Background
Defining foot pain
Prevalence of foot pain
Study | Sample source and description | Foot pain prevalence | Pain outcome measure and notes |
---|---|---|---|
Hill 2008 | 4,060 people aged ≥20 yrs (51% female) recruited by telephone interview (49% response rate) from north-western Adelaide, South Australia | 17% | Foot pain defined as affirmative response to 'On most days do you have pain, aching or stiffness in either of your feet?' |
Menz 2006 | 301 community-dwelling older adults (representing 31% response rate) aged 70–95 yrs (61% female) from Sydney, NSW, Australia | 36% disabling | Disabling foot pain defined as: current foot pain, foot pain in the past month, plus at least one item marked on the Manchester Foot Pain and Disability Index [4]. |
Badlissi 2005 | 784 community-dwelling older adults (representing 85% response rate) aged 65–101 yrs (57% female) from Springfield, Massachusetts, USA | 42% | Foot pain defined as: at least 'fairly often' foot pain in the previous week, or foot pain or discomfort 'most days' within the previous month [1]. |
Garrow 2004 | 3,417 community-dwelling adults (representing 84% response rate) aged 18–80 yrs (55% female) from North Cheshire and Manchester, England: | 22% (9.5% disabling) | Foot pain defined as: foot pain during the past month lasting at least one day. 'Disabling' foot pain defined using the Manchester Foot Pain and Disability Index (defined above) [5]. |
Menz 2001 | 135 community-dwelling older adults, all members of one private health insurance company (response rate of 28%)aged 75–93 yrs (59% female) Sydney, NSW, Australia. | 21% | Foot pain defined as: affirmative answer when asked whether they suffered from painful feet [7]. |
Leveille 1998 | 990 community-dwelling women (70% response rate) with a disability; aged 65 to ≥85 yrs from Baltimore, Maryland, USA | 18% moderate (14% chronic and severe) | Chronic and severe foot pain defined as: 7–10 on 10-point VAS for ≥1 month within the last year and present in the previous month. Moderate foot pain defined as: 4–6 on VAS for ≥1 month within the last year, or pain rated as 7–10 on VAS lasting ≥1 month and not present within the previous month [10]. |
Aetiology of foot pain
Associations and predictors of foot pain
Classification of foot pain
Physiological foot pain
Transduction
Transmission
Role | A-delta fibres | C fibres |
---|---|---|
Myelination
| Thinly myelinated | Unmyelinated |
Neuronal diameter
| 1 to 5 microns | < 1.5 microns |
Conduction speed
| 5–20 metres per second | 0.5–2 metres per second |
Stimuli
| Mechanical and sometimes thermal | High intensity mechanical, thermal and chemical |
Pain sensation
| Fast | Dull, throbbing, aching |
Modulation
Pathological foot pain
Neuropathic foot pain
Characteristic | Definition |
---|---|
Allodynia
| Evocation of pain by a stimulus that does not normally evoke pain. |
Dysthesia
| A spontaneous or evoked unpleasant, abnormal sensation, e.g. hyperalgesia and allodynia. |
Hyperalgesia
| Increased pain response to a stimulus that is normally painful. Might be static, punctate or dynamic, and might occur with thermal stimuli. Suggested to be a consequence of peripheral and/or central sensitisation. |
Hyperesthesia
| Increased sensitivity to stimulation, including diminished threshold and increased response. Excludes the special senses. |
Hyperpathia
| Increased threshold and abnormally painful reactions to stimuli, especially repetitive stimuli. Might occur with dysthesia, hyperalgesia, allodynia or hyperesthesia. Occurs in the presence of fibre loss. |
Paraesthesia
| A spontaneous or evoked, abnormal but not unpleasant sensation. Proposed to reflect spontaneous bursts of A-β fibre activity. |
Paroxysms
| Spontaneous or stimuli-associated shooting, electric-shock like or stabbing pains. Might be elicited by an innocuous tactile stimulus or by a blunt pressure. |
Referred pain
| Abnormal spread of pain from a peripheral or central lesion. Typically referred from deep to cutaneous structures. |
Sensory deficit
| Partial or complete loss of afferent sensory function. Might not involve all sensory pathways. |
Inflammatory foot pain
Chronic foot pain
Changes in foot pain perception with age
Quantifying foot pain
Impact of foot pain
Domain | Impact |
---|---|
Social life
| Inability to pursue hobbies among children and adolescents [72] School absenteeism among children and adolescents [72] |
Physical function
| Fear of movement and re-injury in chronic musculoskeletal pain [76] |
Mental function
| Interpersonal strain due to behavioural changes among children and their families [75] Increases severity of depressive symptoms [85] |
Overall impact
| |
Health care
| Impairs recognition of depression [91] Impairs adherence to medication if coinciding with depression [93] |