Foot and Ankle Pain

The foot and ankle are complicated parts of the body made up of 26 bones, 30 joints and over 100 muscles, tendons and ligaments! When you consider the weight and stress we place on our feet each day, it’s no wonder that two-thirds of us will experience foot or ankle pain at some point in our lives.

Pain can be a result of a number of factors.

An injury or trauma produces an immediate painful response that can take up to six weeks to resolve. You may experience swelling and bruising and be unable to weight-bear fully. An X Ray or scan may be needed to check whether you have broken a bone or damaged a muscle or tendon. It’s important to give your body adequate time to rest and heal after an injury, before returning to your previous activities gradually.

Many acute injuries settle without any specific treatment other than rest, support and light activity. However, sometimes these injuries can take longer than expected to heal. There may be other factors that are affecting full recovery, such as a mechanical issue that may need addressing. This may have been present prior to the injury but hasn’t become apparent until now.

Lifestyle factors often contribute to foot and ankle pain. Spending long periods of time on your feet at work can sometimes put undue strain on your joints particularly if your footwear isn’t up to the job. Even your weight, how well you’re sleeping and stress levels can influence the level of pain you feel.

Arthritis is more likely to develop as we get older and in fact most of us will have some degree of arthritis in our feet once we reach around 50 years old. This isn’t always an issue and may simply cause some stiffening of the joints rather than pain. If you have injured your foot or ankle, are female, overweight, or have arthritis elsewhere in your body, your risk of developing foot arthritis is increased and may affect one or a number of different joints. It can be helpful to have blood tests to detect what type of arthritis you might have. Your Podiatrist can advise you about whether these checks are needed and we would arrange referral you to your GP to have this carried out.

Sometimes, it can be as simple as the wrong footwear. It’s not unusual for a problem to miraculously disappear once you ditch the ‘old faithful’ shoes for a new, more supportive pair! Lumps and bumps can occasionally appear on the feet, either on the surface of the skin or in the deeper tissues. These are usually nothing sinister but can be painful and might require removal.

What is the diagnosis?

When you attend your initial appointment, your Podiatrist will want to gather as much information as possible about your foot pain. This helps us to reach a more accurate diagnosis and start you on the correct treatment. We are likely to want details about any recent injuries, medical history, medication, your general lifestyle and footwear. The relevant joints and soft tissues in the lower limb will be examined and checked for pain or any other abnormality. An ultrasound scan may also be used to help with diagnosis or examine surrounding structures. Nerve function may also be tested. These tests can be carried out while you are on the treatment couch or we might ask you to stand or walk so we can observe how the lower limb is functioning dynamically. If we need to have a look at your gait (the way you walk) more thoroughly, we may ask you to return for gait analysis which involves assessing, recording and analysing your walking or running in more detail using a treadmill and software.

How can it be treated?

This would depend on the diagnosis and the cause of your pain. Sometimes taking simple steps such as changing your footwear is all that’s needed. If your symptoms become worse because of certain activities you are involved in, we may give you advice about reducing or modifying these until you are stronger. Your Podiatrist may prescribe exercises, taping or Shockwave treatment as part of your recovery. Orthoses (devices that fit into the shoes) or insoles can also be helpful in dealing with certain mechanical problems. Referral to your GP, Physiotherapist or Podiatric surgeon can be easily arranged if appropriate as we have excellent links with other local health professionals.

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Steroid Injections

We may offer you the option of a steroid injection if you are experiencing pain with the following conditions:

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Heel Pain (plantar fasciitis)

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Big toe joint pain

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Mid-foot osteoarthritis

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Morton’s neuroma

A steroid injection can be an effective way of reducing pain rapidly and is usually offered in conjunction with other therapies such as insoles or orthotics. We use an ultrasound scan to help direct the steroid and improve its effectiveness. Relief is usually experienced within about 2 weeks and can last for several months.