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Monday, January 12, 2015
Midfoot or Instep Pain: Could it be Arthritis?
So many of my patients develop midfoot arthritis as they age. Golden Rule of Foot: Pain and swelling in the middle of your foot if you are over 60 or have had previous injuries to this area is midfoot arthritis until ruled out by MRI, CT Scan, or bone scan. Like any arthritis situation, it has both a conservative treatment side and a surgical fusion side. I have only had to recommend fusions to a handful of all my patients over the years.
The top 10 treatments for midfoot arthritis/arthralgias:
1. Ice Pack for 10 minutes twice daily to the top of the foot
2. Contrast Bath each evening home for 20 minutes total as a deep flush
3. NSAIDs only when needed to sleep or when the pain over 4 consistently
4. Learn a daily form of tape from supportthefoot.com or Kinesiotape circumferential arch wrap. Daily until symptoms improve, then as needed, like with long hikes.
5. Removable boot, hiking boot, bike and hike shoe, or post op shoe when need to limit motion more.
6. Custom made functional foot orthotic devices with high arch support as a cast initially full time, and then just with activities more stressful.
7. Daily Foot and Ankle Strengthening forever. Go to Youtube and type drblakeshealingsole foot and ankle strengthening playlist.
8. Activity Modifications to create pain free environment, and build core strength and get cardio.
9. Physical Therapy or Acupuncture to reduce inflammation.
10. Occasional cortisone shots to reduce inflammation (the least as possible) if a damaged joint has been localized with MRI or CT scans.