Douglas Pacaccio, DPM
Thomas Nordquist, DPM
September 2021
Foot Pain
Our feet are arguably the most important parts of our bodies because they are responsible for getting us from place to place. However, we often don’t think about our feet until they begin to hurt. If you have pain in your feet, you need to first determine where on the foot you are experiencing it to get to the root of the problem. The most common areas to feel pain on the foot are the heel and the ankle.
Heel pain is most commonly attributed to a condition called plantar fasciitis. Plantar fasciitis occurs when the plantar fascia, which is the band of tough tissue connecting the heel bone to the toes becomes inflamed. Plantar fasciitis pain is usually worse in the morning, and it tends to go away throughout the day. If you have plantar fasciitis, you should rest your foot and do heel and foot muscles stretches. Wearing shoes with proper arch support and a cushioned sole has also been proven to be beneficial.
Some common symptoms of foot pain are redness, swelling, and stiffness. Foot pain can be dull or sharp depending on its underlying cause. Toe pain can also occur, and it is usually caused by gout, bunions, hammertoes, ingrown toenails, sprains, fractures, and corns.
If you have severe pain in your feet, you should immediately seek assistance from your podiatrist for treatment. Depending on the cause of your pain, your podiatrist may give you a variety of treatment options.
Ankle Pain
Pain experienced in the ankle can be caused by a multitude of conditions. While the most common cause is an ankle sprain, other possible problems can include arthritis, gout, ankle instability, an ankle fracture, nerve compression, or tendinitis. In more serious cases, ankle pain can be a sign of improper alignment of the foot or an infection.
Ankle pain can often be accompanied by symptoms such as redness, swelling, stiffness, and warmth in the affected area. Pain can be described differently depending on the condition: short, stabbing pain and a dull ache are some examples. If such symptoms are persistent and do not improve after time, be sure to schedule an appointment with your local podiatrist.
Depending on the condition causing your ankle pain, different treatments may be prescribed by your podiatrist. For ankle sprains, the first step in treatment involves rest, ice, elevation, and compression. Be sure to avoid placing pressure on the ankle, use an ice pack several times a day, and use a compression bandage and elevation to reduce swelling. Other, more serious conditions may require the assistance of certain drugs and medications such as nonsteroidal anti-inflammatory drugs (NSAIDs), physical therapy, or even cortisone injections.
Depending on the severity of your ankle pain and the condition behind it, recovery from ankle pain may take some time.
Consult with your foot and ankle doctor to best determine the cause of your ankle pain and the appropriate treatment.
Limb Salvage
Limb salvage is a procedure that involves saving a lower extremity from amputation. In podiatry, limb amputation often occurs as a result of diabetes, peripheral vascular disease, neuropathy, cancer, and severe crush injury. The fundamental goal of limb salvage is to restore and maintain stability and movement of the affected lower extremity.
The procedure typically involves removing the diseased tissue and a small portion of the surrounding healthy tissue, as well as the removal of any affected bone if necessary. If the bone is removed, it is then replaced with prostheses, synthetic metal rods or plates, or grafts from either the patient’s body or a donor. Limb salvage is typically the preferred choice of procedure over amputation, as the procedure preserves both the patient’s appearance and allows for the greatest possible degree of function in the affected limb.
Upon diagnosis and determining that limb salvage is the appropriate treatment, the podiatrist may enlist the help of a physical and/or occupational therapist to prepare the patient for surgery by introducing various muscle-strengthening, walking, and range of motion exercises. Such exercises may be continued as rehabilitation post-procedure.
Stress Fractures of the Foot and Ankle
Our bones are important aspects of our body and they are constantly changing. The heavier the workload for a bone, the more likely it is that calcium will be placed in it. When a bone isn’t used often, there won’t be much calcium within it. When stress from repetitive loads prevent the bone from being able to repair itself, cracks will start to form. Stress fractures are defined as cracks in a bone that result from repetitive force, such as overuse.
The most common cause of stress fractures is a sudden increase in intensity and duration of physical activity. For example, if you begin to run long distances without working your way into doing so, you will be more likely to develop a stress fracture.
Common symptoms of stress fractures are pain and swelling near the weight bearing area on the injured bone. When initial x-rays are performed, it is possible that the fracture will not show up. However, once the stress on the area continues, the damage will increase, and the fracture will be severe enough to show up on an x-ray. Certain parts of the foot are more likely to develop stress fractures than others. Areas that typically have these fractures are: the metatarsals, the navicular bone, the calcaneus, tibia, and fibula.
Since women are at an increased risk of developing osteoporosis, they are twice as likely as men to sustain a stress fracture. Additionally, old age causes a decrease in bone mineral density which is why elderly people are also likely to develop these fractures.
It is important for you to be professionally diagnosed by a podiatrist if you suspect you have a stress fracture, because there are other injuries that can easily be mistaken for a fracture. Sprains, strains, shin splints, plantar fasciitis, and Morton’s neuroma can all easily be mistaken for stress fractures in the foot. Your podiatrist will likely ask you a series of questions to determine what type of pain you are experiencing. These questions will help your doctor identify whether you have a stress fracture.
The best method of treatment for a stress fracture is rest. Additionally, a walking boot, cast, or crutches, will help rest the area that is injured. The typical healing time for stress fractures is 4-12 weeks, however this depends on which bone is involved.
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