Persistent Foot Pain: Causes and Solutions for Long-Term Relief

Q: Persistent Foot Pain: Causes and Solutions for Long-Term Relief

Hello： Based on your description, the physician should have performed an X-ray to confirm whether there is an old ankle fracture. <br>Your outer ankle often swells and hurts repeatedly due to prolonged standing or wearing shoes, which is caused by injury to the lateral ligaments

My feet start to hurt after wearing shoes for a long time or standing for an extended period?

I experience pain in the sole of my right foot after wearing shoes for a long time or standing for extended periods.
There is a protrusion on the side of my ankle that is painful when touched.
Typically, after resting my foot for 2-3 days, the pain subsides, but it keeps recurring.
I consulted a doctor who mentioned that it is inflammation causing the swelling, which usually resolves in a few days.
However, this time the swelling has not decreased and is even larger than before, and my ankle pain has intensified.
I have a history of sports injuries and have previously undergone surgery for an anterior cruciate ligament (ACL) tear.
Could this be affecting my condition? What recommendations do you have for a definitive treatment? Please provide your insights and suggestions.

Wei Cheng, 30~39 year old female. Ask Date: 2006/08/27

Dr. Huang Longde reply Orthopedics

Hello: Based on your description, the physician should have performed an X-ray to confirm whether there is an old ankle fracture.
Your outer ankle often swells and hurts repeatedly due to prolonged standing or wearing shoes, which is caused by injury to the lateral ligaments or unhealed cartilage damage.
If it is confirmed that there is no fracture, rehabilitation therapy can be initiated.
As for the injury to the anterior cruciate ligament (ACL) in the same knee, it can also increase the burden on the ankle, leading to ankle pain.
Additionally, if the ankle pain is unrelated to the injury, conditions such as gout or other joint disorders should also be considered.

Reply Date: 2006/08/27

More Info

Persistent foot pain can be a complex issue, especially when it has a history of previous injuries and ongoing inflammation. Based on your description, it seems that you are experiencing recurrent pain and swelling in your right foot, particularly around the ankle area. This could be attributed to several factors, including previous injuries, inflammation, and possibly biomechanical issues.

Potential Causes of Your Foot Pain
1. Previous Injuries: You mentioned having a history of sports injuries and surgery on your anterior cruciate ligament (ACL). Such injuries can lead to altered biomechanics, which may place additional stress on your foot and ankle. This can result in chronic pain and inflammation.

2. Inflammation: The swelling and pain you are experiencing could be due to inflammation in the ankle joint or surrounding soft tissues. Conditions such as tendinitis, bursitis, or even arthritis can cause persistent swelling and pain. The "bump" you feel on the side of your ankle could be a sign of inflammation or a bony prominence that has become more pronounced due to swelling.

3. Biomechanical Issues: Flat feet, high arches, or improper footwear can lead to abnormal stress on the foot and ankle, exacerbating pain. If your shoes do not provide adequate support or cushioning, this could contribute to your symptoms.

4. Tarsal Tunnel Syndrome: Given the location of your pain and swelling, there is a possibility of tarsal tunnel syndrome, where the posterior tibial nerve is compressed as it passes through the tarsal tunnel near the ankle. This condition can cause pain, tingling, and swelling in the foot.

Recommendations for Management and Relief
1. Consult a Specialist: Since you have a history of foot and ankle issues, it would be beneficial to consult with a foot and ankle orthopedic specialist. They can perform a thorough examination, possibly including imaging studies like X-rays or MRIs, to assess the extent of any damage or inflammation.

2. Physical Therapy: Engaging in a structured physical therapy program can help strengthen the muscles around your ankle and improve flexibility. A physical therapist can also provide you with specific exercises to address any biomechanical issues and help alleviate pain.

3. Footwear Assessment: Ensure that you are wearing shoes that provide adequate support and cushioning. Consider visiting a specialty running or orthopedic shoe store where they can analyze your gait and recommend appropriate footwear. Custom orthotics may also be beneficial in correcting any biomechanical issues.

4. Rest and Ice: When experiencing pain and swelling, it is crucial to rest the affected foot and apply ice to reduce inflammation. Avoid activities that exacerbate your symptoms, and consider using anti-inflammatory medications as prescribed by your doctor.

5. Gradual Return to Activity: If you are returning to sports or physical activities, do so gradually. Start with low-impact exercises and gradually increase intensity as tolerated. Always warm up before activity and cool down afterward.

6. Consider Alternative Treatments: In some cases, treatments such as corticosteroid injections can help reduce inflammation and pain. Discuss this option with your healthcare provider if conservative measures do not provide relief.

7. Monitor Symptoms: Keep a detailed record of your symptoms, including when they occur, their intensity, and any activities that seem to trigger them. This information can be invaluable for your healthcare provider in diagnosing and managing your condition.

Conclusion
Persistent foot pain can be challenging to manage, especially with a history of injuries and inflammation. A comprehensive approach that includes specialist consultation, physical therapy, proper footwear, and lifestyle modifications can significantly improve your symptoms and quality of life. Remember, addressing the underlying causes of your pain is crucial for long-term relief. Don't hesitate to seek further medical advice if your symptoms persist or worsen.

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