Moving on to the ankle, it is a joint formed by a combination of bones, tendons, and ligaments. It serves as the connection point between the foot and the leg. The ankle acts as a support bracket for the foot and enables jumping and running movements. Any injury to the ankle can result in pain or swelling. Cohen adds, “Ankle pain or lower leg pain can be caused by damage to tendons and soft tissues, and the pain can be localized or more diffuse.” Typically, an injury that causes the foot or ankle to bear weight unevenly can lead to dysfunction or pain in the future. It is important to have a proper understanding of the injury, even for minor ones, in order to facilitate rehabilitation and prevent similar injuries from recurring.
Now, let’s discuss the structure of the foot and ankle and how pain occurs. The foot is a complex structure consisting of 26 bones and 33 joints, surrounded by a network of tendons, ligaments, and muscles. This intricate design supports the weight of the body and allows for movement. According to Larry K. Cohen, a member of the American Osteopathic Association, “Each step we take exerts a force of 2-3 times our body weight on the feet. The total force on the feet can amount to hundreds of tons per day. All these forces are sustained by a small area of the foot, approximately the size of a human fist.”
Foot pain and ankle pain are common problems that can affect your ability to concentrate on work and cause discomfort. The problem tends to worsen with age, and approximately 50% of adults have experienced this issue. It can be caused by certain neurological disorders or structural problems in the foot. These problems can be quite serious and may require orthopedic treatment. The same applies to ankle pain, as the foot has a complex structure and even a minor injury can result in an ankle sprain. Sometimes the pain is bearable and goes away over time, but if it persists, it is important to consult a doctor as it could indicate a more serious injury.
Understanding Foot Pain and Ankle Pain
Different types of pain at different areas of the foot can indicate many different things and it is important to know what your foot pain could mean. For example, pain in the joint located at the base of the toes could be due to arthritis. There are two types of arthritis that can affect this part of the foot. Rheumatoid arthritis will provide a burning sensation at the joint due to inflammation and synovial cysts. This is a sharp pain with movement that is usually followed by a dull ache. Osteoarthritis will be signified by a rigid big toe and hard bumps or spurs around the joint. The pain is a dull ache and it will be difficult to move the toe. This information is critical because discomfort due to pain can significantly lower a person’s quality of life. This will prompt an individual to seek treatment in order to return to the pain-free comfort that they are used to.
Understanding what caused your foot pain is crucial because comfort is of the utmost importance. The function of every muscle and joint of your body is to keep you comfortable. If you are uncomfortable, it could be because a joint or part of your foot is not functioning properly. This could be due to an injury because the function of the body is to keep you comfortable while allowing you to move. If an injury occurs, your body will move differently to compensate for the inability to move the injured part. This could cause pain because other parts of your foot are doing more work to make up for the injured area. There are different types of pain as well because pain is a very general term to mean discomfort. It could be sharp pain with movement or a dull ache at rest. Pain located at specific parts of the foot means that a certain area is not functioning properly.
Importance of Seeking Professional Advice
Similarly, the faster you want to drive to a destination, the more you would need to refer to a map to follow the right directions. The healthcare provider is the map to the destination of recovery.
In any healthcare plans, it is always good to understand the severity of our problem and how it can be rectified in an efficient and cost-effective manner. Typically, it’s usually not very costly to see a healthcare provider as compared to the value of the consultation and the right treatment they could provide. In simple injuries, their consultation could give us fast recovery with the right treatment.
This is important for a few reasons. First, we need to know their opinion about the actual condition of the injury. Secondly, how this could affect us in the future and what are the preventive measures so that the same kind of injury is not repeated in the future. Finally, the opinions of the healthcare provider on the kind of treatment and the time duration required would allow us to understand the overall plan and how much we need to invest in our health.
Seeking a professional healthcare provider to understand our ailment is crucial. Whether it’s a regular sprain, an occasional pain, stiffness, or any other symptoms in the muscles or joints, consulting a healthcare provider is the right start to seek an effective treatment plan and speedy recovery.
Home Remedies for Foot Pain and Ankle Pain
Secondly, consider ice and heat therapy. This is a simple, cost-effective approach with only a small time commitment, but can be very effective at pain relief and aiding recovery. For the first 48 hours post-injury, use ice. This will limit the amount of swelling and pain experienced. After this, a regime of alternating ice one day and heat the next will promote the removal of heme products from the damaged tissues, as well as increasing blood flow to the area and thus the rate of healing. Dual a simple method, it is important to follow some basic guidelines. Use a bag of frozen peas or similar as a cold compress, and apply to the injured area for 20 minutes. Be sure to avoid direct ice contact with the skin, and reseal and reuse the peas in their normal role in between applications. For heat therapy, either use a wheat bag heated in a microwave or take a hot bath. Apply the heat source to the injured area for 15-20 minutes, again ensuring not to burn the skin.
The first remedy you should consider for home treatment is rest and elevation (R&E). This is one of the most effective ways to reduce the pain felt as well as swelling. The aim is to take weight off the joint in order to allow the damaged tissues to begin healing. During the acute painful stage, rest the foot and ankle. If the pain is severe, you may need to use crutches. It is often useful to rest with the leg elevated higher than the level of the heart, as this allows fluids to drain from the damaged area, again reducing swelling. Using pillows to support the limb, aim to keep the foot and ankle elevated in this way for 30% of the day, or 15 minutes out of every hour. This can be useful for those who work in sedentary occupations as this can be done at a desk during work, although for severe injuries it may be necessary to take a few days off and rest completely.
Rest and Elevation
Ice and heat are also of some help. Ice is good for relieving pain, as it will reduce inflammation. Among the best ways to apply ice to an area is to fill a paper cup with water and freeze it. Then massage the ice over the inflamed region for 10-15 minutes. Do this 3-5 times daily. A small bag of frozen vegetables works well as it can be shaped easily to fit the area. Use a thin towel between the skin and the bag. Heat is good for tight, sore muscles and can be applied using an adhesive wheat bag.
The simplest and best way to take care of your foot and ankle is rest. Just stay off your feet and when you are not taking part in the activity which is causing the pain, place both feet up. A podiatrist can help by making an impression of the foot and making a plaster cast to construct an orthotic. If this is the case, it is best to just spend time at a shoe store discussing the options.
Ice and Heat Therapy
Ice and heat are two good ways to get relief from some types of foot pain, which can be further exacerbated by the wrong choice of footwear. For example, if you have pain in the bottom of your heel, consult the top 5 remedies for heel pain. Ice is recommended; it is an excellent pain reliever and its effect is immediate, though it does tend to be short-term. It is especially effective when pain has been caused by recent activity. Apply ice to the painful area for 10-15 minutes, 4 times a day. Use an ice pack or a packet of frozen vegetables wrapped in a cloth. You can discontinue the ice when the pain and inflammation have gone. Heat is recommended for pain that has persisted for a few weeks, although it may take a day or two before you notice any benefit. Heat is a good muscle relaxant and is best used in the form of wheat packs or hot water bottles. You can buy disposable hot packs that do not require a microwave. Electric foot massagers can be useful too.
Stretching and Strengthening Exercises
With consistency and time, stretching the muscles at the back and the bottom of the leg can rid your discomfort altogether.
On a step, a person can push their weight through their foot to stretch the Achilles tendon. The tendon should be held in its position to feel a strong stretch and repeat this stretch often. Any sharp pain while stretching should be avoided, so individual techniques here can be changed or avoided depending on the type or location of pain.
The use of a towel to stretch the top of the foot and toe muscles, while holding the heel stabilized is an effective method too. Again, hold these stretches for 30 seconds and do them 3 times.
Rolling your foot over a frozen bottle of water for 10-20 minutes is also another way to stretch the calf muscles and the muscles on the bottom of the foot. This is an effective stretch but the freezing cold can exaggerate your foot pain. If that is the case, simply perform the same techniques listed above, but with the bottle of water at room temperature.
Stretching the calf muscle can be a very effective way to reduce and prevent foot and ankle pain. It is important to stretch the calf muscle in a position with the knee straight and then with the knee bent to stretch both muscles that are in the calf. Hold the stretches for 30 seconds and repeat them 3 times, switching sides.
Stretching and strengthening exercises are a critical yet often overlooked tactic in relieving foot and ankle pain. Stretching the right muscles will help eliminate your pain altogether. This step is often missed, but it is an extremely important way to provide long-term pain relief. People see an ankle injury and pain as something simple and so they have learned to overlook simple steps to rehabilitation.
Proper Footwear and Orthotics
Wear proper footwear. Footwear plays a very important role in the quality of life of individuals. However, the same footwear can cause pain if it does not fit on the feet. So, using proper footwear for one’s feet is the most important thing. The function of the shoes is to distribute the weight of the body over the entire surface of the foot. This can be achieved by using relatively rigid and flat shoes. Shoes must have an anatomical shape. High-heeled shoes are best avoided. If possible, wear a different pair of shoes each day. This can change the load position on the foot. Do not ignore sandals and slippers. In severe cases, special footwear can be made to measure, with the exact shape and dimensions of the patient’s feet, in order to correct irregularities. Second is to avoid walking with bare feet. During phases of excessive weight or physical activity, it is better to use some orthotic in the shoes – i.e. any device designed to support, align, prevent or correct deformities, or improve the function of the foot – especially if there are irregular load positions on the foot, or mechanical structural changes.
Over-the-Counter Pain Medication
The type of pain medication most commonly used for foot pain is called nonsteroidal anti-inflammatory drugs, or NSAIDs, due to their analgesic and anti-inflammatory effects. This class of medication includes aspirin, ibuprofen, and naproxen. NSAIDs are particularly useful in the treatment of painful conditions resulting from inflammation such as arthritis, muscle strains, and sprains. By reducing inflammation, these medications help to relieve pain. While some NSAIDs are available only by prescription, most are available over the counter. There are many types of over-the-counter NSAIDs, each with a slightly different dosage and duration of effect. These medications are generally safe and effective, providing they are used according to the recommendations on the bottle and your physician’s instructions.
Medical Treatments for Foot Pain and Ankle Pain
One of the most reliable ways to manage acute and often chronic foot and ankle pain is via physical therapy. A physical therapist is specifically trained to understand the mechanics of the foot and ankle in health and disease. They can educate a patient and design a specific treatment regimen that can facilitate an earlier and safer return to activities of daily living. There are a range of therapeutic exercises, ambulatory aids, and special shoe wear interventions that can be employed. Such treatment approaches can provide symptomatic relief by preventing and reducing the abnormal mechanical stresses acting on the joint surface. In other patients, the therapy may provide an environment in which repair and regeneration of the damaged tissue can occur. Postural training and balance activities are important in foot and ankle treatment because of the critical role of the lower extremity in providing support and propulsion, especially during the stance phase of gait. In addition to exercise therapy, some patients may require physical agents such as heat, ice, ultrasound, or electrical stimulation to help relieve pain and muscle spasm. These modalities can be particularly useful prior to an exercise regimen to enhance its effectiveness. This suggests that bracing and splinting can also be an effective adjunct to therapy in foot and ankle pain.
Physical Therapy
If physical therapy is deemed ineffective, or if pain is aggravated by exercise, custom-fitted orthotics may be considered to correct foot function. This can be a stepping stone to returning back to the exercises and therapies provided in physical therapy.
The first step to physical therapy is consulting with a physical therapist. The therapist will examine the affected area and devise a plan of exercises and therapies geared toward pain relief and strengthening. The length of time spent in therapy varies, but generally a minimum of four weeks should provide an indication of the therapy’s effectiveness. At the end of four weeks, some patients are able to continue with a home exercise program without the need for continued therapy.
According to the American Podiatric Medical Association, “Physical therapy is one of the most effective ways to relieve pain and prevent it from returning.” Physical therapy can strengthen the foot and ankle in order to prevent future sprains and provide stability for the foot and ankle. Other benefits of physical therapy include increased flexibility and range of motion. During sessions, ultrasound or whirlpool treatments can sometimes be used to relieve pain.
Prescription Medication
The first and newer type of prescription drugs are fantastic. Medicines like Cymbalta and Prednisone work extensively around the body but offer the option to take them once a day. Cymbalta was first used in the treatment of depression. It has recent evidence that it is also effective in treating foot pain. It works in the brain and spinal cord to reduce the amount of pain. This occurs by stopping the movement of pain signals and by strengthening the signals that are already present. This is how it affects mood, by increasing the levels of serotonin and norepinephrine. So it’s fair to say that Cymbalta is more effective for someone who has both depression and foot pain, but it would work efficiently for others as well. It should be taken in a 60mg dose once daily, with or without food. Cortisone is a type of oral steroid which is used to treat inflammation. Taken for a short time, it has little side effects. Taken for a long period, it can cause more serious conditions. It works by reducing the swelling and decreasing the body’s immune response. This, in turn, reduces the pain and allows movement and normal function. Cortisone is available in meltable tablets or a liquid. Generally cheap, and with a prescription, a person can get a subsidized rate. Though there are serious side effects if taken long term, it is an appropriate try for those with moderate to severe foot pain. Lastly, Orphenadrine is a muscle relaxant. It is often prescribed for those with acute muscle or skeletal pain. In saying that, there is no harm in using it as a trial for chronic pain. Too much pain can cause muscles to contract and spasm around the place that hurts. This can cause further pain and slow down the body’s natural healing process. By slowing activity in the brain and reducing nerve behavior in the part of the brain that controls pain, it relieves muscle pain and is used in conjunction with rest and physical therapy. Due to recent evidence that muscle relaxants are not effective and the side effects involved, Orphenadrine can be a last option, but still has potential to provide relief for some people. This range of medications provides a wide range and effective method of reducing pain in all areas of the foot.
Corticosteroid Injections
It is important to note that any kind of medical treatment for foot pain and ankle pain should only be initiated after consultation with your healthcare provider. Corticosteroid injections are a popular medical treatment for foot and ankle pain. Corticosteroid injections work well to decrease swelling and pain. The high success rate (almost 30-80% in various studies) makes this a favorable treatment option for patients. If a patient can obtain pain relief with corticosteroid injections, the need for surgery can be decreased or eliminated altogether. Corticosteroid injections are not without risk. One study demonstrated that 8% of patients treated with a single local corticosteroid injection had a small reduction in skin thickness and 1% had a skin dimple. Local steroid injection is a proven effective treatment for plantar fasciitis. Corticosteroid injections comparing steroid injection and custom orthotic device showed that the 4-week success rates were 78% and 48% respectively. A recent review of studies demonstrated that corticosteroid injection is superior to any other conservative treatment.
Bracing or Splinting
In some cases, a brace may be prescribed to provide support to the ankle. This ranges from a simple elastic brace to a complex brace which locks the joint in place. The aim of a brace is to provide support by preventing the ankle from turning over. Ankle braces can act like an insurance policy to keep you free from re-injury. Studies have shown that the use of a simple orthosis reduces the frequency of ankle sprains in athletes with a previous history of ankle sprain. Braces may also be used to support the arch of the foot and reduce symptoms of tibialis posterior tendinopathy. Aircast boots are commonly used in patients who require an offloading device or prolonged immobilization, such as in severe cases of plantar fasciitis or following surgery. A splint acts to immobilize a painful joint. This may be used in severe cases of midfoot arthritis or tibialis posterior tendinopathy. Night splints are commonly used in plantar fasciitis, as the first few steps after getting out of bed in the morning are often the most painful. This is because the plantar fascia tightens during sleep, and ongoing microtrauma occurs when the fascia is then stretched with the first steps of the day. A splint holds the foot and ankle in the optimal position to allow the damaged tissue to heal.
Surgery as a Last Resort
Surgery should always be the last line of treatment for any condition. This is because all forms of surgery carry an inherent risk; these can be risks during the surgery or the risk that the surgery may not always work. It is also possible that complications may arise after the surgery and that these are worse than the original lesion. All surgical options should always be discussed in detail with the surgeon. It is important that you are fully aware of the risks and benefits of surgery so that you can make an informed choice of the possibility of surgery. There are different surgical options available depending on the location and severity of the arthritis. Surgery can also be used to correct problem that was in underlying cause of the arthritis. For example, if arthritis was caused by ligament injury, there are procedures that can repair or reconstruct the damaged ligament. The most common surgical options are arthroscopic washout, arthrodesis (fusion of the joint), and joint replacement. Arthroscopic washout is a keyhole procedure that is usually used for mild arthritis. A solution is repeatedly flushed through the joint with the aim of removing any loose cartilage or other debris that is causing inflammation and pain. This procedure will only provide temporary relief, but can delay the need for more major surgery. Fusion involves removing the remaining cartilage in the joint and then fusing the bones together so that they heal to form one single bone. This is an effective procedure in cases of severe arthritis or when the joint has been badly damaged. Joint replacement surgery is the most complex surgical option. It involves removing the damaged joint and replacing it with an artificial joint. This is generally a very successful procedure that provides a permanent solution to pain and can restore lost function in the joint. However, joint replacement is a major surgery with high risk of complication. Artificial joints can also wear and may need to be replaced.
Preventive Measures for Foot Pain and Ankle Pain
High-impact sports and activities are likely to cause pain in the feet and legs. Common injuries experienced in these activities are ligament sprains, stress fractures, and plantar fascia rupture. These injuries often lead to chronic foot and leg pain. The repetitive loading forces of impact sports can also cause a collapse of the foot’s arch and lead to posterior tibial tendon dysfunction. This is a painful and progressive condition in which the tendon is no longer able to perform its function of holding up the arch and supporting the foot. People with flatfoot or fallen arches have a higher risk of developing arthritis in the foot. This condition can also cause a valgus deformity of the heel in which it tilts in a direction toward the inside of the foot. High-impact activity can also exacerbate pre-existing deformities that were caused by muscle and/or nerve diseases.
Foot pain is much more likely to occur in people who are overweight. Because every pound of weight puts 4-5 pounds of added stress on the knee, hip, and ankle, it is no surprise that your feet may be paying the price. With age, the shock-absorbing fat on the bottom of your feet thins out, and the natural padding under the heel and ball of the foot may deteriorate. This can make walking and standing for long periods very uncomfortable. People who are overweight have a much higher risk of developing painful and progressive flatfoot deformity. Think of your feet as the foundation of a building. If the foundation is sturdy, the building will be strong and well-supported. If the foundation is weak or unstable, the building will collapse. That is why overweight people have a higher rate of plantar fasciitis heel pain and tendonitis in the Achilles tendon.
Approximately 80% of the US population will experience back pain at some point in their lives. Similar statistics exist for foot and ankle pain, particularly among the elderly, and the pain can be just as debilitating. Although it is important to see a healthcare professional when you have pain, learning how to prevent injuries and pain can save you a lot of time, money, and suffering. Listed below are several preventative measures that you can take to keep your feet pain-free.
Maintaining a Healthy Weight
The idea of weight loss can seem daunting and overwhelming, but as little as 10 lbs. of weight loss can make a significant difference in the prevention of lower extremity pain. Begin with the first steps in increasing your physical activity. Low-impact activities such as walking or biking are great first options. Taking the stairs instead of an elevator and parking a little further from a store entrance can help increase the number of steps taken in a day. Increasing ambulatory activity results in an increase in the work level. This increase helps burn more calories and is beneficial in weight loss. Physical therapists and personal trainers with experience in fitness programs can help guide you with the appropriate exercises to lose weight and maintain a healthy lifestyle. High-intensity, high-impact activities and exercises should be avoided as they can lead to increased pain and potential injury.
To prevent musculoskeletal stress and pain in the ankle, it is important to maintain an ideal body weight. Calculate your body mass index (BMI) to see if you are at a healthy weight. If you find you are overweight, losing weight can help prevent foot pain. It is estimated that for every 1 lb. of body weight, there is 4 lb. of added stress on the knee and 6 lb. of added stress on the hip. This additional stress can lead to wear and tear on the cartilage of the joints, eventually leading to arthritis. Losing weight can decrease the chance of developing arthritis in the legs and feet. Weight loss results in less pressure and force on the leg, ankle, and foot, thus relieving pain and preventing further injury.
Avoiding High-Impact Activities
Repetitive activities can make a bad situation worse. Too many times, individuals are committed to the “no pain, no gain” philosophy and will push through physical activities even if it is causing them sharp pain. It is important to understand that sharp pain is the body’s signal to stop doing whatever is causing the pain or at least to take a break or slow down. High-impact activities such as jogging, running, sprinting, aerobic dancing or hopping sports can be too much for the feet to handle. In some cases, it can be too much just depending on the individual. A person with a high arch is used to having an overstressed rearfoot and rigid foot. This type of foot structure is poor for absorbing shock because the foot does not flatten out as much as other feet when it comes in contact with the ground. In this case, shock is transferred up the leg to the knee and the dangerous effects are increased. If you notice excessive wear on the inside of your shoes, this is usually due to excess stress and excessive rotation of the foot. People with flat feet need to be extra careful because they are used to an increased range of motion in the rearfoot and midfoot. These people are more prone to tendon and joint pain due to the increased stress on the areas. As an alternative to these activities, it is recommended to switch to a low-impact activity to maintain a certain level of fitness. Biking, using a stationary bike, an elliptical trainer, swimming or water aerobics are good examples. At the end of the day, try to burn the same amount of calories to maintain weight. A simple rule is 100 calories per mile per day. This can be tracked by using a pedometer. This simple change can make a significant difference in the long run by preventing many types of foot and ankle injuries.
Wearing Supportive Shoes and Inserts
Shoe Inserts or Orthotics Orthotics can be used to treat biomechanical foot issues, absorb shock, and/or offload pressure from the problematic area. This can prevent or ameliorate many foot issues and help avoid other overuse injuries. There are two types of orthotics. Functional orthotics are used to correct an abnormal gait and are usually constructed upon the analysis of the patient’s foot in motion. Accommodative orthotics are softer and provide support as well as cushioning. These are often used to treat problems such as plantar fasciitis or diabetic foot ulcers. While certain foot problems will require custom-made orthotics, there are several types of prefabricated orthotics that are widely used for the treatment of foot problems. This is why it is important to always consult a podiatrist about the proper treatment of specific foot issues.
Guideline 1. Wearing shoes that are too tight, uncomfortable, or unsupportive can cause foot pain and injury. People with foot pain should avoid flip-flops, sandals, flat shoes, shoes with high heels, and tight shoes. Instead, they should wear good supportive shoes that distribute weight evenly across the foot. The following comparisons address the needs of specific foot problems.
Regular Foot Care and Hygiene
Moisturize your feet with a little foot cream or non-medicated skin lotion, avoiding the areas between the toes. This will stop the skin from drying out and cracking. A pumice stone can be used to reduce hard skin or calluses. Using a corn plaster may damage the healthy surrounding skin and lead to ulcers. It is best to seek advice from your chiropodist/podiatrist. Airing the feet is also important, and going barefoot where possible can be beneficial. Any swelling, change of color, or numbness should be reported to the doctor or chiropodist/podiatrist.
It is important to keep feet clean and dry. Towel-dry the feet well after washing, especially between the toes. Trimming toenails straight across and avoiding the corners helps prevent ingrown toenails. People with diabetes, poor circulation, or heart problems are more prone to infection and should not treat their own feet because they are more susceptible to infection. They should seek professional medical attention at all times.
Listening to Your Body and Resting When Needed
R.I.C.E is a common method used in the treatment of soft tissue injuries. This stands for Rest, Ice, Compression, and Elevation. Essential to R.I.C.E is the early rest period, and it has been shown to reduce the recovery time in ankle sprains. Ice and compression can usually be continued while maintaining some degree of weight-bearing or non-weight-bearing exercise. Elevation is most relevant when resting after exercise.
Maintenance of general health and fitness is important, and regular exercise has an important role in achieving this. As a general rule, if your pain is confined to above the waist, you can still perform lower limb exercises, and vice versa. Try to remain as active as possible with the pain-free activities. It can sometimes be helpful to use pain as a guide. If you have performed an activity and the pain has increased afterwards or the next day, you should probably avoid this activity in the future.
Listen to what your body is telling you. If you are experiencing pain, don’t ignore it. That is your body’s way of saying it needs a break. Rest is essential in preventing and alleviating foot and ankle pain. Avoiding activities that increase the painful conditions helps to settle the symptoms. Whether you have sustained an injury or have a medical condition that has caused the pain, it is important to rest at the initial stage when the symptoms are more severe. This will help to decrease inflammation and prevent the problem from becoming chronic. It is important to strike the right balance between rest and exercise. Complete rest for certain injuries can be detrimental and may prolong the problem. During this period, it may be necessary to modify your exercise routine to allow you to continue exercising without exacerbating the problem. For example, switching from running to cycling can be less painful and provides an effective workout.
