Foot Pain Part 2: Treatment for the Top 10 Causes of Foot Pain
- Shoes. Get the right shoes. Try wearing shoes that that have a larger toe box. Change your footwear (especially active gear) at regular intervals. If frequent switching is not possible, it is recommended that you have your old shoes stretched.
- Ice. After walking, ice the affected area for 20 minutes which may help in alleviating the pain.
- Bunion Pads. You can also alleviate the pain by using over the counter bunion pads to cushion the bunion.
- Inserts. Padded shoe inserts can help as long as they fit in your shoes and add pressure to your toe box. Custom Orthotics may be more helpful.
- Medications such as Acetaminophen or Non Steroidal anti inflammatory drugs may be helpful.
- Physical Therapy and surgery. Inflammation can be minimized by physical therapy and surgery may be necessary for severe cases.
2. Plantar Fasciitis
- Conservative Treatment: Most cases of plantar fasciitis can be treated with the correct home stretching program. Other conservative treatments include Ice massage, Deep Tissue Massage, Improved Footwear, Anterior Nightsplints and Over the Counter Pain Relieving Medications.
- Persistent Plantar Fasciitis an ultrasound guided ablation procedure may be needed, and rarely even surgery.
3. Heel Spur
The pain associated with Heel spur are usually related to Plantar Fasciitis and the treatment is conservative treatment, similar to the treatment for Plantar Fasciitis. See above.
4. Osteoarthritis of the Foot and Ankle
- Medications. Over the Counter Pain Relieving Medications.
- Inserts. Pads or arch supports.
- Physical Therapy. Physical Therapy can be an important and helpful adjunct to treatment of Osteoarthritis of the foot and ankle.
- Corticosteroid or Viscosupplementation injections often done under XRay or ultrasound guidance into the joints are very effective.
- Surgery. If the condition doesn’t responds to the above treatment options, surgical options may be considered to resolve the arthritis pain.
5. Achilles Tendonitis
- Slow down. For mild cases, minimize your walking or running and switch to non-weight bearing activities like strength training of upper body or swimming.
- Be careful. Do not walk uphill as it causes the tendon to stretch further making it weak and irritated.
- Perform regular calf stretches. Physical Therapy to direct you stretching program can be very helpful for Achilles Tendonitis.
- Really slow down and use cold packs. In severe cases, it is advised to limit your physical activity or even avoid it if it hurts a lot. To alleviate pain and inflammation apply cold packs for 15-20 minutes, at least 3-4 times/day.
- Inserts. Orthotics that raise your heel can relieve the stress on your Achilles tendon.
- Care. Watch your recovery. As you recover, try to keep your foot in a neutral position, or on a flat surface and gradually build the intensity of your exercise.
- Children however are lucky enough to outgrow this condition whereas the adults usually require treatment.
- Shoe padding: Padding the corns or calluses that often result from Hammertoe can relieve the symptoms
- Shoe choice: Avoid pointed shoes or shoes with narrow toe boxes or shoes with high heels.
- Orthotic. An orthotic can help control the muscle/tendon imbalance.
- Injection therapy.Corticosteroid injections are sometimes used to ease pain and inflammation caused by hammertoe.
- Medications. Oral nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, may be recommended to reduce pain and inflammation.
- Splinting/strapping.Splints or small straps may be applied by the surgeon to realign the bent toe.
- Surgery. At times surgery is required in order to straighten up the toes.
7. Morton’s Neuroma
- Conservative Options: Change your shoes. Try wearing spacious toe box shoes. Minimize the time you spend in high heels and wear supportive and comfortable flat shoes
- Orthotics. You may also use overt the counter orthotics to absorb the shock, alleviate the pressure and decrease the pain.
- Medications. Oral non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, may be recommended to reduce pain and inflammation.
- Corticosteroid injections. Ultrasound guided Corticosteroid injections are a good supplement to conservative treatments for early Morton’s neuroma.
- Ultrasound Guided Ablation Procedures. These procedures can cure most cases of Morton’s neuroma while avoiding surgery.
- If it persists, seek help from a clinician who is experienced in treating Morton’s neuroma since Morton’s neuroma can often mimic other conditions.
8. Corns and Calluses
- Correct the problem. The main goal of treatment is to pinpoint and correct the underlying biomechanical cause of friction or pressure.
- Shoes. Wearing shoes that fit better or using non-medicated pads may help.
- Bathing. While bathing, gently rub the corn or callus with a washcloth or pumice stone to help reduce the size. To avoid infection, do not try to shave off the corn or callus.
9. Ingrown toenails
- Shoes. Buy bigger shoes. In normal circumstances, your foot undergoes some degree of swelling with moderate exercise. With an ingrown toenail, this can cause significant pain so it is wise to opt for a shoe-size that is at least half-a size bigger than your regular size, especially if you are buying sneakers.
- Nail care. Trim your nails carefully. When trimming your toenails, try using toenail clippers and cut the nails straight across instead of rounding the corners.
- Orthotics can help. Orthotics can help reduce the pronation of your foot and this can help to reduce the intensity of symptoms.
- Seek help. If you have any circulatory disorder or diabetes, consult a podiatrist at periodic intervals.
10. Toe fungus
- Medications. Oral medications are very effective, along with topical medications such as lotion and creams. In some cases you may need to have the nail removed.
- Foot Care. Keep your feet dry and clean. Chose socks that wick away moisture. Wear shower shoes when walking in public places like locker rooms and public swimming pools.
Janet D. Pearl, MD, MSc is the Medical Director of The Center for Morton’s Neuroma and Complete Spine and Pain Care, an interventional and integrated Pain Management program located in Framingham, Massachusetts. Previously, Dr. Pearl was the Co-Director of the Pain Management Center at St. Elizabeth’s Medical Center, where she was also the Director of the Fellowship program. She is the former Director of a satellite pain center of the Brigham and Women’s Hospital, Pain Management Center, located at the HealthSouth Braintree Rehabilitation Hospital. Dr. Pearl held academic appointments at Harvard Medical School and Tufts Medical School. She serves on the Health Care Services Board of the Commonwealth of Massachusetts Department of Industrial Accidents since 2000 as one of its physician representatives and is Chair of the Committee on Pain Management.