Dear Dr Harvey,
I have been having a great deal of foot and ankle pain lately. The pain has been getting worse. I have been to a podiatrist and an orthopedic surgeon. They recommended some anti-inflammatory drugs or a cortisone injection to reduce the inflammation. I would rather not take drugs or get a shot. What could you do to help me?
Problems with the foot and ankle are very common. They range from a simple trauma, like stubbing a toe or getting a blister, to more complex conditions such as torn ligaments or fractures. They may also be from improper biomechanics: that is, the relationship and movement between the bones and soft tissue.
The foot is a very complex thing. It has 26 bones (on average) and many different ligaments, tendons, and muscles. There is also a very complex nerve-blood supply to all areas of the foot.
Consider the complexity of the foot and the abuse that it takes from constant standing, walking, and running. There is a rarely a person who has not had some pain in their foot or ankle.
One of the most common types of injuries to this area is to sprain the ankle. This happens to most runners at some point, and most athletes have done it more than once. The standard treatment is rest and ice. In severe cases, taping or a brace may be used for a while.
However, one think that most people do not consider is what happens to the relationship of the many bones in a significant sprain or strain of the foot and ankle.
The soft tissue of the foot may heal over time, but often with the bones in the wrong alignment. Many people notice that after an ankle injury they get sprains or strains on a regular basis, or the condition becomes chronic. One of the major causes of chronic inflammation or pain in this area is improper biomechanics or alignment. Until the alignment is restored, this condition will continue and will often get progressively worse.
Our approach to the treatment of this problem starts with an exam of the area and possibly X-rays. It is also common for the knees or the pelvis to be considered contributing factors.
Once the problem is discovered, a course of treatment is started. The solution may be as simple as adjusting the foot back into proper alignment. In more severe cases, taping or bracing may be used for a short time.
Another very common treatment is to fit the patient for a set of custom orthotics. An orthotic is something that is worn in the shoe and provides support for the foot, especially the arch.
Treating your condition with anti-inflammatories and the like only addresses the symptom. It makes more sense to find out what the cause of your problem is and treat that. Then the inflammation will be gone.
In conclusion, we have treated hundreds of cases similar to this and achieved the desired results many times after the traditional medical approach had failed. Please, if you are having this or any similar condition, contact us. We may have the answers you are looking for.
©2009 Dr. Harvey