Foot and Ankle Pain Treatment in Las Vegas

The foot and ankle are associated with around 120 muscles, nerves, and ligaments. Damage to any of these structures can result in foot or ankle pain. Foot pain is often related to back problems, ill-fitting shoes, high-impact exercise, and certain medical conditions.

Why are the feet and ankles at risk for problems?

The feet support the entire body’s weight, maintain balance, act as shock absorbers, and serve to propel the leg forward. Compared to the rest of the body, the feet are small, so a lot of force is exerted upon them with each step. During a typical day, a working person spends 4-8 hours on his or her feet.

What spinal conditions can cause pain down the leg and into the foot?

  • Sciatica – The sciatic nerve extends down the back portion of each leg, running all the way down to the toes. When this nerve is inflamed from back problems, pain can radiate down the nerve, which is known as sciatica.

 

  • Lumbar spinal stenosis – When the spinal canal narrows, nerve compression occurs. This leads to radiculopathy symptoms, such as foot pain, tingling, and weakness.

 

  • Spondylolisthesis – When one vertebra slips over the one immediately below it, a portion of the spinal segment is compromised. This results in pain down the foot and leg.

 

  • Herniated lumbar disc – The inner gel-like material of the disc is called the nucleus. When this pushes through the outer layer, it can irritate or press on a nerve root. This pressure causes pain down the sciatic nerve into the lower leg and foot.

What are some common causes of foot and ankle pain?

  • Metatarsalgia – This chronic condition produces pain at the ball of the foot. This can be treated with orthotics, box-toed shoes, and gel cushions.
  • Morton’s neuroma – The nerve between the third and fourth toe can become inflamed, creating a cramping, burning pain. This condition is worsened by ill-fitting shoes and prolonged standing.
  • Plantar fasciitis – The arch of the foot and front of the heel is painful with plantar fasciitis. This condition is treated with rest, medication, and orthotics.
  • Achilles tendonitis – The Achilles tendon is at the back of the heel. Any injury or inflammation to this structure can cause pain, which is worse with physical activities.
  • Ankle bursitis – When arthritis occurs in the ankle, it can lead to stiffness and pain.

How is foot and ankle pain treated?

The treatment of foot and/or ankle pain depends on the cause, the severity of the condition, and the patient’s willingness to participate in therapy. Treatment options include:

  • Medications – For inflammation, the doctor will prescribe nonsteroidal anti-inflammatory drugs (NSAIDs), such as ketoprofen or naproxen. To decrease severely inflamed tissues and foot structures, the doctor may recommend a short course of oral steroids. Severe pain is treated with narcotic analgesics, which are used short-term.

 

  • Cortisone injections – For a painful joint, the doctor may inject a corticosteroid agent into the structure. This decreases pain, swelling, and inflammation. Cortisone injections are also used for plantar fasciitis.

 

  • Orthotics and shoe inserts – For certain foot conditions, the doctor may recommend special shoes, heel lifts, gel padding, and other personalized orthotics. These devices are used to alleviate the pain associated with leg-length abnormalities and foot deformities.

 

  • Epidural steroid injection (ESI) – The doctor can inject a long-acting steroid into the epidural space, which lies between the spinal cord and the layer of tissue that surrounds it. This alleviates nerve pain by reducing inflammation. In clinical studies, ESI is reported to have an 80-90% efficacy rate.

 

  • Medial branch block (MBB) – When nerves are inflamed due to certain spinal conditions, the doctor can inject the facet joints along the back of the spine with an anesthetic medication. Based on a recent research report, MBB has an 85% success rate for relieving nerve pain and sciatica.

 

  • Extracorporeal shock wave therapy (ESWT) – For Achilles tendonitis and plantar fasciitis, the doctor can use quick, intense energy waves to treat the area. Based on a recent research study, ESWT was found to have an 80% success rate.

Resources

Falco, FJ, Manchikanti, L, Datta, S, et al. (2012). An update of the effectiveness of therapeutic lumbar facet joint interventions. Pain Physician, 15(6), 909-953.

Thomas MK, Roddy E, Zhang W et al. (2011). The population prevalence of foot and ankle pain in middle and old age: a systematic review. Pain, 152(12), 2870-2880.