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Oh, My Aching Foot! Help for Common Causes of Foot and Leg Pain

Published
August 15, 2013
Publication
Bottom Line Personal
Source
Johanna S. Youner, DPM
Print
4116

The average person walks the equivalent of four times around the world in his/her lifetime. No wonder foot problems plague more than three-quarters of US adults! The good news is that we can take steps on our own to relieve the pain. Here are the most common symptoms and problems—and what you can do…

ACHILLES TENDONITIS

Symptoms: Pain above the heel or in the back of the leg.

Even though the tendon in the back of the heel is the strongest and largest in the body, it’s still among the most vulnerable—and when it hurts, it can hurt a lot.

Inflammation of the tendon, known as Achilles tendonitis, usually is due to overuse. The tendon gets weaker and susceptible to injuries with age. If you overwork the tendon—say, by spending a few hours on the dance floor or the basketball court—the fibers can develop small tears and get inflamed. It typically takes at least three months for it to heal completely. In the meantime, don’t engage in high-impact exercises such as running, and switch to low-impact activities such as biking or swimming. Also…

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Start with ice. Ice is one of the best ways to reduce inflammation and help the tendon heal. When you first feel pain at the back of the heel, apply an ice pack for up to 20 minutes. Keep applying ice throughout the day—and keep the heel elevated as much as possible for a few days. You can further reduce inflammation by taking aspirin or ibuprofen.

Try heel lifts. These are thin wedges that slip into your shoes. Raising the heel as little as one-eighth of an inch reduces stress and helps the tendon heal quicker. Use lifts in both shoes so that your body is balanced. I like Spenco Rx Heel Cushions and AliMed Heel Lifts. Both are available online and in pharmacies and some stores.

Important: If you can’t stand up on your toes even for a second, there’s a good chance that the tendon has ruptured (completely torn). Surgery is the only treatment for a ruptured Achilles tendon.

MORTON’S NEUROMA

Symptoms: Feels as if a pebble is in your shoe…pain in the ball of the foot.

Morton’s neuroma is a thickened nerve in the ball of your foot. It typically causes sharp pain or burning that gets worse when you walk. The abnormal growth of nerve tissue is the body’s response to irritation—usually from shoes that are too tight or from wearing high heels. Anything that puts repetitive pressure on the toes, including activities such as jogging, can cause Morton’s neuroma.

Wear wider shoes. Giving the toes more room to move reduces pressure and causes the neuroma to shrink back to normal, possibly within a month or two.

Stretch your toes. The nerve may be trapped under a ligament in the foot. Stretches will lengthen the ligament and open up space over the nerve. A few times a day, use your fingers to bend your toes up and down. Stretch them as far as you comfortably can, and repeat the stretches about a dozen times.

PLANTAR FASCIITIS

Symptoms: Stabbing pain in the heel of the foot.

A thick band of tissue (the plantar fascia) runs across the bottom of the foot. It connects the heel bone to the toes and creates the arch. Small tears in the tissue can cause burning/stabbing pain, particularly in the morning.

Important: Get a second opinion if your doctor recommends surgery. About 90% of cases heal with conservative care within a year.

Apply ice. Hold an ice pack over the painful area for 15 or 20 minutes, three or four times a day.

Replace your shoe insoles. The Powerstep brand of insoles support and cushion the plantar fascia and help it heal more quickly. You can buy insoles at pharmacies, sporting-goods stores and online for $15 to $60. In many cases, they work as well as prescription products (which can cost $550).

Use a tennis ball or rolling pin to gently roll along the bottom of your foot (while sitting).

Take aspirin or ibuprofen to reduce pain and inflammation.

Replace worn-out athletic shoes. They stop cushioning your feet after about 500 miles of use.

See your doctor if the pain isn’t gone within three months. He/she might recommend a steroid injection. Used judiciously, steroid injections can help heal a chronically inflamed area quickly. Three steroid injections per area are the maximum for one year—more than that in a year can weaken tissue.

SHIN SPLINTS

Symptoms: Pain that runs along the bone on the front of your lower leg.

Shin splints are caused by inflammation that affects muscles and the underlying bone. They usually are caused by activities that involve sudden stops and starts, such as aerobics, jogging, tennis and basketball. They also occur in people who walk a lot in hard-soled shoes.

Use ice to reduce inflammation. It’s the most effective treatment for bone and ligament trauma. When you are in pain, ice the area of the leg—10 minutes on and 10 minutes off, as needed.

Try arch supports. They slip into your shoes and support the bottom of the foot. They reduce stress on the lower leg and will help shin splints heal more quickly. I like the brands Powerstep (see above) and Superfeet.

Talk to your doctor about bone stimulation. If the pain of a shin splint lasts more than a few months, you may have a stress fracture at the tibia. Your doctor might recommend a bone stimulator, a prescription device that uses ultrasound or electrical currents to stimulate new bone growth. Bone stimulators are worn daily for a minimum of three hours per day for 90 to 180 days.

BUNIONS

Symptoms: Bump and pain at the base of the big toe.

A bunion is a bony hump that forms on the outside of the foot, where the big toe emerges from the foot. Take it seriously, even if it doesn’t hurt. It means that your big toe is pushing in the wrong direction. It can lead to joint damage, as well as a misalignment of the other toes. Some people are born with a tendency to develop bunions. More often, they are caused by narrow, ill-fitting shoes (particularly high heels) that press the toes into odd positions.

Wear sensible shoes. “Sensible” means that the shoes are wide enough to allow your toes to move. Avoid shoes with sharply pointed toes or heels higher than two inches.

Do foot exercises to relieve symptoms and increase flexibility. Point and flex your toes, or massage the bottom of your foot with a golf ball.

See a doctor if the bunion is painful or getting larger. It will get worse unless you take care of it. The treatment might be as simple as a custom-made shoe insert that will reduce pressure on the affected joint. Surgery (bunionectomy) is recommended only if the bunion is persistently painful and doesn’t get better with other treatments.

DR. JOHANNA S. YOUNER ANSWERS YOUR QUESTIONS

Bottom Line Personal had a facebook chat with Dr. Johanna S. Youner, a nationally-known Park Avenue podiatrist and foot surgeon. We invited readers to submit their questions about their feet—and Dr. Youner answered those questions.