Causes of Foot and Ankle Pain
Arthritis, which is an inflammatory joint condition, can also be a cause of foot pain, oftentimes at the hindfoot. Finally, pain can be referred from other parts of the body, an example being low back nerve compression.
Sprains usually occur after a sudden trauma and can vary from being a stretched ligament to a complete tear. This usually occurs at the midfoot when the foot is twisted in an inverted or everted position.
Another common cause of foot pain is when one or more of the foot’s many bones are bruised. This can occur after a fall or kicking a hard object. Fractures can also cause severe foot pain, which can be a result of acute trauma (from a fall) or from chronic stress (stress fractures).
The foot’s structure is designed to provide both support and mobility. Pain can occur when ligaments, tendons, or muscles in the feet are used too much or in an incorrect method (too little or too much movement). This occurs when one has biomechanical imbalances (flat feet or high arches) or is overweight.
The foot is an extremely complex piece of machinery, with 26 bones, 33 joints, and a network of over 100 tendons, muscles, and ligaments. Its components are categorized into three sections: the forefoot, the midfoot, and the hindfoot. The forefoot contains the metatarsals and phalanges; the midfoot contains the remaining joints and the connections between the forefoot and hindfoot; and the hindfoot contains the talus and calcaneus.
Foot pain is one of the most common health problems experienced by people of all ages. It can range from mild to severe and can be a frustrating experience because of the limitations it can impose on daily activities. In trying to determine the causes of foot pain, it is important to take a look at the anatomical structure of the foot.
Conventional Treatment Options
There are a great many conventional treatment options for foot and ankle pain, depending on the source of the pain, type of injury, and other factors. In cases of mild to moderate pain, over-the-counter NSAID pain relievers (ibuprofen, naproxen) are often effective. These work well for pain caused by inflammation as well. Rest, ice, compression, and elevation (R.I.C.E.) is a good treatment to use for any minor injury for the first 48-72 hours to reduce swelling and pain. Rest means to stay off the injured foot or ankle as much as possible, or at least avoid activities that will exacerbate the pain. In some cases your doctor may put you in an air cast or a walking boot to immobilize the affected area for a short time to promote healing. This is sometimes done in place of more old-fashioned rigid casting. Crutches are also an option to take weight off the affected foot/ankle. Physical therapy with exercises to increase strength and flexibility of the foot and ankle may be helpful, especially if the pain is chronic or has been treated surgically.
Herbal Remedies for Foot and Ankle Pain
The active properties of arnica have been proven to reduce inflammation and ease pain. It does this by increasing the circulation around the area, which helps to disperse the pooled blood that occurs around the injury. This, in turn, speeds up the healing process and lessens the pain. Unfortunately, the use of arnica in raw form can be toxic to some if too much is ingested. However, this problem is bypassed by homeopathic remedies, which contain arnica but in a highly diluted form.
Arnica – This is an herb that grows in the mountainous regions of Europe and North America. It has been used for centuries to cure various types of pains and aches. This is due to its daisy-like flower, which contains a volatile oil.
The use of herbal remedies has been around since the beginning of time. Many of the remedies have been passed down from generation to generation, and these days many have made their way into conventional medical practice. These few remedies have been shown to help with foot and ankle pain by reducing the inflammation that occurs in those areas.
Arnica
An investigation was conducted to study the effects of the homeopathic medication Arnica 6cH on pain and swelling after surgical treatment of wisdom teeth. The research protocol was approved by an independent ethics committee. After obtaining informed consent, 79 patients were enrolled in the study. The contents of the arnica solution provided by the patients were recorded. Patients who were taking NSAIDs were excluded from the study. The patients were randomly assigned to receive Arnica or Rapicalm (No Arnica), and assessments were repeated at specific intervals over a two-day period. The efficacy of the treatment was evaluated using the patients’ self-reported pain relief on the visual analogue scale as the primary outcome measure. At two days, there was a similar decrease in pain observed in both groups, mistakenly favoring the Arnica group. At the end of two days, the Arnica group had a significantly greater reduction in pain and swelling. These positive results suggest a long-term beneficial effect on postoperative inflammation and pain in wisdom tooth extraction with Arnica 6cH compared to placebo.
Arnica montana is a plant indigenous to Europe. Often called the European form of leopard’s claw, arnica blossoms have been used in herbal prescription drugs for centuries. Arnica pills and gels are used topically to reduce inflammation and lessen pain from sprains and strains. The active ingredient of this supplement is helenalin, which has anti-inflammatory and analgesic activities. When taken orally, arnica can also boost the immune system. Homeopathic preparations of arnica are used to treat symptoms caused by trauma or injuries. The active component in arnica that is believed to enhance its effects is sesquiterpene lactone.
Turmeric
Turmeric (Curcuma longa) is a perennial plant from the ginger family. The bright yellow-orange spice is commonly used in curry dishes. Turmeric has been widely used within Ayurvedic and Chinese medicines as an anti-inflammatory, to treat digestive and liver problems, skin diseases, and wounds. As alternative medicine research continues to grow, this ancient spice is showing promise in treating various conditions. For example, it has been linked to the treatment of inflammatory bowel diseases, improving cholesterol levels, aiding in the prevention of certain cancers, and, as mentioned before, including arthritis and other joint discomforts. An international study has recently shown that turmeric extract was just as effective as ibuprofen in treating knee osteoarthritis pain. Due to the active compound curcumin giving this spice its vibrant color, it is also believed to be a powerful antioxidant. In vitro testing suggests that curcumin has the ability to block cytokines and enzymes that cause inflammation; thus, it is possible that it may be a powerful anti-inflammatory drug.
Ginger
As a herbal remedy for pain, ginger is right up there with turmeric. Its history dates back over 2,000 years as a staple in Eastern medicine. The first recorded uses of ginger took place in ancient China and India. It was used to ease nausea and digestive trouble and eventually as a treatment for pain. Since then, it has traveled through every culture’s traditional medicine as a treatment for things such as headaches to arthritis. Today, ginger is still used for the same and more in various forms such as tea, supplement, or raw root. A ginger supplement serving can range from 0.5 to 3 grams of dried ginger or 2 to 4 ml of liquid extract. Ginger works by decreasing the production of substances that are known to cause inflammation of the body and the pain associated, which makes it an ideal treatment for pain caused by osteoarthritis or rheumatoid arthritis. It is still unknown exactly what part of the ginger root contains its active ingredient to inhibit and relieve pain, but it is believed to be the phytochemical (plant chemical) compounds known as gingerols. In a study published in the November 2003 issue of Life Sciences, scientists at the University of Arizona stated that the extract of ginger “showed a significant effect in reducing knee pain” caused by osteoarthritis. Ginger was also observed to have an impact on the pro-inflammatory compounds (cytokines) and was deemed “an attractive candidate” for anti-osteoarthritic drugs.
Willow Bark
One study found that willow bark is more effective than a placebo at relieving lower back pain. However, it also mentions that using willow bark can take a longer period of time for effects to be felt, with the study itself lasting over four weeks. This shows that willow bark may be more beneficial in chronic conditions such as arthritis, as opposed to more acute injuries. This is due to the fact that salicin in the willow bark needs a higher concentration for anti-inflammatory effects, meaning it would be best to not just stop taking it as soon as pain reduces. This indicates its effects are longer-lasting than other herbal drugs such as arnica, which could be a good idea in order to prevent recurrence of the injury.
Willow bark has been used for pain relief for thousands of years. This is because it contains a chemical called salicin, which is similar to aspirin. In fact, in the early 1800s, salicin was used to develop aspirin. However, because the aspirin could upset the stomach, salicin was later replaced by acetylsalicylic acid to reduce this effect. This is far from the only chemical within willow bark, as it also contains plant chemicals, which could be effective for pain and inflammation.
Homeopathic Remedies for Foot and Ankle Pain
Rhus Tox
Rhus Tox will prove to be a very good remedy treating acute gout attacks at any joint. In particular, it is likely that the patient experiences pain in a foot or ankle joint that has been previously injured and which has become arthritic. In these cases, Rhus Tox will act on the new symptoms of the acute gout attack as well as the chronic symptoms.
Gout: – Pain is often severe and described as throbbing and crushing (an extremely intense quality of pain) – Attacks occur suddenly and pain is usually at extreme during the first 4-12 hours. – Most commonly, the first joint of the big toe will be affected but the forefoot, midfoot and ankle may be areas of gout attack.
The symptoms found in foot and ankle pain can often be related directly to symptoms observed after poison oak exposure. The classic Rhus Tox patient experiences pain and stiffness on initial movement, a feeling of warmth and help to heel pain while foot is kept elevated. Pain is often migratory from small joints to other areas and acute onset pain is sometimes alleviated by walking. Compare this to the experience of a patient with acute gout:
In general, Rhus Tox is considered one of the most important homeopathic remedies for various types of rheumatic pains. Rheumatic pains are characterized by the patient feeling a bit stiff at first, with the pain increasing as movement is continued. These pains are often relieved by warmth and aggravated by cold. The cornerstone of Rhus Tox for rheumatism or arthritis is pain and stiffness on initial movement, which lessens with continued movement. Pain is often relieved by heat and aggravated by cold, wet weather conditions. This remedy is prepared from the fresh leaves of the Poison Oak plant, which is a member of the Anacardiaceae family. The skin of the plant is very toxic and can cause severe dermatitis. The toxic symptoms that this plant causes are very similar to various acute rheumatic type pains and because of this, Rhus Tox is considered a remedy. Other characteristic symptoms of Rhus Tox include the pain being worse during rest.
Bryonia
Bryonia is often a remedy indicated for conditions affecting the synovial membranes, with the pain being aggravated by the slightest movement. In the case of ankle pain, it is often helpful to get the patient to walk a few steps for diagnosis, since the pain of Bryonia is always worse from walking. The Bryonia patient will hop or raise the affected foot from the ground and then feel a sharp pain on returning the foot to the ground. The pain is usually a stitching, tearing pain and the affected ankle is quite stiff. Any movement of the ankle is very painful and the patient must sit down and elevate the affected leg. Most likely there will also be redness and swelling over the affected joint. In cases of acute gout, Bryonia can be an effective medication. Often the pain of gout is so severe that the patient cannot stand to have the joint touched and in Bryonia this is the case. Any contact with the affected joint excites a pain which seems to be intolerable. The patient is very thirsty and usually has a dry mouth. High fevers associated with violent inflammatory reactions can also be relieved with Bryonia.
Ruta Graveolens
In the feet, Ruta can be a very useful remedy for the pain arising from metatarsalgia, especially where it feels like walking on crushed glass, or for conditions affecting the plantar fascia or the Achilles tendon. Ruta patients would rather not walk or stand, but when it is necessary, they find it easier if they continue to move. This is in contrast to Bryonia patients who prefer to remain still and whose pain is worsened from motion. Anecdotal evidence has pointed to Ruta being a very useful remedy for some types of gout, though it is best to seek advice from a homeopath if you are trying to treat this condition.
Ruta graveolens, or simply Ruta, is based on the garden herb known as rue. This remedy is primarily used for conditions affecting connective tissues, strains, and some types of arthritis, especially when the area is swollen and warm. In recent years, it has gained a reputation for being very useful in the treatment of tennis elbow, especially when the pain is located close to the lateral epicondyle and there is a history of overuse of the forearm extensor muscle. Its action is very similar to that of Rhus Tox, but whereas Rhus Tox subjects will be restless and feel temporarily better for movement, Ruta patients are very sensitive to drafts and cold, will be utterly miserable from the pain, and be inclined to stay completely still. People who will benefit most from Ruta are mentally restless and find it difficult to relax because of their pain.
Lifestyle Changes to Manage Foot and Ankle Pain
Both hot and cold packs are beneficial at the end of a long work day. A cold pack will help to relieve acute pain and reduce swelling in the foot and ankle. Heat will help to relieve muscle tension or soreness. Do not apply heat to a foot that is red, hot or swollen. This could worsen the condition by increasing inflammation and swelling.
Stretching is an important part of any foot care program. It’s a good way to prevent and relieve pain. Simple exercises like toe stretches, picking up small objects with your toes, ankle circles, and moving the foot in all directions will increase blood circulation, flexibility, and range of motion in your lower extremities. Try resistance exercise by using an elastic band around the foot for in and out movements to build ankle strength and improve mild to moderate foot dysfunction. This has been shown to prevent the occurrence of foot and ankle sprains. Any exercises for painful or severe foot conditions should be done under the supervision of a physician or physical therapist.
Choosing appropriate footwear is essential to the health of your feet. Select shoes with a good arch, a cushioned sole, and support in the heel. A stable heel will absorb shock and lessen the impact on your foot. Avoid fashion trends that may be harmful, like clogs, which force the toes to grip the shoe causing strain on the foot. Women should minimize the amount of time wearing high-heeled shoes, which are a common cause of foot pain in women. It’s also wise to avoid going barefoot as this increases stress on your foot and ankle. If you feel that you need additional support, arch supports and custom-made orthotic supports can help.
Proper Footwear
Foot and ankle pain can sometimes be the result of footwear. A person with foot pain should really look at their shoes. A properly fitting shoe should be the first thing an individual should look for when purchasing footwear. There are a few tricks to shoe shopping. If you do not shop for shoes in the afternoon or evening, you are cheating yourself an entire size in shoe length. This is very important to remember because as the day goes on, our feet swell. If you do purchase shoes in the morning, be sure to purchase them big. By that, what I mean is if the shoe is borderline being too small or a little tight in the morning, then it is too small. If a shoe is comfortable in the morning, it will be too tight at night. So if shoes are normally purchased in the morning, they wind up being a half size too small. A shoe that is too small is the leading cause of most foot and ankle problems. This can lead to a laundry list of conditions. A small shoe causes too much pressure on the base of your foot. This pressure can cause a neuroma. A neuroma is essentially an overgrowth of nerve endings caused by the constant pressure of too tight shoes. This condition is very painful and requires either cortisone injections or surgery to repair. Other common conditions caused by too small or too tight shoes are plantar fasciitis, 5th MPJ synovitis, or stress fractures. Today’s running shoes are very comfortable and it is easy to buy a model with too much cushion and/or support, resulting in positive heel shoes. These are a big no-no and are a big cause of Achilles tendonitis. A shoe with too much heel lifts the Achilles too high and the constant pounding can cause tendonitis. Shoes with little to no arch support can cause some to develop flat feet and shoes with too much arch support can cause the same decisions. Never discard the box and the receipt. Wear the shoes inside for a day or two and take a short walk around the neighborhood. This way you can get the feel for the shoe. If it does not feel right or there is any type of pressure or pain, the shoe may not be the one for you.
Stretching and Strengthening Exercises
Strengthening exercises are aimed at increasing the strength of foot and ankle musculature to better support the arch and reduce tension on the plantar fascia. Use isometric exercises, where the muscle is contracted without movement, to reduce the risk of further injury or inflammation in the acute stage of pain. A simple exercise called the marble pick-up strengthens the small muscles in the arch. Place marbles on the ground and, while seated, pick them up with your toes and place them in a cup. Try to repeat this 10-20 times within one week. Towel curls are done by sitting in a straight-backed chair with the foot on a towel on a non-carpeted surface. By curling the towel with the toes and pulling it closer towards you, the towel will form a ball. Repeat these curls for 5 minutes.
Wall pushups begin by standing approximately a foot away from a wall, feet shoulder width apart. Keeping your heels on the ground, lean into the wall by bending the front knee. It is important to keep the back knee straight to feel a stretch in the calf and Achilles tendon. Hold the position for 15-20 seconds and repeat 4 times. The stair stretch is done by extending the ball of the foot on a step while keeping the heel planted, then lowering the heel towards the ground to stretch the calf. This position is held for 15-20 seconds and repeated 4 times. A more intense stretch on the calf can be achieved by slightly bending the back knee of the extended leg. Finally, the belt stretch is done by sitting on the floor with legs extended. Place a belt or towel around the ball of the foot, and while keeping the knee straight, pull the ends of the belt towards you.
Stretching and strengthening exercises are an important part of managing foot and ankle pain. Consistent with previous theory, one study of over 1900 people found that stretching is effective in reducing symptoms of plantar fasciitis. Exercises should be done at a minimum of 5-7 days a week for best results. There are three stretching exercises that are most effective for targeting the plantar fascia: wall pushups, the stair stretch, and the belt stretch. Each exercise is done standing and involves prepositioning the foot to place a gentle stretch on the plantar fascia.
Hot and Cold Therapy
Cold, however, causes vasoconstriction, which will reduce blood flow to the area if applied for more than a few minutes. The effect of this is to reduce swelling and inflammation, which is causing additional pain and preventing further function of the injured area. This change in blood flow metabolism caused by the increased blood flow due to heat application and increased rate of tissue healing, and the decreased blood flow and reduced inflammation and swelling cause a quicker change in state of the injured area from one of repair to one of being fully functional. This faster rate of change can effectively reduce the duration of injury and make a faster return to full function a realistic prospect. Hot and cold applications can be stopped as soon as they are no longer effective; there is no necessity to continue treatment beyond this point. This is an advantage over certain drugs which treat the same conditions.
Hot and cold therapy works on the principle of altering blood flow to the affected part in order to speed up the body’s own healing processes. Normally, blood vessels of the body are capable of constricting and dilating, thus altering the blood flow within them. The application of heat to a part causes the blood vessels to dilate and increases the blood flow to that area. Increased blood flow will speed up the rate of metabolism and therefore the rate of tissue healing.
Alternative remedies based on hot and cold therapy are relatively simple and risk-free. Almost everyone has access to hot and cold water. It is a well-known and documented fact that certain types of application can greatly affect the chemistry of the body. For instance, drinking a cup of boiling water can induce immediate sweating, which is the body’s way of attempting to cool off. Application of a bag of frozen peas to a twisted ankle is a familiar and usually effective way of dealing with acute pain and swelling. Controlling pain and swelling are key factors in attempting to restore function to an injured body part. They are also the first things that need to be tackled in an attempt to minimize long-term damage. This is a crucial consideration for this type of therapy, which is aimed at reducing the duration of injury.
Rest and Elevation
Elevation can occur at any time, however it is most often done at night or after activity during rest.
Elevation can also help to relieve pain in the case of certain injuries, especially chronic injuries. An example of this is in people with tendon injuries like Achilles tendinitis who feel pain in the morning. This is often due to the fact that when they are lying down the inflamed tendon is allowed to cool down and for swelling to set in around the tendon. By keeping the leg elevated all night, basically preventing the blood from rushing to the area, they can reduce the amount of morning pain usually felt.
Elevation is also crucial in the healing process both just after the injury and in the later stages. Elevating the injured area above the level of the heart can assist in decreasing swelling by using gravity to encourage extra fluid to be removed from the site via the lymphatic system. Less swelling leads to less pain and earlier return to mobility. Swelling tends to slow people down and makes them less likely to continue activity.
Rest is one of the key features in helping an injury recover. When you are resting, you are letting your body work on healing the injured site. You can usually continue with light activity, but this should be monitored and if pain increases or the area swells, the activity should also stop. Immobilization assists in healing just after an injury or after swelling has subsided.
