Foot Pain (cont.)
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.
- Both feet will be physically and visually examined by the medical
practitioner. The foot and arch will be touched and manipulated possibly with a
lot of pressure 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.
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 antiinflammatory such as aspirin, ibuprofen, or
naproxen will 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.
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 machines 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 off-the-shelf 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.
- Follow up with your doctor until you are better.
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