Common Painful Foot and Ankle Conditions: A Review

Importance: Morton neuroma, plantar fasciitis, and Achilles tendinopathy are foot and ankle conditions that are associated with pain and disability, but they can respond to nonoperative treatment.

Observations: Morton neuroma, consisting of interdigital neuronal thickening and fibrosis, is characterized by burning pain in the ball of the foot and numbness or burning pain that may radiate to the affected toes (commonly the third and fourth toes). First-line nonoperative therapy consists of reducing activities that cause pain, orthotics, and interdigital corticosteroid injection; however, approximately 30% of patients may not respond to conservative treatment. Plantar fasciitis accounts for more than 1 million patient visits per year in the US and typically presents with plantar heel pain. Fifteen years after diagnosis, approximately 44% of patients continue to have pain. First-line nonoperative therapy includes stretching of the plantar fascia and foot orthotics, followed by extracorporeal shockwave therapy, corticosteroid injection, or platelet-rich plasma injection. Midportion Achilles tendinopathy presents with pain approximately 2 to 6 cm proximal to the Achilles insertion on the heel. The primary nonoperative treatment involves eccentric strengthening exercises, but extracorporeal shockwave therapy may be used.

Conclusions and relevance: Morton neuroma, plantar fasciitis, and Achilles tendinopathy are painful foot and ankle conditions. First-line therapies are activity restriction, orthotics, and corticosteroid injection for Morton neuroma; stretching and foot orthotics for plantar fasciitis; and eccentric strengthening exercises for Achilles tendinopathy.

Author/s:

Minton Truitt Cooper

Topical Nonprescription Pain Medications for Adults

Erin Blanchette — Tue, 14 Nov 2023 20:48:41 +0000

Date Added:

November 14, 2023

Journal/Publication:

JAMA

Publisher:

American Medical Association

Publication Date:

November 3, 2023

URL:

Topical Nonprescription Pain Medications for Adults

Type:

Patient Education Materials

Format:

Article

DOI (1):

doi:10.1001/jama.2023.13813

Keywords

clinical pharmacy and pharmacology

PMID (1):

37921785

MeSH

Anti-Inflammatory Agents

Anti-Inflammatory Agents, Non-Steroidal

Nonprescription Drugs

Information for patients on three types of nonprescription topical analgesics. James W. Mold, MD, MPH

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This JAMA Patient Page describes the types of topical nonprescription pain medications and tips for using them.

Topical nonprescription pain medications are over-the-counter drugs applied to the skin to treat pain.

Topical pain medications can effectively treat pain caused by several acute and chronic conditions. Because they are applied directly to the skin, topical pain medications are easy to use and less likely to cause side effects or interact with other medications than oral pain medications. Pain relief typically occurs within several days of starting a topical pain medication.

Author/s:

Sarah E. Vordenberg