OVERVIEW OF ANKLE & FEET PAIN

Most people experience pain in and around their feet or ankles at some point in their lives. It is one of the most complex and hard-working regions of your body.

Pain in the ankle can result from inflammation or injury to any of the structures in this region, including the bones, joint space, cartilage, ligaments, tendons, or muscles.

By employing the appropriate treatment, you can work towards pain-free ankles.

WHAT CAUSES ANKLE AND FEET PAIN

  • Rheumatoid Arthritis (RA)

RA occurs when your immune system attacks your joints by mistake. If you have it, both ankles are likely to hurt. Pain, swelling, and stiffness often start in the toes and front of your foot and move slowly back to the ankle. If untreated, RA can lead to long-term joint damage, heart problems, and disability.

  • Osteoarthritis

Osteoarthritis occurs when the ankle cartilage wears off over time, causing the bone to rub directly against each other. This can lead to pain, stiffness, and loss of motion. If untreated, Osteoarthritis has the potential to severely impede mobility.

  • Gout

Gout occurs when a waste product called uric acid turns into needle-shaped crystals that collect in your joints. This causes intense pain and swelling. If untreated, gout can cause erosion and destruction of a joint.

  • Achilles tendinitis

A heavy or sudden strain can cause tiny tears in the Achilles tendon, which connects your calf muscles to your heel. It commonly affects people who do a lot of running or jumping. Symptoms include swelling, difficulty moving the foot up and down, or a lump on the tendon. If untreated, it can develop into chronic tendinosis and cause permanent degradation of your tendons. In some cases, it can even lead to tendon rupture, which requires surgery to fix.

  • Chronic medial and lateral ankle pain

Pain on the inside and outside of your ankle because of ligament tears which may be acute or chronic after a sprain. High grade tears of the lateral and medial ligaments make the entire joint less stable and leads to more injury and pain. If untreated, it can result in chronic ankle instability.

  • Bursitis

Bursitis causes pain and inflammation, commonly around hard-working joints such as in the big toe, ball of the foot, heel, or ankle.You can get bursitis between your ankle and heel if you keep wearing shoes that rub or pinch on the area. Shoes that are too tight and high heels regularly cause bursitis. It often appears as a red, painful, swollen lump. If untreated, it can cause chronic inflammation and pain, and even muscle atrophy in the long-term.

  • Tibialis posterior dysfunction

This condition is caused by inflammation, damage or a weakness which over-stretches the tibialis posterior tendon and causes pain, redness, warmth and swelling in the tendon that connects the inside of the calf to the arch of the foot. Your ankle or heel may feel weak and it can cause the arch of your foot to drop. It can make walking, standing for long periods of time, or rising to your tip toes difficult. If left untreated, it can eventually make the arch of the foot collapse. 

  • Plantar fasciitis

This condition is caused by damage to the plantar fascia, which runs from the heel to the base of the toes and commonly causes pain in the centre and inner side of the heel. The plantar fascia helps to spread your weight evenly through your foot, so you can walk, run, or stand without difficulty. Plantar fasciitis can make it difficult and painful to use your foot properly, particularly just after rest or following activity. If left untreated, it can lead to unexpected hip, back, and knee pain.  There are mimics of plantar fasciitis which need to be diagnosed so it is treated correctly.

 

What are the symptoms of Ankle & Feet Pain?

  • Swelling or bruising
  • Redness or tenderness
  • Numbness or tingling
  • Instability
  • Burning pain
  • Inability to bear weight
  • Stiffness

 

What are the treatment options for Ankle & Feet Pain?

  • Musculoskeletal Ultrasound Imaging

Musculoskeletal Ultrasound is the first line imaging for soft tissue injury of the ankle. It is able to diagnose all tendinosis and tears of the ankle and foot tendon and ligaments. Bursitis around the ankle can also be diagnosed. It can also assess and grade ligament and tendon injuries. This is important as high-grade injury of ligaments can lead to chronic ankle instability. Regenerative injections under ultrasound guidance such as PRP and steroid injection can be performed for medium grade injuries.

  • Conservative therapy such as physiotherapy and rehabilitation

Physical therapy can help to reduce the pain, swelling, and stiffness. There are two main types of physical therapy—passive and active treatments. Physical therapy, though effective, has a long road to recovery and may not be suitable for those who are seeking quick and effective solutions to help you get back on your feet in no time.

  • Regenerative injection

Regenerative injections with proven results include PRP for Chronic Achilles tendinosis and tendons and partial tears of tendons around the ankle. Steroid can be injected for bursitis such as retrocalcaneal bursitis and plantar fasciitis. Stem cells can be injected into post repaired Achilles tendon tears to promote healing.

Read More About Regenerative Injections

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