Lower Extremity Pain: Causes and Treatment Approaches

Part I: Lower Extremity Pain

As biped (two-footed) animals, the average able-bodied human utilizes their feet more than any other body part on a day-to-day basis. From active movement to sedentary standing, the structures of our foot and ankle provide the basis of necessary support for the rest of our anatomical structure. Due to this chronic use and reliance, it is extremely common to find associated pain, discomfort and imbalance when discussing the lower extremities. Many people find this pain debilitating and are often sidelined from activity as a form of avoidance, which can lead to various other problems such as obesity, type II diabetes mellitus or increased blood pressure.

Some people with foot or ankle discomfort decide to continue with regular activity or “play through the pain”, and are often met with new or exacerbated issues in other body parts such as the knees, hips or low-back. As the human body is a complex, interwoven unit of evolutionary engineering, it comes as no surprise that an imbalance somewhere can cause an additional imbalance elsewhere. In the case of the lower extremities, damage to ligaments, tendons, muscles or fascia (covering tissue) can cause decreased mobility and an increased shift of weight away from the affected area. For example, if the outside of the foot or ankle becomes irritated or injured, there can be an unequal shift of pressure or compensation to the inside to avoid greater harm or further discomfort. Like a domino effect, this unequal and often subconscious shift of weight can put a greater mechanical pressure on the unaffected area, which in turn can affect the pressure placed on the joints above and below the injured body region In the case of the foot and ankle, the most commonly affected and related areas are the neighboring knees and lower back (lumbar region). 

Part II: Common Injury & Effect

One of the most commonly seen clinical issues related to the foot and ankle is plantar fasciitis. This condition is simply acute or chronic inflammation of the plantar fascia on the heel of the foot due to overstretching or overuse of the tissue. This increased pressure can cause damage to the ligaments and muscles within and surrounding the foot. This added stress can cause greater tension through the ankle and leg muscles and into the knee joint above, leading to pain and imbalance. An imbalance of the knee joint can, in turn, lead to instability of the lower-back, and of the connected hip joints  generating new pain in a region that previously was unaffected. The human body relies on harmony and balance for structural integrity and optimal movement. When one component of the system becomes compromised, it can cause a detrimental effect in other areas due to the interconnectivity. For this reason, it becomes imperative to prioritize the treatment of an injured body part (such as a foot or ankle), before other areas of the body (such as the low-back or knees) are also affected down the line.

Part III: Treatment Options (PRP vs. ESWT)

PRP, or Platelet-Rich Plasma, is plasma that’s full of the growth factors and platelets derived from the blood circulating around your body. Through centrifugation techniques, this platelet-rich plasma is concentrated to a high level. At New Regeneration Orthopedics of Florida (NROFL), our board-certified physicians are able to precisely inject PRP into the affected area(s), which in turn, can aid in healing and stabilization. You can find more about PRP and its usefulness in treating orthopedic issues here.

ESWT, or Extracorporeal Shockwave Therapy is an extremely convenient, effective and non-invasive modality that can aid in healing through the process of neo-angiogenesis (or the formation of new blood vessels). This technology harnesses the pulsing energy of either acoustic or electrical waves targeted at the affected area without breaking the surface of the skin. These short 10-15 minute treatment sessions are usually completed serially over the course of several weeks allowing for a compounded and optimal healing effect. You can learn more about ESWT and its specific benefits for foot-related pain here.