Many other medical conditions, including nerve compression and systemic illness, can contribute to discomfort in the ball of the foot. Although different causes of top-of-foot discomfort demand different approaches to treatment, conservative measures usually yield positive results first.
However, in some cases, more intensive medical treatment, such as injections or surgery, may be required. This article compares and contrasts the benefits of both conservative and medicinal ways to treating pain at the top of the foot.
Conservative Treatments
Non-surgical approaches, such as those recommended by a physical therapist or practiced at home, make up the scope of conservative treatment.
Without the use of pharmaceuticals or invasive procedures, these techniques aim to alleviate discomfort, reduce inflammation, relieve pressure, and speed recovery.
Top-of-foot discomfort is typically treated first with conservative measures.
Rest
Rest is often prescribed as part of noninvasive treatments. In order for symptoms to lessen and healing of injured tissues to begin, it is necessary to limit aggravating activities and motions. Rest is crucial, but too much of it might cause you to lose flexibility, muscle strength, and mobility.
Benefits:
- Allows inflammation and pain to resolve
- Promotes tissue healing
- Prevents re-injury or further damage
Potential Drawbacks:
- Joint stiffness
- Muscle atrophy
- Diminished flexibility and conditioning
- Prolonged activity avoidance delays resumption of normal function
Ice
Intermittent use of ice packs has been shown to be effective in the treatment of pain and inflammation.
Every two to three hours after exercise, or as needed, apply ice for ten minutes to reduce swelling and soreness. To avoid getting frostbite, keep your skin away from the cold.
Benefits:
- Reduces localized swelling around injury
- Alleviates pain through numbing effect
- Non-invasive and easy to implement
Potential Drawbacks:
- Can cause skin damage or frostbite with overuse
- Provides only temporary, symptomatic relief
Elevation
Elevating the foot above the level of the heart has been shown to aid in the reduction of swelling and fluid accumulation. This, along with ice, needs to be done regularly throughout the day.
Benefits:
- Gravity reduces localized swelling
- Decreases throbbing and discomfort
- Facilitates circulation and healing
Potential Drawbacks:
- Not always practical throughout normal activities
- Needs to be implemented consistently for best results
Orthotics
Custom-made orthotic shoe inserts can help address biomechanical problems and provide arch support and cushioning. By limiting the range of motion in the foot, orthotics can reduce stress on wounded tissues.
Benefits:
- Offload pressure from painful areas
- Improve foot alignment and mechanics
- Allow continued physical activity with less pain
- Prevent recurrence in chronic conditions
Potential Drawbacks:
- Can take time to get used to
- May require shoe modifications to accommodate
- Success depends on appropriate prescription and fitting
Physical Therapy
Customized strengthening and mobility exercises are possible while working with a physical therapist. They might also use massage, joint mobilization, and ultrasound. In order to alleviate foot discomfort, therapy focuses on addressing underlying issues.
Benefits:
- Targeted stretching maintains/improves flexibility
- Strengthening exercises support joint stability
- Modalities reduce pain and inflammation
- Normalize gait and foot mechanics
Potential Drawbacks:
- Requires weekly visits initially
- Home exercise compliance is needed
- Results are gradual over 4-6 weeks
Taping
Compression and support can be provided by taping the foot and ankle in a certain way. Painful movement and excessive foot flexibility are both reduced by taping.
Benefits
- Allows continued activity with enhanced support
- Can be used with braces or orthotics
- Non-invasive and easily adjusted
Potential Drawbacks:
- Can irritate skin with prolonged use
- Effects are temporary
- Proper taping technique is required
Medical Treatments
Medical measures may be necessary if conservative treatments for top-of-foot discomfort are insufficient. There are a variety of in-office treatments available to help alleviate inflammation and pain rapidly, such as medicines, injections, surgery, and more.
Oral Anti-inflammatory Medication
Non-steroidal anti-inflammatory drugs like ibuprofen are often recommended to alleviate pain and inflammation. They should be taken as directed by your physician.
Benefits:
- Significantly decreases pain and swelling
- Allows increased function for activity and therapy
- Convenient oral administration
Potential Drawbacks:
- Can cause stomach, kidney, liver problems with prolonged use
- Do not facilitate healing of underlying cause
- Symptoms may recur when medication is stopped
Corticosteroid Injections
Injecting corticosteroid medication directly into injured joints or tendons helps potently reduce inflammation. Effects may last for several months.
Benefits:
- Provides targeted anti-inflammatory effects
- Usually leads to rapid pain relief
- Allows time for conservative treatments to take effect
Potential Drawbacks:
- Can weaken connective tissue over time
- Repeated injections may be required
- Does not address underlying biomechanical causes
Surgery
If non-invasive treatments are ineffective and impairment persists, surgical intervention may be considered. Pain can be alleviated with a variety of surgical procedures, including the excision of bone spurs, arthrodesis, tendon release/repair, and joint implants.
Benefits:
- Definitively addresses underlying anatomical problem
- Allows return to full activities without pain
- Restores stability and normal alignment
Potential Drawbacks:
- Invasive procedure requiring prolonged recovery
- Risk of complications like infection and blood clots
- May require activity limitations, therapy, and rehabilitation after
