Feet can often be one of the most neglected and forgotten parts of our bodies. So it’s little wonder that around 40% of Australians experience some form of foot problems in their lifetime. It is estimated that 60-83% of Australian aged care residents are affected. Alarmingly, pain is often seen as ‘normal part of ageing.’ It isn’t!
Podiatrists play a major role in managing painful foot conditions. The majority of patients who present for foot care are motivated by a desire to eliminate or reduce a painful condition. In essence, we are pain management specialists, albeit in a very different way.
Podiatrists work across the lifespan continuum assisting patients with their pain with the aim of;
- Diminishing pain
- Improving quality of life where possible
- Preventing acute and sub-acute painful conditions developing into chronic pain
Types of pain
Acute pain is generally accepted to be the pain associated with acute tissue damage. The damage may be due to an event such as an injury or surgery or an active disease process within the tissues. The pain is considered to be driven by peripheral factors responding to the tissue event. As tissue structure is re-established, the inflammation process resolves and tissue healing takes place, pain will also resolve. Pain in this situation provides an effective warning system, protecting vulnerable tissue, and is a symptom related to a distinct pathological condition or surgical procedure. When pain does not resolve it is relabelled persistent pain, or chronic pain. Pain lasting for longer than three months can be classified as chronic pain.
Sometimes, after the original source of pain is healed or no longer present, chronic pain patients may continue to feel pain. This can also lead to reduced mood or even depression and avoidance or fear of normal movement and activities. This can then lead to more pain. Pain that becomes chronic is often linked to changes in the nervous system, when tissues become highly sensitised, creating abnormal pain responses. Patients move less, or move in ways to protect themselves from more damage,
Your general health may adversely affect your feet. Some common examples are; diabetes, arthritis, poor circulation, stroke, and osteoporosis. In fact, your podiatrist may be the first to recognise a serious health problem from an examination of your feet. Obesity may adversely affect your feet. Some types of heel and arch problems are more prevalent among overweight persons. Stiletto shoes can potentially alter your posture, which can lead to back, neck, leg and foot problems. In the long term, wearing high heels can potentially damage your Achilles tendon and cause clawing of toes resulting in hammertoe deformities.
How Podiatrists can help
- Education about pain processes
- Pain coping strategies so that you have effective tools to manage episodes of pain
- Postural and biomechanical assessment
- Re-education of normal posture and movement patterns
- Assessment of the feet, knees and hips
- Advice about the types of shoes most suitable to the activity and the foot shape
- Address movement behaviours that you may have developed that are not helpful
- Prescription of orthoses or shoe inserts to remove pressure from painful areas
- Liaison with GPs and specialists where required
Foot pain has a multitude of causes. Your podiatrist can assess your problem, and treat it appropriately.