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Ouch! Do I Have To Live With Foot Pain?
By Ivar E. Roth DPM
Every day we abuse one of the most vital parts of our body-the foot! Can you imagine what daily life would be like without proper use of your feet? Think about it. You would not be able to get up in the morning when your alarm goes off, could not drive to work, or run into a coffee shop to get your daily fix of caffeine, or more importantly, run to respond to your crying child. The list is endless. Yet, I often see patients who tolerate the discomfort associated with foot problems because they think that it is a sign of aging, simple daily use, or that it will go away.


The foot, like any other part of the body, should perform pain free. The bottom line is that most foot pain does not go away without treatment. Once injured, the fact that we walk on the injured foot means that the injury just can not heal. The most disappointing explanation I hear is that the patient has been told by a medical professional that there is nothing that can be done. This response really means the doctor has not diagnosed the problem properly and you need to find a new doctor, not live with the problem. In this day and age there is no substitute for seeking the advice of a specialist. The days of going to your General Practitioner for these types of problems have long gone. For foot problems, seek the advice of a board certified Podiatrist or Orthopedist who specializes in feet.

Many of my patients state that they just don't have time. MAKE THE TIME! If a doctor diagnosed you with cancer, wouldn't you take the time to get a second opinion? Why not give the same credence to your feet? Remember what a critical role your feet perform daily.

The real story is that over 95% of the time foot problems can be resolved with conservative care. Surgery is considered an option only after exhausting conservative options.

Conservative care usually means several months of active care. It is a very rare day indeed when a foot or ankle problem can not be resolved or helped. Sometimes the problem is as close as looking at your shoes, as many foot problems are directly related to patients wearing an improper shoe size. This occurs most often when a patient assumes they always wear the same size shoe. Most often as we age, the foot flattens and becomes longer. Wearing the same size

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shoe one did twenty years ago, could mean foot problems. Also as we age many deformities of the foot get worse and finding a more appropriate shoe becomes important.

TREATMENT

Treating foot problems can be compared to baking a cake. If you need 6 ingredients and you only have 5 you have a failure.
Even if you have all the ingredients if they are not put in the correct order a failure is the result.

1. Communication
Over the years I have come to the conclusion that providing adequate medical care is not enough to get great results. The magic answer is attention to details, such as providing an office environment where the patient feels comfortable to explain what their problem is and the Doctor takes the time to carefully listen to and examine the patient.

2. Treatment Plan
Once this rapport has been established, a detailed treatment plan is formulated and carefully explained to the patient, beginning with simple non-invasive procedures. Because most foot problems fall into a specific
diagnosis, the doctor will be able to assure the patient of the outcome thus relieving their anxiety.

As a foot doctor I always strive to be as proactive as possible to knock the problem out. For instance, I would rather give a larger dose of an anti-inflamatory medication to insure the patient is comfortable than not, again since we walk on our feet and use them all the time we have to over compensate with our treatment because most people just can't stop walking.

3. Follow Directions
Setting and attending scheduled appointments in a timely manner is critical.

4. Work Toward A Common Goal
The bottom line is that success is possible if all parties work toward the goal of good open communication and understanding what the goals of treatment are.

I have found over the years that making treatment as simple as possible is a key to success. For instance it is far easier and more convenient for the patient to take a once a day medicine than one that must be taken three or four times daily. Treating feet is truly an art and science, as each patient requires a customized treatment taking into consideration lifestyle.

So remember: If you have a foot problem and it is not responding to treatment or "getting" better, it is time to see the foot specialist.

Finally if you should need surgery, I strongly recommend a second opinion. Go to an independent doctor who is not affiliated with the treating doctor. Be sure to ask the operating doctor if he has a financial interest in the facility where your surgery will be performed. It is better to have all the answers up front. As they say, measure twice cut once.
Ivar E. Roth DPM/MPH is on active staff at Hoag Hospital, practicing in Newport Beach. www.DrRoths.com

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