Foot and Ankle Pain Treatment

Pain in the feet and lower limb can stem from structural or functional issues involving the bones, joints, ligaments, and tendons. This pain may be localized, affecting areas such as the heel, ankle, ball of the foot, or between the toes. Individuals may experience problems when walking or standing, or they may suffer from persistent pain that disrupts sleep, work, or daily activities, including common conditions like ankle pain. A thorough biomechanical assessment can help diagnose such issues, leading to effective treatment through foot orthoses.

Foot orthoses differ significantly from the insoles available at pharmacies or online retailers, which primarily provide cushioning with gel or foam and may even help with smelly feet. In contrast, orthoses are professional medical devices designed to redistribute pressure away from stressed joints and tissues. Their design is tailored to the patient’s unique gait and foot pathology, considering individual foot posture and shape. Consequently, most foot orthoses are bespoke or semi-bespoke and necessitate a written prescription.

There is a wide variety of orthoses available, each with different customization methods to suit individual patients. Podiatrist services may vary, with different practitioners utilizing various types and techniques based on their business setup and practice style.

While some orthoses are prefabricated with specific pathologies in mind and can be purchased off the shelf, others can be customized with additional features and heat molded to fit the patient's foot. Most orthoses are created from a standard shell or a cast of the patient's feet, with the prescription requirements integrated directly into the orthoses, making them truly bespoke for each patient.

Examples of conditions that can benefit from the use of foot orthoses include heel pain and other foot ailments.

Put simply, a biomechanical assessment is a series of tests involving the active and passive manipulation of joints, muscles, and tendons of the lower limb and foot while standing and sitting. This assessment includes measured observations of foot and body posture during gait or walking, and it thoroughly examines the circulation and sensation of the feet. Additionally, a complete medical and drug history is taken to understand any underlying issues related to conditions such as ankle pain or heel pain.

The aim of the assessment is to identify and isolate the problem or pain, attempt to reproduce it, and deduce the actual cause from the structural or functional issues identified. Typically, a biomechanical assessment can pinpoint the problem, and the next step is to offer options for treatment, which may include the use of prescription or off the shelf foot orthoses.

However, some problems may not be identified through a biomechanical assessment or relieved by foot orthoses. In these instances, other treatments may be available after further testing, including referrals to GPs for medication, imaging, or physiotherapy, and in some cases, surgery.

Provided you have adequate space for a podiatrist to examine you walking, standing, and sitting, in most cases, a simple assessment can be conducted at home. Please refer to our price list for more information on our podiatrist services.

Bunions, neuromas, fibromas, and plantar fasciitis are common foot conditions that can lead to significant heel pain and ankle pain. A thorough biomechanical assessment by a podiatrist can help identify these issues. Other conditions such as osteoarthritis of the joints, ankle sprains, metatarsalgia, and heel fissures may also contribute to discomfort. Flat feet can lead to further complications, including bursitis and tendonitis. Utilizing foot orthoses can provide relief and support for these various conditions.

The type of foot orthoses you choose will depend on your budget and the specific condition requiring treatment, such as ankle pain or heel pain. Conditions involving significant changes in the structure of the foot may necessitate more robust, fully bespoke orthoses that have a longer lifespan and can withstand increased wear and tear. Conversely, some cases may only require a simple off-the-shelf option that is designed to last just until the inflammation or pain subsides. These options will typically lie at opposite ends of the price spectrum, with various choices available in between. After your biomechanical assessment, we will always provide you with treatment options tailored to your needs.

We currently employ a specialized laboratory to manufacture all of our semi and fully bespoke orthoses. Following your assessment, a prescription is sent to the laboratory, and the orthoses are usually delivered to our office within 2-3 weeks. At that point, we will contact you to arrange a fitting appointment at your home.

Simple, off-the-shelf orthoses can often be supplied during your appointment or ordered to arrive within 2-3 weeks. For more information, please speak to your podiatrist or refer to our price list regarding our podiatrist services.

Occasionally, pain in some soft tissues and joints, such as heel pain and ankle pain, can persist despite rest, foot orthoses, and medication. In particular, the painful symptoms of Plantar Fasciitis, Bunions, and Neuromas may be stubborn and refuse to respond to other types of treatment. 

Following your biomechanical assessment, and depending on your medical history and the particular condition, you may be suitable for a corticosteroid injection. Please speak to your Podiatrist and refer to our price list for more information. 

Steroid injections, also called corticosteroid injections, are anti-inflammatory medicines used to treat a range of conditions in the body. Steroids are a man-made version of hormones normally produced by the adrenal glands, two small glands found above the kidneys. 

When injected into a joint or soft tissue, steroids reduce redness and swelling (inflammation) in the nearby area. This can help relieve pain and stiffness. In the foot, methylprednisolone with a local anaesthetic provides immediate pain relief that lasts a few hours. The steroid in the injection normally takes a few days to start working. 

Most people can have steroid injections. However, you usually need to wait at least six weeks between injections, and it is generally recommended to have no more than three injections in the same area over the course of 12 months.