|In this issue of HEALTHbeat:
• 9 ways to fix foot pain
• Foot massage
ways to fix foot pain
Pain is a symptom common to many foot conditions, and pain medications
are a good solution for most types of foot pain. You also can try other
approaches, either before resorting to pain relievers or in conjunction
with them. For example, you can try an ice pack or a warm foot soak before
reaching for the pain pills. In general, if your skin feels warm to the
touch (indicating that your foot is inflamed and possibly swollen), apply
ice. Don’t apply warmth to an inflamed area because it will only
increase the blood flow and make the inflammation worse.
If your feet are tired and sore and your skin feels normal or cool to
the touch, try soaking your feet in a warm bath to relax and soothe them.
Pharmacies sell gel packs that you can either freeze or heat in the microwave,
then apply to your feet. You can also try massage (see “Foot massage,” below).
Gently rubbing sore muscles and joints can often provide needed relief.
But don’t massage a foot that is inflamed or that you think might
When it comes to pharmaceutical treatment, there are a number of different
options. Some medications are topical — that is, you apply them
to the skin. Others are systemic; these are usually taken in pill form.
A summary of the major categories of pain relief medications follows.
- Analgesics. This
class of medications encompasses pain relievers, such as acetaminophen
(Tylenol), which relieve pain without relieving inflammation. Be aware
that doctors caution people who drink regularly against using acetaminophen
because alcohol can combine with this drug to cause liver damage.
analgesics. Topical pain medications are available in lotion,
cream, or gel form. They are spread on the skin and penetrate inward
to relieve some forms of mild foot pain. Some topical preparations — such
as those containing menthol, eucalyptus oil, or turpentine oil — reduce
pain by distracting the nerves with a different type of sensation.
Another group delivers salicylates (the same ingredient as in aspirin)
through the skin. A third group counters a chemical known as substance
P, which is a neurotransmitter that appears to transmit pain signals
to the brain. These creams contain a derivative of a natural ingredient
found in cayenne pepper. For that reason, they may burn or sting when
anti-inflammatory drugs (NSAIDs). NSAIDs are available both
with and without a prescription. Popular over-the-counter NSAIDs include
aspirin (Bayer, Bufferin, others), ibuprofen (Advil, Motrin, others),
and naproxen (Aleve). If you are taking an NSAID solely to relieve
pain, expect to take a low dosage for a limited amount of time — usually
until the pain is gone. If you have a condition that involves inflammation
as well as pain, such as Achilles’ tendinitis or a sprain, your
doctor may advise you to take an NSAID at a higher dose and for a longer
period, sometimes as much as several weeks. Why the difference? You
can feel the pain-relieving effects of NSAIDs almost immediately, but
you do not experience the full anti-inflammatory effects until a sufficient
amount of the medication builds up in your bloodstream. Be aware that
NSAID medications have a variety of side effects, so it is important
to discuss your personal health risks with your doctor when considering
their regular use.
If these over-the-counter options don’t solve your foot pain problems,
your doctor can prescribe a variety of prescription medication and treatment
options, as described below.
inhibitor. A type of prescription NSAID known as a COX-2 inhibitor — such
as celecoxib (Celebrex) — relieves pain and inflammation and
may reduce the risk for gastric ulcers and bleeding, which sometimes
make older NSAIDs difficult to tolerate. COX-2 inhibitors have their
own side effects, though, so it is important to discuss your personal
health risks with your doctor when considering the long-term use of
analgesics. Prescription drugs that contain opioids such as
codeine are useful for pain that can’t be relieved by analgesics
or NSAIDs. They provide stronger pain relief because they block certain
chemical pathways that send pain signals through the central nervous
system. Many of these medications also cause drowsiness.
pain medications. Pain caused by nerve damage may not respond
well to opioids, so doctors rely on other medications. Two mainstays
in treating nerve pain in the feet include the antidepressant amitriptyline
(Elavil), which increases the levels of brain chemicals that ratchet
down pain signals, and the anticonvulsant gabapentin (Neurontin), which
apparently works by interfering with nerve signaling involved in pain
as well as seizures. In December 2004, the FDA approved a medication
for nerve pain relief, pregabalin (Lyrica), which also doubles as an
blocks. A nerve block is an injection that numbs a particular
nerve to prevent pain signals from reaching your brain (much as lidocaine
does in a dentist’s office). It’s effective for severe
pain or for use during a surgical procedure.
- Corticosteroids. These
medications are synthetic forms of naturally occurring hormones produced
by the adrenal glands. Corticosteroids may be given in the form of pills
or injections to decrease inflammation and thus relieve pain. Topical
corticosteroids, applied directly to the skin, are useful only in treating
rashes, not for pain due to musculoskeletal injuries.
- Ultrasound. This
is not a medication, but rather a treatment in which high-frequency sound
waves are directed at an inflamed area to speed healing and reduce inflammation.
It works best on soft tissue injuries.
When you think of massage, you may think of a neck or back rub.
But your feet also benefit from a regular rubdown. And you may
even be able to do it yourself. Massage improves circulation, stimulates
muscles, reduces tension, and often alleviates pain. It also provides
a time for you to examine your feet, giving you the chance to notice
a problem before it gets worse. To do a massage:
- Sit in a comfortable chair. Bend your left
leg and rest your left foot gently on your right thigh.
- Pour some skin lotion or oil into your hand. Rub
it gently into your foot and massage your whole foot — toes,
arch, and heel.
- Do a deeper massage. Press the knuckles of
your right hand into your left foot. Knead your foot as you would
bread. Or work the skin and muscles by holding a foot with both
hands and pressing your thumbs into the skin.
- Using your hands, pull the toes back and forth or apart. This
gently stretches the muscles underneath.
- Repeat on the other foot.
To enhance your massage, you can buy massage devices in local
drugstores or health stores. Look for foot rollers; these can provide
fast foot massages at home or at work — take off your shoes
and roll your feet over the massagers for a quick pick-me-up.
- The fantastic foot
- Keeping your feet healthy
- Heels that hurt
- Arches that ache
- Tormented toes
- Skin and toenail problems
- Foot surgery
- Treating foot pain
Reprinted from Foot Care
Basics — A Special Health Report from Harvard Medical School,
Copyright © 2009 by Harvard University.
All rights reserved.
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Foot Care Basics: Preventing and treating common foot conditions provides
information about your feet and how they function. This report
describes the major causes of aching feet and what you can do about
them. It will also help you recognize and treat common skin and
nail ailments and discusses circumstances that require special
care, including diabetes, vascular problems, and nerve disorders.
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