Anatomy of Foot and Ankle

Our feet are complex structures consisting of 26 bones, 30 joints, and nearly 100 muscles and ligaments. Synchronized functioning of all these parts – from toes to the Achilles tendon, is necessary to maintain balance and stand upright. Feet bear the weight of the body and absorb the pressure when we walk. So, disorders related to ankles not only cause pain but also disrupt our daily routine significantly.

What are the Causes of Foot and Ankle Pain

There can be several reasons behind persistent pain in the feet and ankle. They include:

Plantar Fasciitis
One of the most common causes of foot pain, plantar fasciitis, is characterized by inflammation of the tissue along the arch of the foot and sharp stabbing pain. The symptoms worsen in the morning and alleviate with rest.

Metatarsalgia
In patients suffering from Metatarsalgia, the ball of the foot gets inflamed and causes pain. Activities like jumping or running that put pressure on your feet lead to this condition.

Peripheral Neuropathy
Peripheral neuropathy is marked by unusual pain and tingles, burning, or stabbing sensations. It is caused due to peripheral nerve damage following an injury, infection, or diabetes.

Neuroma
A neuroma is characterized by inflammation or enlargement of the digital nerve. In addition to numbness/tingling/ burning of toes, the patient feels the presence of a foreign object along the bottom of the foot.

Sesamoiditis or Sesamoid Stress Fracture
Sesamoids are two tiny bones that lie beneath the ball of the big toe. When they become overloaded and inflamed, the condition is called Sesamoiditis. Pain and swelling are classic symptoms of Sesamoiditis. Sometimes, the overloading leads to a stress fracture, called Sesamoid Stress Fracture.

Some more causes of foot pain are:

• Poorly fitting footwear
• Osteoarthritis
• Inflammatory arthritis
• Connective tissue diseases
• Poor blood circulation

When to see a Doctor

A lasting foot pain that hampers your day-to-day activities requires medical attention. You must see a doctor if you have the following symptoms:

• Pain that is preventing you from walking
• Dizziness or nausea along with foot pain
• Fever or swelling along with foot pain
• Worsening pain

How is the Cause Diagnosed

To detect the cause of the foot/ankle pain, the doctor will conduct a thorough physical examination. He will ask you to stretch your toes and observe the movements, check for tenderness and sensitivity, and determine if there is any bruising, ingrown toenails, or an injury that can cause the pain. Based on the result of the diagnosis, you are referred to a podiatrist or an orthopedist. You might have to get an X-ray or some other imaging tests run to see if there is a bone fracture or a skeletal issue.

How are Foot and Ankle Pain Treated

The treatment varies based on the cause of foot and ankle pain. Some ways the pain can be managed include:

Dietary changes 
Including healthy anti-inflammatory supplements like turmeric, lemon, and antioxidants in your food can reduce the swelling.

Medication
If the pain is severe and persistent, opioid drugs such as oxycodone or hydrocodone are prescribed. Opioids should not be used without prescription because they are addictive.

Cortisone injections are recommended to plantar fasciitis, sesamoiditis, and neuroma patients when analgesics fail to provide relief. CAM boots/ surgical shoes can also provide relief from pain caused by these conditions.

Surgery
This is the option when there is damage caused to the bone. Surgery is recommended only when conservative treatments fail. Surgery fixes the position of the joints by resetting the bones or fusing the joint.

Surgery is recommended to:

• Correct valgus heel or hammertoes
• Remove a neuroma or rheumatoid nodules
• Remove a part of the bone from a bunion and reshaping the toes
• Fix a fracture