ones with a narrow toe box.
• Avoid activities that put pressure on the neuroma.
• Ask your doctor about surgery.

Sesamoiditis is the inflammation of tendons near the big toe.  It’s a form of tendinitis, common with runners and ballet dancers.

Treatment includes:

• Resting your feet.
• Icing where it hurts.
• Wearing a pad under the toe.
• Taping the toe to immobilize the joint.
• Wearing low-heeled shoes.
• Asking your doctor about steroid injections.

Flat feet, happen when the arches of the feet flatten. It can cause foot pain. 

Treatment includes:

• wearing shoe inserts
• shoe adjustments 
• resting 

Neuropathy is nerve damage in the feet. The pain can be burning, stinging, or feel like electricity. It can happen anywhere in the feet. 

Treatment includes:

• Pain relievers. 
• Anti-seizure medications. 
• Topical treatments. 
• Specific Antidepressants that may block the nerve pain.

So what we are seeing from these treatments is that they block the pain but do not cure it. They may provide relief while we continue to use them. When we stop the pain may still be there.

Alternative treatments include:

• Acupuncture is one of the few treatments that has been shown to improve nerve function, helping to lessen symptoms and promote healing. Studies on peripheral neuropathy show improvements in clinical symptoms and also objectively showed improvements when testing nerve conduction. (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8247887/)
• Vitamins and minerals: B vitamins are useful in treating neuropathy since they support healthy nervous system function. Peripheral neuropathy is sometimes caused by a vitamin B deficiency. (Healthline)

Tendinitis is inflammation and irritation of the tendons, the bands attaching the muscles to the bones. 

Treatment includes:

• Resting your foot.
• Taking pain relievers.
• Steroid injections.

My own personal story with fibro and feet problems.

I have a history of fibromyalgia and peripheral neuropathy. I was a ballet dancer for many years so I am no stranger to foot pain. 

Also I have always had a large bone on the heel of both feet which I recently found out is called Haglund's deformity. It has never really caused me a problem until recently except for finding shoes that were soft at the back. 

Switch to lower heels

About seven years ago I decided I would never wear heeled shoes again. I wore them very rarely but the last two times I did they caused so much pain and I went over on my right heel both times. 

I had difficulty just walking in normal shoes but having so much pain, from fibro, in the legs and hips and feet it is hard to work out where the problem is originating from. 

My foot pain did not improve. I started to focus on my feet more.  I have found thick rubber soled shoes very helpful. I prefer lace up walking shoes for the best comfort. I was never a person who even wore shoes around the house so this is a big, and beneficial, change for me.

I also researched and bought support socks which really do give a feeling of extra support. 

Also wearing supportive socks is very soothing and does seem to reduce the tingling. The ones I really like are Thorlos Unisex Walking Thick Padded Crew Sock or any sock that is padded in the foot. I find they really give more support and less pressure on the foot.

My peripheral neuropathy became unbearable, as besides being in the feet and legs, hands and arms it was in my face. The doctor at the pain clinic suggested a small anti-depressant dose which worked brilliantly to block the sensations. 

Once these tingling pain sensations were blocked I could feel other pains in my feet when I walked or stood too much. 

The pain on walking increased and I did develop plantar fasciitis in one foot. I did the prescribed exercises and stretches and after a while the pain subsided. 

I then developed pain in the achilles area and the heel. I also realised that the bone that protudes at the back of my heel, (haglund's deformity) was causing a pulling sensation and also aching a lot of the time. 

See the doctor.

If you are like me it is difficult to work out what is wrong with your own feet and you really need an expert to navigate through all the pain and limping. I am still awaiting my appointment with the specialist and will update this when I find out the official diagnosis.  

How I keep moving.

What I have learnt is it is important to keep my joints moving. However I needed to try different types of exercise because of the painful feet. 

I am exercising in water. The buoyancy of the water takes the  pressure off my ankles and feet and I can move more freely than I can on land. I can also get my heart rate up, for a short while, so this may help with weight loss. 

Support shoes

I went to the Athletes Foot shoe store where they assess your walk and they said my right foot was pronating which means it needs an arch support. I purchased the shoes they suggested and I can feel that they support my feet much better but I still have foot pain. 

I also purchased the shoe inserts they suggested which I can put in my other shoes. These orthotics have a slight arch and extra heel support. 

So my suggestions for reducing foot pain include:

• Switch to lower heels.
• Lose weight if you need to.
• Exercise in water.
• Wear support socks.
• Wear support shoes designed for your foot.
• Wear orthotics.
• See a foot doctor: a podiatrist or an orthopaedic foot and ankle surgeon.

So you can see that feet problems can be ongoing and complex. I have learnt a lot but am still awaiting professional help. 
Do you have a foot problem that I have not mentioned here? I would love to hear about it. 

RESOURCES:   
National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)
U.S. National Library of Medicine.
WebMD
Arthritis Australia

Acupuncture treatment of diabetic peripheral neuropathy: An overview of systematic reviews