Jayson Goo, ATC, MA, CKTI, a National Athletic Board Certified Athletic Trainer, graduated from the University of Hawaii and earned his master's degree in human performance with a specialty in corrective therapy from San Jose State University. Jayson also is an active Certified Kinesio Taping Instructor.
Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.
When should I seek medical treatment for foot pain?
When the pain begins to interfere with your
activities of daily living or if you cannot perform your desired activities
without pain, you should consider seeking medical attention. Indicators that you
should seek medical care are if the area looks deformed, you have loss of
function, change of sensation, a large amount of swelling with pain, prolonged
change of skin or toenail color, the affected area becomes warmer than the
surrounding areas, becomes exquisitely tender to the touch, or is causing you to
move differently.
How is foot pain diagnosed?
The doctor will ask you several
questions to determine how the problem began. It can be helpful to tell the
physician about how and when it started, how it affects you, when it bothers
you, what you may or may not have done to make the pain better or worse. If
necessary, a thorough physical exam may be conducted to evaluate for any other
injuries.
Feet will be physically and visually examined at rest, with weight- and non-weight-bearing movement by the medical practitioner.
The foot and arch will be touched and manipulated and inspected to identify obvious deformities, tender spots, or
any differences in the bones of the foot and arch.
The medical practitioner
will examine how the muscles of your foot function. These tests may involve
holding or moving your foot and ankle against resistance, you may also asked to
stand, walk, or even run.
The nerves in the foot will be tested to make sure no injury has occurred there.
An X-ray, MRI, or bone scan of the foot and arch may be taken to determine if
there are abnormalities of the bone and/or soft tissues.
What is the treatment for foot pain?
When you first begin to notice discomfort or pain in the area,
you can treat yourself with rest, ice, compression, and elevation (RICE).
Over-the-counter medications may also be used to reduce discomfort and pain.
Rest will allow the tissues to heal by preventing any further stress to the
affected area. Crutches should be used if you have difficulty putting weight on
the foot. Appropriate use of commercially available ankle and foot supports may
provide rest, comfort, and support to the affected area.
Ice should be applied no
longer than 20 minutes. The ice may be put in a plastic bag or wrapped in a
towel. Commercial ice packs are not recommended because they are usually too
cold. If extreme discomfort occurs, icing should discontinue immediately.
Compression and elevation will help prevent any swelling of the affected
tissues.
There are two types of over-the-counter medications that may help with
the pain and swelling of foot pain. Acetaminophen (Tylenol) will help reduce the
pain, while a nonsteroidal anti-inflammatory such as aspirin, ibuprofen (Motrin), or
naproxen (Naprosyn) can help lessen the pain and as well as reduce the inflammatory
response. Caution should be taken when using these drugs as dosage should not
exceed the labeled directions.
A popular home remedy for relief of plantar fasciitis is rolling a golf ball on the ground with the bottom of the foot.
Blisters occur as a result of chaffing. These
"hot spots" should be attended to immediately with padding or friction reducers.
If these spots progress to a blister and are unbroken, the doctor can drain them
by puncturing from the side with a clean needle, and drained, the skin will act
as a natural bandage and should not be trimmed away. If the skin over the
blister is broken, the loose skin should be peeled back and the area should be
treated as an open wound. Blisters should be covered and padded before returning
to activity; in simple cases, a Band-Aid may solve the problem. If the blister is
bigger, donut pads, gel pads, or commercially available blister pads may be more
appropriate.
Medical treatment
Once the severity and cause of foot pain is determined, a
course of corrective and rehabilitative actions can be started.
Qualified medical personnel may use electrical medical devices such as ultrasound, various forms of electrical stimulation, LED light therapy (laser), and/or manual therapies to reduce pain and increase circulation to the area to promote healing.
Maintenance of fitness levels via modification of activity may be
prescribed.
Substitute activities that aggravate the pain and
soreness. Running causes the body to have repetitive impact with the ground. The
use of bicycling, elliptical trainers, step machines, swimming, or ski machines
minimize impact and allow you to maintain and improve your fitness.
Corrective
prophylactic measures
New shoes or the replacement of current shoe insoles
Proper footwear fitting, including lacing and sock combinations to eliminate
compression and friction issues
Additional supports added to the shoes such as heel pads or cushions, arch
supports, and various wedges to help maintain the foot in a proper position
Athletic shoes lose the elastic properties of the
soles through usage and age. A good rule of thumb is to replace your shoes every
six months or more often if there is heavier usage. The use of replacement
insoles can increase energy absorption and add support to the foot.
Corrective and over-the-counter orthotics may also improve the biomechanics of the foot.
Muscle strengthening and flexibility
You may be given exercises to increase
the strength and stability of the affected area and to correct muscles that may
not be balanced.
Exercises to increase flexibility will maintain or improve
the length of a muscle. Flexibility helps to make a stronger muscle and less
likely to be injured.
Appropriate medication to control inflammation or
disease-related symptoms
In some cases, surgery may be necessary.
Biomechanical evaluation
Your body will create various changes in movement
when you have an injury. A therapist can evaluate these changes and help you
make the appropriate corrections. Prolonged, uncorrected biomechanical changes may lead to secondary mechanical changes that are painful and difficult to correct.
Gout is a condition that results from crystals of uric acid depositing in tissues of the body. Gout is a condition that can lead to abnormally elevated levels of uric acid in the
blood, recurring attacks of joint inflammation (arthritis), deposits of
hard lumps of uric acid in and around the joints, and decreased kidney
function and kidney stones.
Athlete's foot (tinea pedis) is a skin infection caused by the ringworm fungus. Symptoms include itching, burning, cracking, peeling, and bleeding feet. Treatment involves keeping the feet dry and clean, wearing shoes that can breathe, and using medicated powders to keep your feet dry.
Common warts are skin growths causes by the human papillomavirus. There are many types of warts, including plantar warts, common hand warts, warts under the nails, mosaic wars, and flat warts. Over-the-counter treatments typically involve the use of salicylic acid products.
Ankle pain is commonly due to a sprain or tendinitis. The severity of ankle sprains ranges from mild (which can resolve within 24 hours) to severe (which can require surgical repair). Tendinitis of the ankle can be caused by trauma or inflammation.
Corns and calluses are sometimes painful areas of thickened skin that appear between the toes and fingers or on the soles of the feet. Abnormal foot anatomy, ill-fitting footwear, and unusual gait can put increased pressure in specific areas, causing corns and calluses. Treatment may involve using over-the-counter salicylic-acid products, visiting a podiatrist to be fitted with an orthotic device, or surgical removal.
The common bunion, an enlargement of the inner portion of the joint at the base of the big toe, primarily affects women. The signs and symptoms of bunions include inflammation, redness, tenderness, and pain of the first metatarsophalangeal joint. The little toe may also develop a bunion (tailor's bunion). Rest, walking shoes, stretching, cold packs, and antiinflammatory medications may alleviate pain. Surgery is also a treatment option.
A broken toe is one of the most common fractures among individuals. There are many causes of a broken toe, whether it is the big toe, middle toes, or little toe (pinky). Common symptoms of a broken toe include pain, swelling, stiffness, and bruising. A broken toe can be treated with buddy taping the toe. There are instances where a physician should be consulted for a broken toe.
Shin splints result from inflammation from injury to the tendon and adjacent tissues in the front of the outer leg. Shin splints commonly occur in runners or aggressive walkers, causing pain and discomfort. An increase in workout intensity, weak ankles and pronation may be to blame for shin splints. Stretching, strengthening, and icing the affected area are effective treatments for shin splints. Rest and anti-inflammatory medications are also advised.
Leprosy (Hansen's disease) is a disfiguring disease caused by infection with Mycobacterium leprae bacteria. The disease is spread from person to person through nasal secretions or droplets. Symptoms and signs of leprosy include numbness, loss of temperature sensation, painless ulcers, eye damage, loss of digits, and facial disfigurement. Leprosy is treated with antibiotics and the dosage and length of time of administration depends upon which form of leprosy the patient has.
Fractures occur when bone cannot withstand the outside forces applied to the bone. Fractures can be open or closed. Types of fractures include: greenstick, spiral, comminuted, transverse, compound, or vertebral compression. Common fractures include: stress fracture, compression fracture, rib fracture, and skull fracture. Treatment depends upon the type of fracture.
Bone spurs are pointy outgrowths of bone that develop in areas of inflammation or injury. They commonly occur on the heel and spine and may be the result of reactive arthritis, ankylosing spondylitis, or diffuse idiopathic skeletal hyperostosis. Symptoms include pain, numbness, and tenderness. Treatment focuses on decreasing inflammation and avoiding re-injury.
A bruise, or contusion, is caused when blood vessels are damaged or broken as the result of a blow to the skin. The raised area of a bump or bruise results from blood leaking from these injured blood vessels into the tissues as well as from the body's response to the injury. Treatments include applying an ice pack and pressure to the area by hand.
An injury to a ligament is called a sprain, and an injury to muscle or tendon is called a strain. Sprains and strains may be caused by repetitive movements or a single stressful incident. Symptoms include pain and swelling. Though treatment depends upon the extent and location of the injury, rest, ice, compression, and elevation are key elements of treatment.
There are several bones in the foot, and these bones can be broken (fractured) in a variety of ways. Falling from heights, dropping heavy objects on the foot, or stress fractures from running or walking. Treatment of a broken foot depends on what bone in the foot is broken.
Ingrown toenails are caused by the growth of the toenail into the surrounding nail fold. Symptoms include toe pain, swelling, redness, and yellow drainage. Treatment at home involves soaking the affected foot in diluted white vinegar or Epsom salts, elevating the foot, and trimming the nails straight across. Surgery is also an option for severe cases. Prevent ingrown toenails by wearing shoes with a wider toe box and avoiding repeated injury to the toenails. Avoid curving or cutting the nails short at the edges.
A Morton's neuroma is an inflamed nerve between the bones at the ball of the foot. Symptoms include a burning, sharp pain on the bottom of the foot. Treatment involves resting the foot, wearing better-fitting shoes, ice packs, and cortisone injection.
Diabetes-related foot problems can affect your health with two problems: diabetic neuropathy, where diabetes affects the nerves, and peripheral vascular disease, where diabetes affects the flow of blood. Common foot problems for people with diabetes include athlete's foot, fungal infection of nails, calluses, corns, blisters, bunions, dry skin, foot ulcers, hammertoes, ingrown toenails, and plantar warts.
Regular physical activity can reduce the risk of disease. Regular exercise can also reduce the symptoms of stress and anxiety. There are fitness programs that fit any age or lifestyle.
Nonsteroidal antiinflammatory drugs (NSAIDs) are prescribed medications for the treatment of inflammatory conditions. Examples of NSAIDs include aspirin, ibuprofen, naproxen, and more. One common side effect of NSAIDs is peptic ulcer (ulcers of the esophagus, stomach, or duodenum). Side effects, drug interactions, warnings and precautions, and patient safety information should be reviewed prior to taking NSAIDs.
Turf toe is a sprain to the ligaments around the big toe joint. Symptoms and signs include pain, swelling, a popping sound, and limited range of motion. Treatment may involve taking ibuprofen, immobilizing with tape, cast, or a walking boot.
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