Foot Pain in Fibromyalgia

Is it a Symptom or Something Else?

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Does fibromyalgia cause foot pain? Certainly, with this condition, pain can hit anywhere, at any intensity, at any time. Several studies show that we fibromites have more foot pain than other people.

While all kinds of pain are unpleasant, some have a bigger impact on your life. Chief among these is foot pain, because walking is an essential function. Some readers have said:

  • "The bottoms of my feet felt like they were on fire. These pains come and go, sometimes [lasting] for months."
  • "[I] can't wear a flip flop or any kind of shoe."
  • "I can't stand to touch my bare feet to the floor. I have to wear memory foam slippers around the house."

During a flare of foot pain, you may find that just resting your foot on the floor causes a burning pain. Shoes can hurt not only on the soles of your feet but the tops as well. Walking? Agony. Stepping on something like an electrical cord can feel like you're being cut by a razor blade. A common complaint is waking up with feet that feel like you've been walking for hours.

Foot pain is a major problem. When every step is agony, it makes it hard to do much of anything. When you're already limited because of fibromyalgia, you hardly need one more thing to keep you from doing what you want or need to do.

What Causes Foot Pain?

We're just starting to see research specifically on foot pain in fibromyalgia. So far, we can't say anything for sure about what causes it, but we're starting to get support for some likely suspects.

A study published in Arthritis Research & Therapy found that about 50 percent of people with fibromyalgia report pain in one or both feet. That seems like a lot of us, but the same study showed that 91 percent have neck pain 79 percent experience hip pain. In fact, the feet were among the least likely places to hurt.

Still, it's important to look at foot pain because your ability to walk has a big impact on how functional you can be. Foot pain can make you walk differently, which may lead to back, hip and knee problems.

Research lead by Ginevra Liptan, M.D., may shed light on one possible cause of our foot pain. It suggests that fibromyalgia involves inflammation of the fascia, which is a thin layer of connective tissue that runs throughout your entire body. If the word "fascia" reminds you of "plantar fasciitis," there's a good reason.

Plantar fasciitis is a common cause of foot pain involving a band of fascia that runs along the bottom of your foot, helping support the arch. We don't know anything for sure yet, but some people speculate that plantar fasciitis is a symptom or common overlapping condition with fibromyalgia.

Another common condition in us, which also involves the fascia, is myofascial pain syndrome. It involves small, ropy nodules in the fascia called trigger points, which can be painful and may also cause what's called referred pain, which is felt away from the trigger point.

In a 2016 study published in Pain Medicine, researchers say that pushing on trigger points reproduced foot pain in participants.

They also found high sensitivity to pressure in the plantar region of the foot.

Also in 2016, the journal Foot published a study suggesting that the subtalar joint, which is just below the ankle, is frequently dysfunctional in fibromyalgia. Out of 20 women who participated, 12 had hypermobility (excessive range of motion) in that joint, while five had hypomobility (limited range of motion.)

However, a 2017 study in Foot found no abnormalities in the joints of the feet, ankles, or legs of 50 people with fibromyalgia. We'll need more research in this area to know for sure whether we're more especially likely to have joint problems that could contribute to foot pain.

It's also possible that, for some of us, foot pain is caused purely by fibromyalgia. Our nerves are highly sensitive, and few areas take a beating like our feet. It stands to reason that they could hurt "just" because the nerves get riled up.

Your foot pain may also come from an overlapping pain condition such as:

    Foot pain can also come from a lot of other sources that have nothing to do with fibromyalgia. If you have foot pain that is persistent or limits your ability to function, be sure to talk to your doctor about it and don't just assume it's part of your fibromyalgia.

    No matter the cause of foot pain, fibromyalgia amplifies it, just as it does with all pain.

    Easing Your Foot Pain

    When foot pain is caused by an injury or an overlapping condition, your doctor can help you find the right treatment.

    Otherwise, you'll need to find ways to manage it. The following is a list of things that have helped some people with these conditions ease their foot pain (remember than these are only personal experiences and they might not work for you):

    • soft, well-cushioned slippers
    • thick socks or diabetic socks
    • soft-soled shoes
    • soaking in hot water and Epsom salts
    • gentle stretching
    • extremely gentle massage
    • cooling lotion
    • orthotics

    A 2012 study on custom orthotics suggested that they may help people with fibromyalgia function better overall. (It did not look specifically at foot pain.)

    It's likely to take some time and experimentation to find the best way(s) to relieve your foot pain.

    Sources:

    Friend R, Bennett RM. Distinguishing fibromyalgia from rheumatoid arthritis and systemic lupus in clinical questionnaires: an analysis of the revised Fibromyalgia Impact Questionnaire (FIQR) and its variant, the Symptom Impact Questionnaire (SIQR), along with pain locations. Arthritis research and therapy. 2011 Apr 8;13(2):R58.

    Liptan, GL. Fascia: A missing link in our understanding of the pathology of fibromyalgia. Journal of bodywork and movement therapies. 2010 Jan;14(1):3-12.

    Padin Galea JM, Fernandez-Acenero MJ, de la Fuente JLM. Characteristics of patients with fibromyalgia. Foot. 2017 Apr 4;32:27-29. doi: 10.1016/j.foot.2017.04.001.

    Silva AP, Chagas DD, Cavaliere ML, et al. Kinematic analysis of subtalar eversion during gait in women with fibromyalgia. Foot. 2016 Aug;28:42-46. doi: 10.1016/j.foot.2016.09.010.

    Tornero-Caballero MC, Salom-Moreno J, Cigaran-Mendez M, et al. Musicle trigger points and pressure pain sensitivity maps of the feet in women with fibromyalgia syndrome. Pain medicine. 2016 Oct;17(10):1923-1932.

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