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Monday, January 12, 2015

Midfoot or Instep Pain: Could it be Arthritis?

Midfoot Arthritis/Arthralgias

     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. dreamstime_m_31137730.jpg  


    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 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.


  1. I really appreciate your website and the helpful information. My podiatrist is very conservative and I have begun prolotherapy treatment for midfoot arthritis. I was wondering if you had any professional opinion of this treatment. Thanks and God bless.

  2. Hi Dr Blake.
    If there is degenerate ligaments (AAF), as well as DJD, is there any possibility that Hyaluronic Acid or PPR injections would help?

    1. There is a chance, but I have no experience to say for sure.Sorry. Rich


Thank you very much for leaving a comment. Due to my time restraints, some comments may not be answered.I will answer questions that I feel will help the community as a whole.. I can only answer medical questions in a general form. No specific answers can be given. Please consult a podiatrist, therapist, orthopedist, or sports medicine physician in your area for specific questions.