My instep hurts, what's going on?

If you feel pain in the instep of your foot as if a tendon has been pulled, you should be alert as it may be caused by fasciitis. Fasciitis is a common inflammation. At this time, local hot compress can be used for treatment, which can promote blood circulation. If the pain is severe, you can take some painkillers for treatment, or you can use certain traditional Chinese medicine methods to treat it, such as taking muscle-soothing and blood-activating tablets.

Fasciitis generally includes:

1. Lumbar myofasciitis. In the acute phase, patients experience severe lower back pain and a burning sensation. Chronic cases are manifested by low back pain, muscle stiffness and a feeling of heaviness. The pain often worsens when the weather changes, such as on rainy days, at night, or in humid areas. The low back pain worsens every morning and can be relieved by a little activity, but worsens again after fatigue.

2. Myofasciitis of the neck and back generally refers to the aseptic inflammation of soft tissues such as fascia, muscles, tendons and ligaments, which causes symptoms such as pain, stiffness, limited movement and weakness in the neck and back. The trapezius, rhomboids and levator scapulae muscles are often involved.

3. Plantar fasciitis, which is a chronic injury caused by exercise. The most common cause is frequent long-term walking, including mountain climbing, hiking, shopping and other activities. Walking for several days in a row can easily cause chronic injury to the sole of the foot, leading to plantar fasciitis. In addition, heels that are too hard can cause pressure on the heel and cause plantar fasciitis. Wearing high heels frequently can also aggravate damage to the soles of your feet.

4. Necrotizing fasciitis, a rare severe soft tissue infection, is different from streptococcal necrosis and is often a mixed infection of multiple bacteria.

Treatment of fasciitis

Surgical treatment: More than half of the patients can have their symptoms relieved by rest. Hot compresses and massage can dissipate nodules. Blocking painful nodules is also quite effective, but exercising the lumbar muscles may still be the most important. A small number of patients with stubborn symptoms that cannot be cured for a long time require surgical treatment. During the operation, cracks can be found in the local fascia and fat herniates from the cracks. These are the nodules palpable clinically. Adhesions of fat to surrounding tissues, including fascia and adjacent cutaneous nerve branches, may be the cause of pain. Surgery should include excision of the nodule, repair of the fascia, separation of adhesions, and excision of the cutaneous nerve. The effect is often good, but because the lesions are often multiple, surgery can only solve the symptoms of one place, so the surgical indications should still be strictly controlled.

Mutual transformation: Acute lumbar myofasciitis can have a tendency to naturally improve and recur. It can be alleviated by bed rest, but it can be aggravated by fatigue and cold. Through bed rest, lumbar immobilization, anti-inflammatory and analgesic drugs, and physical therapy, most patients can quickly relieve pain. Usually the symptoms can be significantly alleviated within two or three days, and disappear within 1 to 2 weeks without leaving any sequelae. However, this disease can recur, causing certain pain to the patient and affecting the patient's study, work and life.

Treatment for patients in the chronic stage: The treatment for patients in the chronic stage is mainly based on proper rest, oral and topical anti-inflammatory and analgesic drugs and muscle relaxants and sedatives, the use of Chinese medicine for promoting blood circulation and removing blood stasis, and proper muscle relaxation massage. After the symptoms of back pain caused by lumbar muscle strain are relieved, you should actively strengthen the training of your back muscles, adjust your work and life rhythm, strengthen the health of your waist, prevent your waist from being stimulated by adverse factors such as cold, trauma, strain, etc. You should sleep on a hard bed or a relatively hard mattress, avoid sleeping on a camp bed or a soft sofa, and do some appropriate waist exercises after getting up. Otherwise, the symptoms of chronic lumbar muscle strain may recur very easily.