Foot and Ankle Pain
MANY OF US HAVE suffered from occasional foot and ankle pain, which may resolve on its own over time. However, due to the complexity of the foot - with its 26 bones and over 30 joints (not including the ankle) - unremitting pain can lead to significant disability, which can interfere with work and play.
According to Gainesville podiatrist Dr. Angel L. Cuesta, many people seeking medical attention for a painful foot or ankle have been dealing with the pain for some time and have tried a home or drugstore remedy. Dr. Cuesta explains that many foot and ankle conditions can be treated successively without surgery, and avoided altogether with some common sense.
Shoes – “The culprit of many foot conditions is ill-fitting shoes”, says Dr. Cuesta. Shoes that are too short or narrow can result in skin and toenail problems, corns, hammertoes, and irritation of nerves. In diabetics, improperly fitting shoes can lead to more serious problems including loss of limb. “When choosing shoes, function over fashion should be the rule and normal function can only occur with ample room to prevent crowding.” Dr. Cuesta suggests tracing the outline of your foot and comparing it to a chosen shoe; this may show restriction of needed space. “If pain persists after the use of functionally sound shoes, you should seek medical attention.”
Heel pain – This complaint accounts for up to 70% of patients coming to see a podiatrist. Although there are many causes of heel pain, plantar fascitis (also known as heel spur syndrome) is the usual cause. This condition is thought to develop due to a gradual loss of flexibility of the Achilles tendon, which causes a strain on the tissues surrounding the heel bone. Aggressive stretching of the calf muscles and Achilles tendon is now considered the first line of treatment. Cortisone injections are effective, but should be used judiciously due to inherent risks.
Stubbed toes – Most of us brush off a stubbed toe or other minor injuries to the foot or ankle. However, persistent pain, swelling or discoloration beyond 2- 3 days may indicate a fracture. Neglecting early care can lead to permanent deformity and pain that can only be relieved with surgery. If pain and swelling persists and interferes with walking, Dr. Cuesta says you may need xrays to determine if you have a fracture.
Bunions – Also known as hallux valgus, a bunion is a prominent bump on the side of the foot where the big toe joins the rest of the foot. Most likely hereditary in nature, certain shoes can aggravate and accelerate the development of a bunion deformity. Corrective surgery for most painless bunions is not recommended; however, if pain persists or shoe fitting is difficult, surgery may be necessary. The surgery should not only remove the bump, but also correct the deformity causing the bunion to prevent recurrence.
Arthritis – As we age, general pain and stiffness in the foot and ankle can be attributed to arthritis; in fact, this can be the first area where the disease is noticed. “Arthritis is a broad term for a number of different conditions that destroy the workings of a normal joint. The foot, with its many joints, can become a source of significant pain and functional disability.” Laboratory tests, x-rays, bone scans, CT and MRI scans can often confirm the presence of arthritic conditions. Antiinflammatory drugs, injections of steroids, physical therapy, shoe inserts, or custom- made braces can greatly help patients with a confirmed diagnosis of arthritis. Surgery is sometimes also necessary.
In summary, Dr. Cuesta believes pain relief can be achieved by the patient taking an active role in their treatment. “Proper shoes, weight control, stretching and exercise go a long way to cure and prevent future foot and ankle problems.” G
To make an appointment with Dr. Angel L. Cuesta, please call 352-331- 3077. Dr. Cuesta is Board Certified by the American Board of Podiatric Surgery, and is a Fellow of the American College of Foot & Ankle Surgeons. Most insurance accepted. He is located behind North Florida Regional Medical Center in Gainesville.