Foot and Ankle Pain

How can an osteopath help with foot and ankle pain?

  • Depending on the diagnosis and your age and fitness we can use a variety of gentle massage and manipulative techniques to increase the mobility of the joints and the flexibility of the muscles in the foot.
  • We will often look at muscles and joints in the lower limb, the knee, hip and lower back and may treat any joint restrictions and muscle tightness we find there. Often improving the movement in the joints of the lower will help the foot and ankle function better.
  • We may offer specific balancing, strengthening or loosening exercises.
  • We may offer advice on strapping and brace supports, footwear and any lifestyle factors that might be hindering healing. We may refer you to a podiatrist for their opinion and specialist foot supports
  • X-rays, scans or other tests may be required to make a diagnosis and we may refer you to your GP for any additional investigations and treatment such as advice on pain killers and anti-inflammatory medications

  • Foot pain is a common problem with a wide range of possible causes. Many conditions that cause foot pain can be managed yourself at home, but you should see your GP if you're concerned about any severe or persistent pain in your feet.

    Common causes of foot pain

    Common causes of foot pain include:

    Sprains and strains

    Sprains and strains are very common injuries that affect muscles and ligaments (strong bands of tissue around joints that connect one bone to another). They often occur if you change direction or speed suddenly, fall and land awkwardly, or collide with an object or person, such as when playing sports.

    A sprain means one or more of your ligaments have stretched, twisted or torn. A strain means muscle fibres have stretched or torn.

    As well as pain, a sprain or strain can cause swelling, bruising and tenderness, and may result in you being unable to put weight on your foot.

    Most sprains and strains can be managed at home using PRICE therapy (protection, rest, ice, compression and elevation) and painkillers.

    Gout

    Gout is a type of arthritis caused by a build-up of uric acid (a waste product) in your joints. It causes sudden bouts of severe pain, redness, swelling and warmth in affected joints, even when you're resting.

    These attacks usually last a few days at a time and most often affect the big toe joint. It can sometimes be difficult to tell the difference between gout and a severely inflamed bunion (see below).
    The pain caused by gout can usually be treated using ice packs and by taking non-steroidal anti-inflammatory drug (NSAID) painkillers. You may also need additional treatment to prevent further episodes.

    Verrucas

    Verrucas are small growths that usually develop on the soles of the feet. They can be painful if you put weight on them when you stand up or walk.

    Verrucas are fairly easy to identify. They look like small, flat white circles of skin that often have black dots in the centre.

    Most verrucas will often eventually clear up by themselves, but this can take a long time. There are over-the-counter verruca creams, gels and plasters that may help.

    Blisters, corns and calluses

    Poorly-fitting shoes that rub on the feet can damage the skin and may cause: 

    These conditions can all result in pain and discomfort when you walk.

    Most blisters heal naturally in a few days and don't require medical attention. Wearing comfortable, well-fitting shoes can help stop them returning. Read more about treating blisters and preventing blisters.

    Corns and calluses don't necessarily improve on their own and you may need to see a podiatrist or chiropodist, who can advise you about appropriate treatment. Read more about treating corns and calluses.

    Bunions

    A bunion is a bony swelling at the base of the big toe that can be painful when wearing shoes and make walking difficult.

    Bunions are a common foot problem, particularly in women. The big toe points towards the other toes and the big toe joint sticks out, forming a bony lump.

    Bunions can get worse if they're left untreated, so it's best to see a GP for advice. Non-surgical treatments are usually tried first, including wearing comfortable and wide shoes, orthotics (insoles), painkillers and bunion pads. Corrective surgery may sometimes be necessary.

    Plantar fasciitis

    Plantar fasciitis is the result of damage to the tough band of tissue (fascia) that runs under the sole of the foot, which causes pain in the heel. It most commonly affects people aged 40 to 60 who are overweight or on their feet for long periods of time.

    The pain tends to develop gradually over time and is at its worst when you wake up in the morning and at the end of the day.

    Resting your heel, regular stretching, applying ice packs, taking painkillers and wearing well-fitted, supportive shoes can often help relieve the pain.

    Morton's neuroma

    Morton's neuroma is a condition that affects the nerves between the toes.

    Fibrous tissue develops around the nerve, which becomes irritated and compressed. This causes severe burning pain on the ball of the foot and at the base of the toes.

    Morton's neuroma can occur on one foot or both feet. It usually affects the nerve between the third and fourth toes, but sometimes the second and third toes are affected.

    If you have Morton's neuroma, it may help to wear shoes with more room for the toes. You can also take painkillers or have steroid injections to help ease the pain. If these treatments don't work, surgery may be needed.

    Metatarsalgia

    Metatarsalgia is the term for pain that occurs in the front section of the foot.

    It's is often described as a burning or aching pain that ranges from mild to severe and gets worse when walking. It can affect one or several toes near the ball of your foot, or sometimes the entire foot.

    Anything that puts extra strain or pressure on the ball of your foot can bring on the pain – for example, wearing tight-fitting shoes for a long period of time, high impact sports, or being overweight. Older people are more susceptible to metatarsalgia.

     

    Most cases of metatarsalgia can be managed using PRICE therapy (protection, rest, ice, compression and elevation), painkillers, changing your footwear and using shock-absorbing insoles. In rare cases, surgery may be required to repair underlying damage to the foot.

    Arthritis

    In older people, repeated episodes of foot pain and stiffness can indicate a sudden worsening of osteoarthritis, which is the most common type of arthritis in the UK. This long-term condition caused by wear and tear results in swelling of the tissues in and around the joints, including the big toe and heel joints.

    Treatments include wearing suitable footwear to reduce the strain on your joints, painkillers, anti-inflammatory medication, physiotherapyand surgery in some cases. Read more about treating osteoarthritis.

    Less commonly, foot pain can be caused by rheumatoid arthritis, which is a type of arthritis caused by the immune system attacking the joints and causing the joint tissues to become inflamed. It almost always affects other joints too, so foot pain will probably not be your only symptom.

    Achilles tendon injuries

    Pain and stiffness along the back of your heel could be a sign of damage to your Achilles tendon. This is known as Achilles tendinopathy.

    The pain can often be relieved with rest, ice packs and painkillers at home, although it may take several months to resolve completely.

    If you experience sudden and severe pain in your heel, which may have been accompanied by a "popping" or "snapping" sound, you may have ruptured (torn) your Achilles tendon.

    You should seek medical advice as soon as possible if you think you have ruptured your Achilles tendon. Often this will be treated with immobilisation (wearing a plaster cast or plastic boot) for several weeks. Surgery may sometimes be required to repair the tear.

    Oedema

    If your whole foot is painful, heavy and swollen, it may be a sign of oedema.

    This is a build-up of fluid (mainly water) in the body's tissues, causing swelling to occur in the affected area. Oedema will usually affect your whole lower leg as well. See your GP, or if the pain and swelling is severe, go to your nearest accident and emergency (AE) department.

    Diabetic foot problems

    People with diabetes can experience a number of potentially serious problems affecting their feet, some of which can be very painful. This is because the condition can damage nerves and blood vessels in your feet. Foot problems that can affect people with diabetes include:

    Contact your GP or diabetes care team immediately if you have diabetes and think you have developed a problem with one or both of your feet.

    A broken or cracked bone (fracture)

    A broken or cracked (fractured) bone in your foot can occur suddenly after a severe injury, or gradually over time as a result of doing lots of high-impact sports (such as long-distance running). Occasionally they can occur as a result of osteoporosis (weakened bones).

    Any bone in and around the foot can be affected, including the:

    The affected area will be very painful and tender to touch, and the skin may be bruised. You should stop all activity immediately and avoid putting weight on your foot until you see a doctor.

    Information taken from NHS UK website.

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