Other Treatments for Foot Pain
Aside from medication and surgery, there are other treatments for foot pain. These treatments can help the following types of foot pain:
RICE stands for rest, ice, compression, and elevation—the four basic elements of immediate treatment for acute injuries to the feet.
- Rest —Rest your foot as soon as possible.
- Ice —Ice is particularly important to reduce swelling and promote recovery during the first 48 hours. A bag or towel containing ice should be wrapped around the injured area on a repetitive cycle of 20 minutes on, 40 minutes off. Do not put ice directly on the skin.
- Compression —An Ace bandage should be lightly wrapped around the area.
- Elevation —Use pillows to elevate your foot above heart level.
Removing Corns and Calluses —To remove a corn or callus, soak it in very warm water for five minutes or more to soften the hardened tissue. Then, gently sand it with a pumice stone. Several such treatments may be necessary. Do not trim corns or calluses with a razor blade or other sharp tool. If the cutting instrument is not sterile, infection can result, and it is easy to slip and cut too deep, causing injury and bleeding.
Medicated Solutions and Pads —There are a number of over-the-counter pads, plasters, and medications for removing corns and calluses. These treatments commonly contain salicylic acid, which may cause irritation, burns, or infections that are more serious than the corn or callus. Use caution with these medications. You should not use them if you have:
- Reduced feeling in your feet due to circulation problems or nerve damage
- Reduced flexibility or poor eyesight, which could impair your ability to use them properly
To relieve pain from ingrown toenails, try wearing sandals or open-toed shoes. Soak your toe for five minutes, twice a day in a solution of warm—not hot—water and Domeboro or Betadine. Seek professional treatment if you have diabetes or another condition that increases your risk of infection.
Antibiotic ointments can be used to treat ingrown toenails that are infected. Apply the ointment and work a small wad of cotton under the nail. Get the cotton under the corner if possible, to lift the nail up and drain the infection. The cotton will also help force the toenail to grow out correctly. Change the cotton daily and use the antibiotic regularly.
Bunions and Bursitis
- Soft, wide, low-heeled leather shoes that lace up
- Athletic shoes with soft toe boxes
- Open shoes or sandals with straps that don't touch the irritated area
A thick doughnut-shaped, moleskin pad can protect the protrusion. In some cases, an orthotic can help redistribute weight and take pressure off the bunion. Nonsteroidal anti-inflammatory drugs (NSAIDs) or corticosteroid injections may offer some pain relief as well.
At first, a
You can often reduce pain from Morton's neuroma by massaging the affected area. Roomier shoes (box-toe shoes), metatarsal pads, and cortisone injections in the painful area are also helpful. If these treatments are not effective, surgery may help.
In most cases, stress fractures heal by themselves if rigorous activities are avoided. It is best to wear low-heeled shoes with stiff soles. Some physicians recommend moderate exercise, particularly swimming and walking. Occasionally, a physician may recommend wearing a special wooden shoe and a compressive wrap to make walking more comfortable.
Rest and reducing stress on the ball of the foot are the first lines of treatment for sesamoiditis. A low-heeled shoe with a stiff sole and soft padding inside is all that is required in many cases. In severe cases, surgery may be necessary.
It is very important to have a correct diagnosis as to the exact cause of heel pain.
The American Orthopaedic Foot and Ankle Society (AOFAS) suggests shoe inserts, medications, and stretching of the Achilles tendon and calf muscles as the first line of therapy for heel pain. One study found that 95% of women who used an insert and did simple stretching exercises for the Achilles tendon and plantar fascia experienced improvement after eight weeks.
If these treatments fail, you may need prescription heel orthotics and extended physical therapy.
Heel surgery to relieve pain may be performed for heel spurs, plantar fasciitis, or bursitis of the posterior heel. Surgery is not recommended until nonsurgical methods have failed for at least six months and preferably up to 12 months. Nonsurgical treatments for heel pain are effective in 90% of patients.
The three major treatment goals for plantar fasciitis are:
- Reducing inflammation and pain
- Reducing pressure on the plantar fascia
- Restoring strength and flexibility
Home Treatments —You can reduce your chances of needing surgery by starting an exercise program as soon as possible and using NSAIDs, splints, arch supports, or heel cups as needed. Pain that is not relieved by NSAIDs may require more intensive treatments and even surgery.
Comfortable Shoes and Insoles —Comfortable shoes that have thick soles and rubber heels, and perhaps an insole, relieve pressure. Cut a round hole about the size of a quarter in the sole cushion under the painful area. This will offer support to the rest of the heel while relieving pressure on the painful spot itself. Some support of the arch with a felt pad secured by adhesive tape may help. When combined with exercises that stretch the arch and heel cord, over-the-counter insoles may offer better relief than prescribed orthotics. Heel cups will help some people, but probably less than 50%.
Exercises to Restore Strength and Flexibility —A moderate amount of low-impact exercise (such as walking, swimming, or cycling) seems to be beneficial. Stretching the plantar fascia is proving to be very helpful for restoring strength and flexibility. One exercise involves putting the hands on a wall and leaning against them. Your uninjured foot should be on the floor in front. Your injured foot should be placed behind so that the heel is not touching the floor. Then stretch the foot gently by pressing the heel toward the floor. With such treatments, the plantar fascia nearly always heals by itself, but it may take as long as a year to be completely pain free.
Night Splints —You may find it helpful to wear splints at night. Try using an Ace bandage and an L-shaped fiberglass splint while sleeping. It keeps the arch of the foot stretched, allowing the fascia to heal.
Extracorporeal Shock Wave Therapy —You may benefit from extracorporeal shock wave therapy. This therapy uses low-energy sound waves to increase the healing potential of the injured plantar fascia.
Haglund's Deformity (Pump Bump)
Apply ice when the posterior part of the heel is inflamed. A pump bump is essentially an inflammation of the bursa protecting a prominent posterior part of the heel bone. Replace your shoes or get soft heel counters so that they do not irritate your foot.
Tarsal Tunnel Syndrome
Pain from tarsal tunnel syndrome may sometimes be relieved with orthotics. Orthotics are specially designed shoe inserts that help redistribute weight to try to take pressure off the nerve.
Like most athletic injuries, Achilles tendinopathy should be treated as early as possible. A tendinopathy may be a tendinitis or tendinosis. A tendinitis involves inflammation of the the tendon and a tendinosis does not. Although the term tendinitis is used most often, most tendinopathies do not have inflammtion and are tendinosis.
Gentle stretching may help reduce the pain and spasms. Exercise may be alright when your Achilles is no longer swollen or tender, if only very mild pain is present. However, it may be best to check with your healthcare provider. If pain increases with exercise, stop immediately.
If pain continues, despite conservative treatment, surgery may be necessary. Partial tears within the tendon may occur with chronic Achilles tendinitis, and most patients with this situation will benefit from surgery.
Most heel spurs do not cause pain. They often show up on x-rays as an incidental finding. If there is pain, it is caused by the attachment of the plantar fascia to the heel bone causing the heel spur and the pain. With pain, insoles and nonsteroidal anti-inflammatory drugs (NSAIDs), such as aspirin or ibuprofen, may be sufficient. If the pain persists, surgery that involves cutting and releasing the plantar fascia and removing the spurs may be recommended, but only as a last resort. Shock wave therapy is showing promise and is a safe and effective alternative.
Arch and Bottom-of-the-foot Pain
In general, conservative treatment for flat feet acquired in adulthood (often due to posterior tibial tendon dysfunction) involves pain relief and insoles or custom-made orthotics. Insoles and orthotics support the foot and prevent progression. In severe cases, surgery may be needed to provide long term arch support, particularly if people want to be active. Because of possible long-term problems, you should have flattened arches examined by a specialist.
For severe conditions, such as fallen arches or structural problems that cause imbalance, podiatrists or physicians may need to fit and prescribe orthotics, or orthoses, which are insoles molded from a plaster cast of the patient's foot. Orthotics are usually categorized as rigid, soft, or semi-rigid.
When to Contact Your Doctor
Depending on the severity of your symptoms and your general health, experiment with shoe changes and over-the-counter products as long as you are making progress.
You should contact you doctor if you have:
- Persistent or progressive pain
- Worsening infection
American Diabetes Association website. Available at: http://www.diabetes.org/home.jsp .
American Orthopaedic Foot and Ankle Society website. Available at: http://www.aofas.org/i4a/pages/index.cfm?pageid=1 .
American Podiatric Medical Association website. Available at: http://www.apma.org/s_apma/index.asp .
National Institute of Diabetes & Digestive & Kidney Diseases website. Available at: http://www.niddk.nih.gov/ .
Last reviewed April 2009 by
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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