From the Guidelines
Pain along the inner foot can be caused by several conditions, and ultrasound (US) is an appropriate diagnostic tool, particularly for soft tissue assessment, as evidenced by its high sensitivity and specificity in diagnosing plantar fasciitis 1. The causes of pain along the inner foot include:
- Plantar fasciitis
- Posterior tibial tendon dysfunction
- Tarsal tunnel syndrome
- Stress fractures
- Arthritis
- Flat feet Ultrasound is useful for evaluating these conditions, especially for diagnosing plantar fasciitis, tendinopathies, and soft tissue masses, with advantages including being non-invasive, radiation-free, and relatively inexpensive 1. According to the American College of Radiology, US has shown good sensitivity (80%) and specificity (88%) in the diagnosis of plantar fasciitis when compared to MRI 1. For initial management of inner foot pain, the following are recommended:
- Rest, ice, compression, and elevation (RICE)
- Over-the-counter NSAIDs like ibuprofen (400-600mg three times daily with food) for pain and inflammation
- Supportive footwear with arch support or orthotic inserts to distribute pressure more evenly If pain persists beyond 1-2 weeks despite these measures, or if pain is severe, professional evaluation is warranted, which may include X-rays to evaluate bone structures, and MRI for more complex cases requiring detailed imaging of both soft tissues and bones 1.
From the Research
Causes of Pain Along the Inner Foot
- Pain along the inner foot can be caused by various factors, including plantar fasciitis, which is the inflammation of the plantar fascia, a band of tissue that runs along the bottom of the foot [(2,3,4,5)].
- Other potential causes of inner foot pain include ankle and foot pain due to cutaneous, vascular, and neural system issues 6.
Diagnostic Tools for Inner Foot Pain
- Ultrasound (US) can be used as a diagnostic tool to assess the thickness and echogenicity of the plantar fascia [(2,4,5)].
- US-guided corticosteroid injections can be an effective treatment for plantar fasciitis, with studies showing significant improvements in pain and function [(2,4,5)].
- However, the use of therapeutic ultrasound as a treatment for plantar fasciitis has shown mixed results, with one study finding no significant difference in outcomes between the treatment and control groups 3.
Appropriateness of Ultrasound for Diagnostic Purposes
- US can be a useful diagnostic tool for assessing plantar fascia thickness and guiding corticosteroid injections [(2,4,5)].
- However, the effectiveness of US as a diagnostic tool may depend on the specific condition being diagnosed and the expertise of the practitioner [(3,6)].