Inflammation of the foot: Causes, Symptoms, and Treatment

From injuries to inflammation of the foot, several different types of damage and malfunctions can lead to significant problems.

The foot is a complex structure made up of a multitude of bones, muscles, tendons, and ligaments that all interact with each other. Its structure is similarly complicated as the hand. Each of these structures can, therefore, lead to problems and complaints.

The foot can roughly be divided into three parts: Forefoot (consisting of the five toes), metatarsus (consisting of the five metatarsal bones), and hindfoot (consisting of a multitude of tarsal bones).

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Symptoms of the inflammation of the foot

Symptoms of inflammation of the foot can have the same characteristics as any other inflammation of the body.

The classic signs of inflammation are swelling, redness, overheating, pain, and functional impairment.

Depending on the location of the inflammation in the foot, the restrictions and symptoms can be quite different.

If an inflammation is only in the forefoot, almost normal walking is most likely possible. The further the inflammation is located in the direction of the heel, the higher the restrictions in walking can become.

Not only the localization leads to different symptoms, but also the cause of inflammation.

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While the classic signs of inflammation determine the clinical picture in bacterial nail bed inflammation, a fungal nail bed inflammation often results in a weeping wound. Also, the affected nails are yellowish discolored, thickened, and crumbled. However, if the nail bed is affected by a viral inflammation with a herpes virus, redness with blisters is the most common symptom. Also, the patient often experiences a burning sensation and pain in the area of the nail bed.

A sudden severe pain, which occurs mainly at night or after meals with an unusually high meat content at the metatarsophalangeal joint of the big toe, is typical for gout, which has its origin in a metabolic disorder.

In the case of rheumatoid arthritis as the cause of inflammation in the foot, patients complain above all of increasing joint stiffness in the morning, which improves with movement. A regular occurrence of the joint complaints is typical here. Often both hands or both feet are therefore affected. In the course of the disease, the joints become increasingly deformed and destroyed, which significantly impairs mobility. In addition to the severe pain suffered by rheumatics, symptoms such as fatigue, fever, and a general loss of strength can also occur.

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Causes of the inflammation of the foot

Inflammation of the forefoot, midfoot, and hindfoot can have many different causes.

In principle, an inflammation of the foot can have its origin in pathogens such as bacteria, fungi, and viruses. Autoimmune diseases such as rheumatoid arthritis and so-called reactive arthritis, which can occur as a result of a bacterial infection of the gastrointestinal tract, the urinary tract, or the sexual organs, can also play a role.

However, inflammation can also be caused by gout. This is a metabolic disease that originates in an accumulation of uric acid crystals in the joints. In an acute attack of gout, for example, it is usually mainly the metatarsophalangeal joint of the big toe that is affected and leads above all to severe pain during rolling movements.

Chronic joint degeneration (arthrosis) can also sometimes become inflamed and then lead to severe pain and discomfort.

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In case of a nail bed inflammation of a toe, the inflammation is mainly located in the area of the tip of the toe. Bacteria, viruses, or fungi can penetrate the nail bed through open areas and lead to a pronounced inflammatory reaction and spread to other parts of the foot.

The causes of such a lesion are manifold. Among others, incorrect foot care, chemicals, cuts, and injuries, as well as pressure points, can cause injuries to the foot. Common and known pathogens that lead to nail bed inflammation are bacteria such as staphylococci and streptococci, herpes viruses, and yeast fungi.

The most severe form of nail bed inflammation is an inflammation caused by the bacterial germs staphylococci and streptococci. A superficial inflammation must be distinguished from a deep inflammation.

In case of a purely superficial infection, local antiseptic therapy with creams is sufficient. As soon as an infection goes deeper, antibiotic or surgical therapy must be carried out. People with a weakened immune system are particularly affected by such a deep bacterial inflammation of the nail bed. In this case, diabetes mellitus (diabetes) can often be found in the previous history. Also, in the case of a nail bed inflammation caused by yeast fungi, the majority of patients have poorly controlled diabetes mellitus in their history, which provides an optimal breeding ground for these fungi.

Herpesviruses, on the other hand, once they have entered the body, remain there for a lifetime. Situations in which the body is exposed to increased stress, illness, or even UV radiation cause these viruses to multiply actively with symptoms.

Inflammation of the foot can also be caused by pressure points (decubitus) in the heel area, which often occurs during prolonged bed rest if the heel is not adequately protected prophylactically. Pressure points with ulcer formation (ulcer formation) should also be mentioned here, which can often be caused by shoes that are too tight in patients with peripheral nerve damage caused by diabetes mellitus or also by peripheral arterial vascular disease. These ulcers can then become inflamed by colonization with skin germs.

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Diagnosis of the inflammation of the foot

The foot is also clinically examined. The diagnosis is based on a combination of anamnesis, laboratory diagnostics, physical examination, and imaging.

The first step is to find out the symptoms. It is essential to find out when these began, how intense they are, whether they occur frequently, and whether resting brings relief from the symptoms. These questions help the examiner to narrow down the number of possible illnesses.

This is followed by a clinical examination of the foot. During this examination, particular attention is paid to external changes such as redness, swelling, wounds, or pressure points.

The next diagnostic step is usually followed by a laboratory chemical examination of the blood with consideration of the inflammation values such as the C-reactive protein (CRP), the blood sedimentation rate (BSG), or the leukocytes (white blood cells).

Besides, radiological methods such as conventional x-rays, magnetic resonance imaging (MRI) or computer tomography (CT) can also be used.

If nail bed inflammation is responsible for foot complaints, a smear can be used to identify the pathogen. If this is not possible, a so-called culture can be made, which allows the pathogens, if any, to multiply.

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The therapy of an inflammation of the foot depends on the cause of the complaints and whether it is an acute or chronic event.

In principle, painkillers can be administered to the patient when pain occurs. One therapeutic option is the administration of so-called non-steroidal anti-rheumatic drugs such as ibuprofen or diclofenac. Paracetamol has proven to be another pain medication. For very severe pain, the administration of opioids such as morphine can be considered. Painkillers only treat the symptom but not the actual cause.

If an inflammation of the foot, for example, an inflammation of the nail bed, has its origin in pathogens such as bacteria, fungi, or viruses, one tries to eliminate the germs.

In case of a purely superficial infection, a local antiseptic therapy with creams is sufficient.

As soon as an infection goes deeper, antibiotic or surgical therapy must be carried out. The antibiotic therapy depends on the expected bacterial spectrum. Since herpes viruses often cause a viral infection of the nail bed, the administration of an antiviral drug such as Aciclovir must be considered. In addition, in the case of nail bed inflammation, it is essential to avoid the trigger of the inflammation. In many cases, bacterial or fungal nail bed inflammation is accompanied by poorly controlled diabetes mellitus, so that blood sugar should first be optimally adjusted and regularly checked.

Baths and ointments with anti-inflammatory additives have a supportive effect in case of an inflammation of the nail bed. Usually, such an inflammation is accompanied by pain, so that immobilization of the affected area is advisable. In any case, it is essential to consult a doctor in time. It is not advisable to treat the inflamed area independently.

If the cause is an acute attack of gout, the administration of non-steroidal anti-inflammatory drugs such as indomethacin and steroids or colchicine can provide relief.

Non-steroidal anti-inflammatory drugs and steroids are also used in rheumatoid arthritis. Besides, methotrexate and, depending on the severity and inflammatory activity, biologicals such as Infliximab can also be used. In any case, ergotherapy should be used to support the treatment.

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An important preventive measure against an inflammation of the foot is, first of all, to pay attention to appropriate foot care. This is particularly important for older people, as they are often unable to take care of their feet themselves due to limited mobility. In this case, it is recommended to make an appointment for foot care with a podiatrist.

Even the smallest injuries, which are an entry point for germs and bacteria, can be caused by ingrown nails, for example, and can be effectively prevented by proper and regular foot care. Therefore, it is always recommended to cut the nails straight and file them down to prevent ingrown nails.

After washing, the feet should always be wholly dried off so that no bacteria or fungi can multiply in the moist and warm spaces between the toes. It is also recommended to wear comfortable and wide shoes to avoid pressure points on the feet.


The prognosis depends mainly on the cause of the inflammation.

If a rheumatic disease such as rheumatoid arthritis is the cause of the inflammation of the foot, a cure is not possible. This is an autoimmune disease that progresses in relapses and thus sometimes appears more or less. However, with the introduction of new drugs, such as so-called biologicals, the progression of the disease can be treated much better. If bacteria, fungi, or viruses are the cause of a foot inflammation, a cure can be achieved by eliminating these germs.

In people with diabetes who have a high predisposition to colonization by such germs, a rapid reduction in symptoms can be achieved by consistent treatment of the germs, blood sugar, and suitable footwear.

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