Lateral Foot Pain: 6 Possible Causes

What is Lateral Foot Pain?

Lateral foot pain describes any pain that is on the outside of the foot, from the base of the foot, up to the ankle joint. Lateral foot pain can be either an acute injury, like a sporting injury, or a more chronic overuse problem.

What are the symptoms of lateral foot pain?

Pain in the lateral foot is felt from the outside of the foot and ankle. It can occur before, during or after activities such as walking and running. Other symptoms include instability, tenderness, swelling, susceptibility to ankle sprains, and difficulty moving around from standing on your foot and walking.

What causes lateral foot pain?

There are many potential causes of lateral foot pain, but often it is due to overuse injuries, such as running problems, poor footwear, or a combination of both. Lateral foot pain can result in stress injuries, peroneal tendonitis and even plantar fasciitis.

1. Stress Fractures

Also referred to as hairline fracture, a stress fracture can happen when you get tiny cracks in your bone from overuse or repetitive motions.[1] The root cause can differ from a regular fracture that only occurs when there is a single injury. Activities like intense exercise or playing basketball or tennis are common causes of a stress fracture.

Complaints of nagging pain usually happen when weight-bearing or pressure is applied to the foot. To diagnose this, your doctor will perform a physical examination, testing various movements and exercises. They may also do diagnostic imaging to get a better view of your foot internally, like an MRI scan, CT scan, X-Ray, or bone scan.

In some cases, stress fractures require surgery, but most heal within six to eight weeks. At this time, you will need to rest your foot and avoid putting pressure on it. You may want to use crutches, shoe inserts, or a brace to reduce stress on your foot.

To lower your risk of a stress fracture, you should warm-up before exercises, slowly ease into new physical activities or sports, and ensure your shoes are not too tight, with support if you have flat feet.

2. Cuboid Syndrome

The cuboid is a cube-shaped bone in the middle of the outer edge of your foot that provides stability and connects your foot to your ankle. Cuboid syndrome happens when you injure the ligaments or dislocate the bone from trauma.[2]

It can cause a lot of pain, weakness, and tenderness along the edge of the foot. The pain noticeably becomes sharper when you stand on your toes or twist the arches of your feet outwards. It may also spread to the rest of your foot when you walk or stand.

The leading cause of the cuboid syndrome is overuse, from not giving yourself enough recovery time between exercises. Other causes include wearing tight shoes, spraining a nearby joint, and being obese.

Diagnosis with cuboid syndrome involves examining the foot and applying pressure to check for pain. The medical practitioner may also do imaging such as a CT scan, X-Ray, or MRI scan to confirm. Treating cuboid syndrome usually requires six to eight weeks of rest. If it is dislocated, you may need physical therapy.

Meanwhile, to prevent the cuboid syndrome, it is best to stretch your legs and feet before exercising and wear custom shoe inserts for additional support.

3. Peroneal tendonitis

The peroneal muscle runs from the back of your calf, the outer edges of the ankle, to the little and big toes. Peroneal tendonitis is when the tendon is swollen or inflamed due to overuse or a carryover symptom from ankle injuries.[3]

Symptoms include pain, weakness, swelling, and warmth just below or near your outer ankle. There may be a popping sensation when moving the lower leg, specifically the ankle.

Treating peroneal tendonitis depends on whether the tendons are torn or inflamed. For the former, you will need surgery to reconnect the tendons. If it is only inflamed, treatment is with nonsteroidal anti-inflammatory drugs (NSAIDs) to help decrease inflammation and reduce pain.

Rest is also vital for about six to eight weeks. You might need to wear a splint or cast, especially after surgery, to immobilise the area. Physiotherapy is advised to help you increase the range of motion of your foot. Exercises will be provided that include stretching and strengthening your peroneal muscles and tendons.

4. Arthritis

Mainly, arthritis is when tissues in your joints are inflamed. Two types of it are osteoarthritis (OA),[4] where inflammation is secondary to ageing and culmination of old injuries, and rheumatoid arthritis (RA)[5] is an autoimmune disease affecting the joints and overall well-being.

The symptoms are mostly the same, including pain, swelling, redness, stiffness, and popping or crackling sound in the joints. The difference is that OA occurs on one side of the body, and RA happens to both areas of the limbs. Treatment options for both OA and RA are the following:

• Taking NSAIDs to reduce inflammation and pain

• A corticosteroid injection can help relieve swelling and pain near the affected joints

• Physical therapy may help if stiffness in your outer ankle makes it hard to move your foot

• In rare cases, you may need surgery to repair a worn-down joint.

While this is unavoidable, you can reduce your likelihood of both OA and RA by not smoking, maintaining a healthy weight, and wearing supportive shoes or inserts.

5. Sprained ankle

An inversion sprain or a twisted ankle happens when the foot rolls under the ankle, stretching and potentially tearing the ligaments outside the ankle.[6] It is most common when playing sports, running, or walking.

Some people are more likely to twist their ankles than others by how their feet are structured. If you have severely injured an ankle in the past, you are more likely to twist your ankle again.7

Symptoms of a sprained ankle are pain, swelling, tenderness, and bruising around your ankle. As this is a prevalent injury, your doctor will be able to examine your ankle and do an X-ray to make sure there are no fractures.

Whether mild, moderate or severe, most twisted ankles do not require surgery unless the ligament is torn. The usual duration of the rest of the injured ankle is about six to eight weeks for it to heal.

Treatment includes taking NSAIDs to help the ligament heal and physiotherapy to strengthen your ankles. As well as train your leg for better balance and proprioception.

6. Tarsal coalition

This condition typically occurs in a person born with tarsal bones that are not connected properly.[7] These individuals experience symptoms rarely in childhood but gradually as they reach their teenage years.

Symptoms are pain and stiffness near the back and sides of the feet that feel sharper after numerous physical activities. Individuals with tarsal coalition may appear limping walking and could cause flat feet, precipitating more complications.

Diagnosis can be through X-ray and CT scans by a physician, and in severe cases, they require surgical treatment.

Tarsal coalition is managed with:

• Shoe inserts to support your tarsal bones

• Physiotherapy to strengthen your foot

• Steroid injections or NSAIDs to relieve pain

• Temporary cast and boots to stabilise your foot.

How to relieve lateral foot pain

Immediate treatment is essential, regardless of what is causing the pain on your lateral foot. The most common option is the RICE method to reduce inflammation, pain, and discomfort in the area.

• Rest the foot while lying down or sitting.

• Icing the foot with cold packs regularly for 20 minutes, multiple times a day.

• Compression of the foot by wearing an elastic bandage. Keep it firm without straining the area. It is best to check the toe, if it turns pink or red once pinched, loosen the bandage.

• Elevate your foot above your heart to reduce swelling and the likelihood of oedema.

Other tips for relieving pain outside of your foot are wearing comfortable, supportive shoes, stretching your feet and legs for at least 10 minutes before exercising, and cross-training or switching up an exercise routine to give your feet a break.

Key Takeaways

Lateral foot pain frequently happens, especially in people who regularly exercise or play sports. If you feel pain in your lateral foot, give it a rest for a few days. If it does not go away, visit your GP or physiotherapist to know more about its cause and the appropriate treatment.