The Agony of De‘FEET’

When Foot Pain Makes Walking, Let Alone Athletic Efforts Nearly Impossible

Bunions, arthritis, plantar fasciitis, microfractures of the ankle bone – there’s a variety of painful problems that can occur in the feet. Considering this variety, it’s no surprise that so many American adults complain of pain in their feet. Unfortunately, many traditional treatments like surgery are a no-go – most Americans can’t afford to be off their feet for the long post-operative recovery time. Regenerative care, like platelet-rich plasma (PRP) treatments can be effective for many foot pains and may be a better option than surgery or steroids.

Foot Pain Can be Disabling and Affects the Young and Old Alike

According to a 2014 survey by the American Podiatric Medical Association (APMA), 77% of American adults have experienced noticeable pain in their feet (1). Foot pain, especially chronic foot pain, can affect anyone, young, adult, or elderly, and can be somewhat debilitating. Think of all the activities one would have to restrict if they’re having a lot of pain while walking.

An insistent foot pain would make work, leisure activities, and even walking around the house feel unmanageable. Anyone experiencing chronic foot pain that cannot be explained by simple solutions such as poorly fitting shoes or over-exercise should seek help from a doctor (1).

Try Conservative Care Options First

Since there is a large variety of reasons that a patient might experience foot pain, it is usually best for patients to first try conservative care options to reduce pain (2). Some foot pain can be alleviated with solutions as simple as rest, stretching, orthotics or more supportive shoes. Other foot pain is more intensive and might require doctor-recommended anti-inflammatory drugs, physical therapy, or chiropractic care (2).

Please Consider Other Options Before Corticosteroid Injections in the Feet

Cortisone shots can provide rapid and effective pain relief but, the effects are generally not permanent, and many people will experience a return of symptoms. Typically the effects of a corticosteroid shot will last from six weeks to six months. And, healthcare providers will advise against getting too many shots due to possible harms (3).

Repeated cortisone injections are simply not healthy for tissues. Over time, the shot can damage cartilage and lead to necrosis (death) of nearby bone.There can also be complications for diabetes patients (3).

To avoid this, orthopedic surgeons will generally limit the number of cortisone shots in any one body space to no more than three per year (3).

What You Should Know Before Having Foot Surgery

A Woman’s Health Magazine article first published in 2015 proposes: “Don’t let your feet go under the knife until you read this” (4).

The article continues: “Most patients walk (or hobble) out of the hospital just hours after their surgery, sporting a lovely surgical boot…You’re going to be in a boot for a long time before you get back into heels” (4). The article cites that for a common bunion surgery (one of the most common foot surgeries for young women) or for hammertoe surgery you may expect 4 weeks in a boot, with total recovery time 8-12 weeks (4). And of course, many providers consider bunion or hammertoe foot surgeries elective.

Consider Non-Surgical Platelet Rich Plasma (PRP)

Regenexx specializes in non-surgical options for orthopedic conditions, often recommending procedures using platelet-rich-plasma. A platelet-rich plasma procedure is a non-invasive, non-surgical procedure designed to stimulate the body’s healing response (5). During a PRP treatment, a physician extracts a sample of a patient’s own blood, isolates the white blood cells and platelets, and creates a solution heavily concentrated with these growth factors (5). This solution is then re-injected into the area of treatment, with precise imaging guidance (5). The platelet concentration helps stem cells reduce inflammation and treat soft tissue injuries (5). 

PRP Recovery and Effectiveness as an Alternative to Steroids and Surgery

While PRP treatments are not new, they are on the rise as their efficacy in treating various conditions continues to be studied by researchers. However, one benefit of PRP and other regenerative treatments over traditional invasive surgery is the relatively shorter recovery time. Patients can often quickly get back to doing things they enjoy – and the improvement keeps building over multiple years, vs. a potential six month life for relief from a corticosteroid injection (5).

PRP patients quickly show improvement, and improvement continues over multiple years.

See Regenexx Patient Outcomes Data here.

Please see below how studies show that PRP may be effective for foot pain.

PRP for Plantar Fasciitis

The most common cause of heel pain in adults (7), plantar fasciitis is inflammation of the plantar fascia, a thick tendon that runs down the length of the foot from toe to heel (6). Plantar fasciitis is incredibly painful; it involves a stabbing pain in the heel that is typically worse when the afflicted person gets up in the morning, or when they stand up after periods of sitting (6). Risk factors for plantar fasciitis include: (6)

  • Age (Plantar fasciitis is most common in adults 40-60 years old.)
  • Being overweight
  • Frequent exercise that places stress on the heel (running or dancing)
  • Jobs that involve standing for long periods of time

There are multiple treatment options for plantar fasciitis, some more commonly used than others. A study comparing corticosteroid injections and platelet-rich plasma (PRP) injections in the treatment of plantar fasciitis found no significant difference between the two treatments at first, but after a longer period of time, the patients who received PRP injections generally felt less pain than those who received corticosteroid injections when more time had passed post-treatment (7).

PRP for Ankle Micro Tears

It is possible for the talus bone in the ankle to develop small tears known as osteochondral lesions of the talus (7). A common treatment option for this type of foot injury is microfracture surgery. A randomized study compared the healing of patients with osteochondral lesions of the talus who received only microfracture surgery, and patients who received microfracture surgery combined with PRP treatment (7). About 16 months post-treatment, the authors of the study found that both groups of patients reported a positive increase in well-being, but the PRP group had better reviews for the treatment than the microfracture surgery only group (7).

It is possible that bone marrow concentrate (BMC) treatments could benefit patients with osteochondral lesions of the talus, since the affliction is within the talus bone warranting further study (7).

PRP and Foot or Big Toe Arthritis

Osteoarthritis is a very common inflammatory condition that causes joints and the bones lying under them to deteriorate, leaving the afflicted person with pain and stiffness in the joint area (8). Part of what makes this condition such a problem with elderly populations is that it can occur in practically any joint, especially those that are used most often or those that are often under a lot of physical stress (like the ankle, or the toes). An experiment by Fukawa et. al. tested the validity of treating osteoarthritis of the foot with PRP shots (8). Patients with osteoarthritis received three PRP injections over the course of six weeks, and the authors found that the pain and function of the patients’ feet greatly improved for 12 weeks and then peaked (8).

Bunions and PRP

When the toe bones move out of place, the big toe can bend to the side, and a bump called a bunion can jut out from the big toe joint (9).  Bunions have a variety of causes; they can be formed from frequently wearing too-narrow, ill-fitting shoes, they can be hereditary and develop later in life, or they can be a deformity present at birth (9). Bunions can cause pain, swelling, and inflammation in the big toe. For a patient with bunions, walking or putting stress on the foot might be difficult. A PRP injection may be beneficial for a patient with bunions – the white blood cells and platelets in the concentrated solution may work to reduce pain and inflammation in the big toe (9).

You don’t have to live with “The Agony of De‘FEET’. If you think a non-surgical PRP procedure may help, find out if you’re a Regenexx candidate?–Tap the “TALK TO AN EXPERT” BUTTON below.

SOURCES:

  1. https://www.prnewswire.com/news-releases/new-survey-reveals-majority-of-americans-suffer-from-foot-pain-259775741.html
  2. https://centenoschultz.com/stem-cell-treatment-for-foot-pain/
  3. https://www.verywellhealth.com/how-many-cortisone-shots-can-i-have-2549573
  4. https://www.womenshealthmag.com/health/a19984945/foot-surgery/
  5. https://www.mayoclinic.org/diseases-conditions/bunions/symptoms-causes/syc-20354799
  6. https://www.mayoclinic.org/diseases-conditions/plantar-fasciitis/symptoms-causes/syc-20354846
  7. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6220005/
  8. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7015825/
  9. https://regenexxpittsburgh.com/platelet-rich-plasma/

About The Author
Dr. Jesse Sally

Dr. Jesse Sally

Dr. Jesse Sally

Dr. Jesse Sally

Related Posts

Docs on KDKA Radio

For an easy way to research whether non-surgical regenerative orthopedics for joint pain are right for you, listen to Dr. Lieber and Dr. Adelsheimer on KDKA radio, 4.2.24 at 7PM.

Read More »

Watch a Non-Surgical Solution for Neck Pain and Related Headaches

Watch a Non-Surgical Solution for Neck Pain and Related Headaches. Regenexx physician Dr. Lieber uses fluoroscopic real-time X-ray imaging for precise image guidance, as he injects platelet lysate into the patient’s cervical spine in order to help treat her nerve pain and cervicogenic headaches. Dr. Lieber’s procedure has been edited to 4-minutes.

Read More »

Follow Us

Recent Posts

Are You a Regenexx Candidate?

About Regenexx Pittsburgh COVID-19 Protection Zone

At Regenexx Pittsburgh, we are foremost committed to the health and safety of our patients. Our team adheres strictly to COVID-19 protection protocols and ALL staff wear masks and are COVID-19 vaccinated.

Advanced IOF Certifications

Certified at the highest level for Ankle / Foot, Wrist / Hand, Hip, Knee, Shoulder, and Spine Intradiscal

Specialized Certifications

Top available certifications in Diagnostic Ultrasound, Bone Marrow and Adipose Aspirate, and Nucleated Cell Counting

Educational Certifications

Our doctors have earned both General Instructor as well as Spine Instructor certifications.

Knee

Regenexx® Procedures are non-surgical injection treatments that are intended to help reduce pain and improve function for those who are suffering from pain due to common injuries, arthritis, and overuse conditions. View Details About Knee Treatments >

Commonly Treated Conditions:

  • Arthritis
  • Meniscus Tears
  • Patellofemoral
  • Syndrome/Chondomalacia
  • ACL Tears + PCL, LCL & MCL Tears & Sprains
  • Patellar Tendonitis
  • Pes anersine bursitis
  • Baker’s cyst
  • Instability
  • Hamstrings Tendinopathy & Biceps Femoris Insertional Tendinopathy

Lower Spine

Regenexx® Procedures are non-surgical injection treatments that are intended to help reduce pain and improve function for those who are suffering from pain due to common injuries, arthritis, and overuse conditions. View Details About Spine Treatments >

Commonly Treated Conditions:

  • Lumbar Facet Injury
  • Degenerative Disc Disease
  • Herniated or Bulging Disc
  • Radiculopathy (pinched nerve)
  • SI Joint Syndrome
  • Many More Disc and Low Back Issues

Foot & Ankle

Regenexx® Procedures are non-surgical injection treatments that are intended to help reduce pain and improve function for those who are suffering from pain due to common injuries, arthritis, and overuse conditions. View Details About Foot & Ankle Treatments >

Commonly Treated Conditions:

  • Arthritis
  • Ankle Instability
  • Plantar fasciitis
  • Peroneal tendon tear or split
  • Ligament sprain or tear
  • Sub-talar arthritis or instability
  • Tarsal tunnel syndrome
  • Bunions

Cervical Spine

Regenexx® Procedures are non-surgical injection treatments that are intended to help reduce pain and improve function for those who are suffering from pain due to common injuries, arthritis, and overuse conditions. View Details About Spine Treatments >

Commonly Treated Conditions:

  • Cervical Instability
  • Cervical Facet Injury
  • Neck, Back or Rib Instability
  • Many More Disc and Cervical Issues Causing Pain

Shoulder

Regenexx® Procedures are non-surgical injection treatments that are intended to help reduce pain and improve function for those who are suffering from pain due to common injuries, arthritis, and overuse conditions. View Details About Shoulder Treatments >

Commonly Treated Conditions:

  • Rotator cuff tears
  • Arthritis of the shoulder joint
  • Thoracic outlet syndrome
  • Labral tears or degeneration
  • Rotator cuff tendonitis & tendonosis
  • AC Joint Separation
  • Recurrent shoulder dislocations

Elbow

Regenexx® Procedures are non-surgical injection treatments that are intended to help reduce pain and improve function for those who are suffering from pain due to common injuries, arthritis, and overuse conditions. View Details About Elbow Treatments >

Commonly Treated Conditions:

  • Arthritis
  • Instability
  • Tennis Elbow or Golfer’s Elbow
  • Nerve entrapment (ulnar nerve)

Hip

Regenexx® Procedures are non-surgical injection treatments that are intended to help reduce pain and improve function for those who are suffering from pain due to common injuries, arthritis, and overuse conditions. View Details About Hip Treatments >

Commonly Treated Conditions:

  • Arthritis
  • Osteonecrosis
  • Bursitis
  • Tendinopathy
  • Labral / Labrum Tear

Hand & Wrist

Regenexx® Procedures are non-surgical injection treatments that are intended to help reduce pain and improve function for those who are suffering from pain due to common injuries, arthritis, and overuse conditions.

View Details About Hand & Wrist Treatments >

Commonly Treated Conditions:

  • Hand Arthritis
  • Basal Joint Arthritis or CMC / Carpometacarpal
  • Arthritis
  • Instability
  • TFCC Tear
  • Carpal Tunnel SyndromeTrigger Finger