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What Could It Be That’s Causing Your Ankle Pain Without Injury?

ankle pain without injury

The ankle joint is a very important joint that allows you to have proper mobility. When it starts hurting for no apparent reason and it’s slowing you down, you’re very likely feeling frustrated. You’ll start to wonder what I did and what can be done about it. In this blog I’ll give you some incites as to what the pain could be coming from. In many situations its it could be related to overuse but in other situation it may not be. This is why we think there should be a discussion about “ankle pain without injury?”, because this may stop a person from getting back to regular activities due to lingering joint issues.

The ankle joint– The ankle joint is one of the most important joints in your feet and ankles for normal ambulation. It’s the primary joint in the foot that allows the foot to move up and down which is very important for walking, running, and a multitude of activities. It has various ligaments and tendons around it that help to stabilize the joint and support your weight on the joint. The primary foot bone that sits inside the ankle between the tibia and fibula is called the talus. It is thought to be the hardest bone in your body. Why? Because all your body weight has to be placed on this small surface area of bone. Imagine how much wider your knee joint is compared to your ankle joint and you’ll begin to appreciate the strength of this bone inside the ankle joint.

Common causes of ankle pain

Problems associated with overuse or trauma

Osteoarthritis – another name for this is degenerative joint disease. This can occur for two reasons

  • Overuse – from years of activities that can cause damage to the joint, the wear and tear that will come over time
  • Trauma- old ankle injuries which may include a history of multiple ankle sprains. Every time you sprain your ankle there is the potential for damage to the cartilage inside the ankle joint. This repeated damage over time can create osteoarthritis state. This can then create joint pain.
  • Ankle fractures – If you have a history of an ankle fracture this can increase the likelihood of arthritis in the joint. In some cases, surgery may have been performed to reposition the bones in proper alignment and because of this the joint alignment may not be as precise as it was before surgery, and this may lead to more wear and tear to the joint cartilage over time.
  • Flatfeet – The type of foot you’re born with may also lead to ankle pain. If you have a foot that overpronates, flattens, this may also cause pain in the ankle joint. A flatfoot can lead to more wear and tear on the ankle. It may also lead to other problems including Achilles tendon pain which would cause pain behind the ankle. Achilles tendonitis would make the tendon painful to touch and may cause swelling. Another tendon that helps support the foot and ankle is called the posterior tibial tendon. It is located around the inside of the foot and ankle and may also get overused because of the flatfoot. This can cause pain and swelling on the inside of the ankle joint.

Problems not caused by overuse and trauma

  • Gout – Sudden ankle pain without injury can be from gout. The pain from gout can be very severe and can come on very quickly for no apparent reason. The ankle will become swollen, and heat and redness will be associated with it. The affected ankle will feel warmer to touch than the opposite ankle and will look more red. Gout can often be mistaken for an infection. Gout occurs as a byproduct of protein metabolism. Uric acid is a byproduct of that metabolic process. When Uric acid gets into a joint it’s recognized as being foreign to the body’s immune system. So, your body’s immune system begins to attack these uric acid crystals in the joint as if the crystals were bacteria. A medication called Indocin is frequently used to treat acute attacks. If the gout attacks keep returning further workup may be necessary to see if there is a related medical cause and potentially the use of medication to lower Uric acid levels in the body may be recommended.
  • Autoimmune disease – These may include rheumatoid arthritis and Lupus. An autoimmune disease will create inflammation to the ligaments and joint capsule around the ankle joint. This may also cause damage to these soft tissue structures leading to less support for the join and ultimately damage to the joint cartilage. With an autoimmune disease your body’s immune system will attack and damge these soft tissue structures. Medications are frequently needed to treat these conditions.
  • Ganglions – This is soft tissue fluid filled sacs that may originate from the ankle joint or from tendons sheaths around the ankle. If painful these are treated with aspiration of the fluid from the sac or surgical removal.

What can be done about ankle pain without injury?

If you find yourself experiencing ankle pain, consider some of the following suggestions.

  • If it’s very sudden and your ankle feels hot and looks red get immediate medical attention as most likely this may be a gout attack.
  • If there is no redness of heat consider RICE, rest, Ice, compression and elevation. You may also consider using non-steroidal anti-inflammatories NSAID, which may help.
  • If you have flat feet you may want to consider more support shoes or consider over the counter arch supports.
  • If the pain persists with your attempts, then consider seeing your podiatrist

What will a podiatrist do?

It starts with a good medical history from you as this can give us good insight into what it may be. X-rays and diagnostic ultrasound to look at the joint and the soft tissues around the joint may be needed. Examination of the foot and ankle by itself can tell us a lot simply by the appearance and location of the ankle pain without injury.

Options we consider

  • Orthotics– custom made arch supports may be recommended especially if the problem is related to flatfeet. Also, this treatment can be helpful if the joint is getting osteoarthritis from previous trauma, overuse or autoimmune diseases.
  • Regenerative medicine treatments- this involves using what is now referred to as human cellular tissue products. Currently we use umbilical cord or placenta cell products. These are injected into the joint in a clinic setting. Minimal down time is needed and there is minimal discomfort. This is usually a one-time treatment and we have had great success in helping with pain and prevent ankle surgery.
  • Laser treatment- MLS laser treatment can also help reduce the pain and inflammation in joint and surrounding soft tissues.
  • Surgery – This usually involves ankle scope surgery. Two small incisions are made to access the joint and through these incisions the joint and its structures can be visualized and damaged cartilage or soft tissue removed. Usually, you can get your foot wet within a few days and can bear weight within a few days. You can return to full activity relatively quickly with this technique. It’s also useful to have this done early if ankle arthritis is severe enough that ankle replacement surgery could be a consideration in the future.

I hope this blog eliminated some of the confusion that can happen when your ankle hurts without an injury.

Regenerative Patient Testimonial Video

Ankle Scope Patient Testimonial Video

What to Know About Arthritis Foot Care and What You Can Do

Arthritis is a very common problem in the foot and ankle area and can occur in different locations. Because the foot has so many bones, there are many joints that can become painful. 

arthritis in feet causes, symptoms, and treatment

Symptoms

First, it is important to understand what the symptoms of arthritis are. Symptoms tend to present as a deep, dull type of pain that occurs when you first get up in the morning, Then after you take a few steps, it can gradually get better.  As the arthritis becomes more severe, it can present all the time, particularly when you’re active. Understand that arthritis occurs when the cartilage that lines the joint becomes worn down and thinner. In severe situations it can wear down to bone.  Cartilage is very slick- even slicker than ice! It acts that way to let your joints move more easily.   

Causes

There are a multitude of causes that can result in arthritis. It could be from gout attacks, where inflammation in the joints destroys the cartilage, or even rheumatoid arthritis, where patients have autoimmune diseases that can affect the joints.

There may have even been an injury to the joint or bone that caused the cartilage to be damaged. This is especially common in the ankle joint in the case of someone who is a chronic ankle sprainer or has had an ankle fracture.  All these conditions can be called “secondary arthritis” as they are related to another issue. 

For many that suffer from arthritis, it is commonly referred to as primary arthritis, meaning there is no direct cause. As we age from using our joints, the cartilage tends to wear down

Lastly, the most overlooked cause is foot structure. Very few doctors are trained  to evaluate foot structure and foot biomechanics. Some foot types, particularly flat feet, might lend themselves to wearing down joints more than feet that have a normal biomechanical structure.

 Where does arthritis occur most commonly?

 It occurs most commonly in the great toe joint, ankle and midfoot. In the great toe, it will frequently cause a stiff toe joint, referred to as Hallux Rigidus.  It can also occur in the midfoot area, halfway between the toes and the ankle in the arch area. This is also more common as we get older. Finally, it can occur in the ankle joint, especially if you have had multiple ankle sprains, or if you have any kind of history of ankle fracture- this lends itself to a greater possibility of having ankle arthritis at some point in your life.

Five things you can do

  • Avoid inflammatory foods: Foods high in sugars and carbohydrates should be reduced. Why? Because they create inflammation in your body. Breads, sugar and white flour should be avoided. Also watch out for fructose as this is used in many beverages such as fruit juices and is probably worse than just scarfing down a candy bar. Instead of fruit juice, choose to eat the actual fruit as it’s much healthier for you. This will also help keep your weight down.    
  • Exercise: Yes, that is right, keep moving. Maybe if you used to run and it bothers you too much, consider biking or walking. You may want to take on swimming or other activities. Make sure to modify the frequency and duration because motion helps your body create more growth hormones which can help repair your joints. 
  • Consider supplements: Supplements such as Turmeric, Sam-e , Hyaluronic Acid and Collagen may also be effective and help fight inflammation. 
  • Avoid anti-inflammatories: While they may make you feel good today, the long-term effects are negative for your joint health. An exception to this would be if you have an autoimmune disease such as rheumatoid arthritis that is managed by your doctor. 
  • Use more supportive shoes: If you think you may be an overpronator, meaning you have flat feet, supportive shoes should be considered. You may also want to use an inexpensive over the counter arch supports. 

Treatment

  • Support the foot and ankle: Oftentimes orthotics are recommended as they are custom-made inserts that go in the shoes. They are especially important to help stabilize the bony areas that can lend themselves to arthritis.
  • Repair and restore the joint: At Anderson Podiatry Center, we do this using stemcell treatment. Regenerative medicine is something we have been using now for over a decade and has been extremely useful for ankle joint problems, great toe joint pain, and pain in the midfoot area and the mid arch. It has proven to show improvement 80-90% of the time. 
  • Block your ability to feel the pain: We do this by shutting off pain signals to the brain.   In some cases, especially if the arthritis is in the midfoot or up by the ankle, we can remove one or two branches in the lower leg that block your ability to feel the arthritic pain in your foot or ankle.  This is also especially useful and has prevented many patients from going through ankle replacement surgery or ankle fusion surgeries (which have a significant risk factor and recovery time). 
  • Joint surgery: In the worst-case scenarios, when all else fails, there may be a need for revision of a joint by scoping it in the example of an ankle joint. Or finally a joint replacement or fusion. 

In summary, if you have these problems, it is important to understand that there’s a lot that you can do to repair your condition. And at Anderson Podiatry Center, we can offer non-surgical approaches and low invasive procedures such as stem cell or nerve resection, which may avoid more major joint replacement surgeries. Do not assume that you have to have an ankle joint replacement or other joints fused to treat your arthritis. Consider the options that you can do first, and if you are still struggling and want to get back to full activity, consider our unique approach. 

What Are the Benefits of Wearing Orthotics?

As a podiatrist, we often recommend orthotic devices as they can be of great benefit for the wearer. Before we dive into the benefits of wearing orthotics, let’s answer the question of what an orthotic is, from a podiatrist point of view.

benefits-of-orthotics

In today’s world, it seems like everyone is marketing their orthotics. You see them in retail stores, shoe stores, ski shops, and even Facebook ads. As a podiatrist, the whole concept of what an orthotic is has been muddied. My opinion is shared by my colleagues- podiatrists believe there is a non-weight-bearing, neutral-point position of the foot. And so, whatever technique is utilized to fabricate an orthotic, an impression of the foot should be taken in this position.

The foot is positioned at its optimal functional position. Any kind of orthotic that is made from a technique that involves any partial or full weight-bearing, we feel is not done accurately. There are small, torsional abnormalities, sometimes between the front half and rear foot, that are not taken into account when the foot is bearing weight. A podiatrist’s orthotic is much more precise and is able to support and control excessive motion in the foot more accurately. That is not to say that an orthotic made from a weight bearing technique won’t work, but the chances are greatly reduced. It is a common story of patients we treat.

Benefits of Orthotics

I am writing this blog at a time where some advocate barefoot running, or running in minimalist shoes. So hear me out from a foot specialist’s point of view. Outside the office, when someone finds out I’m a podiatrist, I’m often asked what types of shoes are best. Using tact, I’ll make the point that it’s like asking an optometrist what lens prescription they should have. We expect that kind of precision for our eyes, but medicine seems to not think the same rules apply to the feet.

If one has excellent foot structure, I’m not opposed to the idea of barefoot running. My point is that it all starts with what foot type you’ve inherited. It has been observed that 70% of people may have feet that overpronate. Pronation is simply the motion that involves the flattening of your feet. The foot will flatten the arch and abduct, or move away from the other foot. A more ideal foot type does not overpronate, and the actual bony structure helps stabilize and support the foot. There is a locking mechanism that takes place in the bones in the midfoot area. Those that have feet that are much more flexible, or pronates more easily, are thought to have a foot where the bones do not lock and support the foot. Therefore, soft tissue needs to. This can cause excessive stress on structures such as tendons, joints, nerves and other soft tissue structures such as fascia. So, how do you know if custom orthotics might be useful? The following are some tips and specific conditions you should know about.

If you keep getting the same type of injury or foot pain over and over, or if you’ve had that injury for an extended period of time, it may be time to look into orthotics. Especially if you’ve already tried resting, anti-inflammatories, and icing the area. This could also be an indication that your foot type lends itself towards having specific issues.

Soft tissue problems

  • Plantar fasciitis and Achilles tendinitis
    • One of the more common problems is plantar fasciitis commonly referred to as heel pain. Orthotics will reduce the stress of the plantar fascia pulling on the bottom of the heel. For Achilles tendonitis the stress on the Achilles will be reduced.
  • Foot deformities
    • Bunions may also be helped with orthotics. If you have an enlargement on the inside of your big toe you may benefit especially in the early stages of the deformity.

Nerve problems

  • Neuromas and tarsal tunnel syndrome
    • Neuromas are a nerve enlargement that can occur in the ball of the foot. If you’re experiencing burning, tingling and numbness on the bottom of your foot, you may have tarsal tunnel syndrome.
  • Joint pain
    • Arthritis in the foot can also be treated with orthotics and it’s a safer, drug free approach. This may include big toe joint pain commonly referred to as Hallux limitus. Also, ankle pain and pain in the small joints in your arch.

Final Thoughts

  • You may save money as you’ll quit shopping for shoes to solve your foot problems. The orthotic can be taken from shoe to shoe and will neutralize the less optimal shoe as it’s designed precisely for your foot.
  • You’ll avoid injuries as certain foot structures lend themselves to certain injuries
  • You could lose weight and sleep better as you become more active.

If you yourself frustrated with your inability to stay active, please consider a consultation with us to truly understand more about the foot structure you have and how it may be the issue that no one has explained to you. There are many benefits of wearing orthotics, so it’s time you discover for yourself!

Our Revolutionary Approach to Restless Leg Syndrome Treatment

restless leg syndrome treatment

The name “restless legs syndrome” does not do the severe nature of the condition justice as it has been said that 10% of the population suffers from restless legs; and out of those, half have it severely. Restless leg syndrome is also known as Willis-Ekbom disease and is twice as common in female patients. Here at Anderson Podiatry, we have a revolutionary approach to the treatment of restless leg syndrome and are eager to share our findings with you.

Symptoms of Restless Legs Syndrome

The symptoms of restless leg syndrome almost always occur at night or at rest, making it difficult for those suffering to fly on a plane or sit in a movie theater. That’s the frustrating thing about restless legs; during the day you may be functioning just fine; but once it’s time to go to bed, it all starts up again. Day after day, the same symptoms occur. At first, it may be mild, but then it can become more severe until it’s consistently happening every night.

symptoms of restless leg syndromeSymptoms are experienced in the legs; particularly from the knee down rather than above. The symptoms can be a combination of cramping, a creepy crawly sensation- like bugs or ants are going on your skin, pain, or jerky legs. However, the most prevalent symptom is an anxious or nervous feeling that makes you want to get up and walk. In fact, most patients have said this is what they have to do during the night.Restless leg syndrome comes on quite slow, and because of this, patients do not realize the severity of the condition. In fact, many in healthcare do not even realize the severity, and their hands are tied because, in many cases, they’re not sure how to help.

Aside from all the physical symptoms, maybe the worst of them all is the psychological effect. This includes the anxiety people experience during the day- not wanting to think about what’s going to happen when they go to bed at night- to the anxiety of being up at night when everybody else in the world seems to be sleeping. Then comes the morning and you are absolutely exhausted.

The good news is, for many of you, you can come out of the bushes because at Anderson Podiatry, we understand how severe this is. In fact, we actually have a solution for many people suffering from restless leg syndrome. This is something we’ve been practicing for approximately seven years.

The Conventional Approach to Treatment of Restless Legs Syndrome

In conventional medicine there’s no known cause for restless leg syndrome, so people are often left helpless. In many cases, people also find that their doctors or loved ones do not understand the severity of the problem. This is incredibly unfortunate because restless leg syndrome is a very serious problem that can affect people’s general health. Recent studies have shown that there’s a higher incidence of early death with people experiencing severe restless legs due to lack of sleep. This lack of sleep can cause all sorts of secondary problems, such as increased incidence of diabetes, cancer, and heart disease. 

In the world of conventional medicine, the treatment options are very minimal. They usually involve pharmaceutical medications that deal with dopamine levels in your brain, or band-aiding the pain with medications that are used for treatment of neuropathy (namely Lyrica and gabapentin). Outside of this realm of drugs is the possibility that some of your restless legs could be caused by your back. Maybe you have a pinched nerve in your back that could be radiating symptoms in the leg.

So basically, the restless leg syndrome treatment options are relegated to two things; either it’s coming from the back, or in the vast majority of cases, it’s something the medical community does not know how to treat. However, many of these treatments, especially the drugs, can have detrimental side effects patients don’t like, including significant weight gain.

Our Concept

At Anderson Podiatry we prefer to call this disorder “restless legs compression syndrome” because we’ve been able to reverse the symptoms by opening up tight nerve pathways in the lower extremity. When the nerve tunnels become tight it can be damaging, which results in restless legs syndrome symptoms for many. For most, the success rate is incredibly high and there is minimal chance of worsening the condition. We also treat patients with restless leg syndrome non-surgically by utilizing laser and e-stim. Both of these treatments help to restore more normal nerve function and have proven very effective. However, for many patients with severe restless legs, the surgical option may be the best treatment of choice.

So you may be wondering, what do we do when we do surgery? We’re basically opening up nerve tunnels- usually three, but sometimes just two. Two of these nerve tunnels are in the lower leg just below the knee, and third is down in the front of the lower one-third of the leg. These tunnels can create a lot of pressure on the nerves in the legs. Instead of treating you with pharmaceuticals, or hoping that maybe treatment of the back will help, we have found that the fire is truly in the nerve tunnels of the lower extremity. While many treatment options simply blow away smoke from the fire, we believe that we’re able to get rid of the problem by directing our attention to the flames.

Many people are desperate for a solution, and our method of treatment is something you’re not going to hear conventional medicine speaking to. Why? Well, in many cases, it’s because big pharma has no interest in supporting what we’re doing, as it would be contrary to what they want you to think (that restless leg syndrome patients have to be on medication).

In conclusion, if you’re looking to target the direct cause of your problem, consider coming to our office for evaluation of restless leg syndrome treatment. For many, surgery may not be the option you desire, and this is a decision that we can mutually discuss. If you have any other further questions, please contact our office to get a better understanding of how our treatment options work. It’s time for you to get your life and sleep back.

Please visit our YouTube channel, where we have plenty of information about what we do, as well as testimonials from patients that have successfully gone through our surgical procedures and nonsurgical treatment options.

Grace’s Story: Arthritis in Big Toe Joint

On My Feet All Day

As a kindergarten teacher for many years, Grace was used to being on her feet all day. “I was busy,” Grace says, “And I just didn’t have time to address all my aches and pains.”

Grace had pain in her big toes, but she ignored it and kept up with her active life, and her daily one-mile walks. “I just sucked it up,” Grace says, “I think a lot of people do that when they are busy.”

Then The Pain Kicked In

When Grace retired from teaching, suddenly the pain kicked in. “I was having trouble walking because of the pain. Finally, I got tired of dealing with it and decided to find treatment.”

Grace went online, began researching, and soon found Dr. James Anderson, DPM. “I didn’t realize I had arthritis in my big toe joints,” she said. “You just know you have pain, but you don’t really know what’s going on until you go in and make an appointment.”

Regenerative Medicine + Surgery

Dr. Anderson says, “Because of the arthritis, there was a bone spur on her joint. I recommended surgery to remove it and clean up the bone. Then, we could follow up with a regenerative medicine injection.”

Grace decided to have the surgery, and then followed up with the regenerative injection, and laser therapy to help reduce inflammation and prevent scar tissue from forming.

“Regenerative medicine works by stimulating the body’s natural ability to heal, and the stem cell components help to regenerate the damaged cartilage,” says Dr. Anderson. “If we see the patient early enough, we can often use regenerative therapies to avoid surgery completely.”

“For Grace, this treatment approach helped us to save her joint and improve function! Many times, patients will have to have a joint fusion or replacement, and we were able to prevent that.”

Hitting the Trails Again

It wasn’t long before Grace was living the retired life she had hoped for. “I’m back to doing anything that I want,” Grace says.

“I can go hiking, and I can travel! I walk two miles every day, and I can wear any shoes I want to!”

Her advice for others is this. “Don’t wait any longer to address your pain. The longer you put it off, the more damage can occur. And then, that’s more time and money you will have to spend to resolve it.”

“Take the time to take care of yourself. It’s important.”

Call today to make an appointment, and we can discuss treatment options with you.

To learn more about regenerative medicine, click here.