FOOT PAIN
WHAT IS IT?
Foot pain refers to physical discomfort in or surrounding the structures that make up the foot, which include bones, joints, muscles, tendons and ligaments. Foot pain can be felt in the arches, the ball of the foot, the heel, the toes or the ankle. Acute foot pain is commonly caused by an injury or sprain. Acute foot pain will typically settle spontaneously or resolve with modification of activities and instruction in appropriate exercising and self-management. However, foot pain that lasts three months or longer is considered chronic foot pain.
CLINIC LOCATOR
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FOOT PAIN
WHAT CAUSES IT?
Common causes of foot pain include:
- Injury or sprain – a common example is a “rolled ankle,” which refers to a tearing of the ligaments in the ankle
- Plantar fasciitis – this is a condition that causes pain on the bottom of the heel. The plantar fascia is a ligament connecting the front of the foot to the heel. Plantar fasciitis occurs through the overuse or exacerbation of the plantar fascia
- Achilles tendinopathy – this is a condition that causes pain at the back of the heel and distal region of the calf. The Achilles tendon attaches the calf muscle to the heel. Achilles tendinopathy occurs through the overuse or repeated minor injuries to the Achilles tendon.
- Post-surgical foot pain – this can present as persistent pain after foot or ankle procedures where a specific nerve might have been injured
TREATMENT
OPTIONS
Initial treatments for acute foot pain might include:
- Medications, such as over-the-counter analgesics and anti-inflammatory drugs (Paracetamol or Ibuprofen)
- Gentle stretching
- Heat or ice packs
- Physical therapy programs
A physiotherapist might recommend adjustments to your movement to avoid major flareups.
If you are not improving with over-the-counter or prescription medication, as well as physiotherapy, your healthcare professional might recommend:
- Nerve blocks involve the injection of an anaesthetic at a specific nerve root to temporarily “block” the pain generated from a specific nerve
- Corticosteroid injections to reduce inflammation
- Radiofrequency (RF) therapy, which is a proven, low-risk treatment option. During the RF procedure, your doctor will place a thin needle at the site of your pain. This needle will deliver energy to those inflamed, pain-transmitting nerves to create a block, sometimes called a lesion. This disruption reduces the ability of the nerves to send pain signals to the brain.
More advanced care options include:
- Neuromodulation or spinal cord stimulation (SCS), which works to reduce pain by altering the pain signals as they travel up the spinal cord to the brain. A generator, similar to a cardiac pacemaker, sends electrical pulses to a thin wire called a lead. The lead is placed in the epidural space and delivers pulses to nerves along the spinal cord. The pulses modify the pain signals as they travel to different parts in the brain
- Surgery
COMMON
INJURIES
Some common foot and ankle injuries include:
ANKLE SPRAIN
A ‘rolled ankle’ involves micro or larger tearing to the ligaments in the ankle. Initial treatment for an acute ankle sprain involves the RICE principle (Rest, Ice, Compression and Elevation). Further management depends on the grade of the ankle sprain. It may include strengthening, balance restraining, footwear prescription, manual therapy and sports-specific drills.
Achilles Tendinopathy
The Achilles tendon attaches your calf muscle to your heel. It is placed under stress with activities that involve running, jumping or prolonged walking. Those suffering from Achilles tendinopathy usually report pain at the back of the heel and distal calf area. Treatment includes a very specific form of eccentric (lengthening) strength exercises.
PLANTAR FASCIITIS
The plantar fascia is an important structure on the inside of the foot that acts as a ‘sing’ to support the arch and to provide shock absorption. Plantar Fasciitis is an overuse condition, and those affected often have pain of the heel and mid foot that becomes exacerbated by prolonged standing and walking. Treatment including stretches, ankle mobilisations, massage, taping and acupuncture may be recommended to provide pain relief. Non-steroidal anti-inflammatory drugs and cortisone injections can provide short-term relief but need to be combined with sustainable long-term solutions to address the underlying problem.
FRACTURES
The symptoms of an ankle fracture can be similar to those of ankle sprains but are often more severe. The ankle will usually be painful and swollen with an inability to weight bear on the foot. Pain due to a fracture is usually localised. An X-ray may be the first line of investigation if a fracture is suspected, but a CT or MRI scan might be required. Immobalisation in the form of a cast or boot and cessation of activity on that limb is required. Physical rehabilitation can then resume post immobalisation to restore range of movement, strength and flexibility.
FOOT AND ANKLE SURGERY
The foot and ankle area contains multiple nerves. During foot and ankle surgery – even with the utmost care and best surgical technique – a nerve can be injured.