Wong Pei Ying
Family Physician
Source: Getty Images and Shutterstock
Family Physician
Did you know that sprains, strains and other bodily pains are some of the many musculoskeletal conditions that doctors see in their clinics? Among the most common of these musculoskeletal conditions are ankle sprains, shoulder injuries, wrist and finger conditions, as well as pain in the knee or foot.
Read on to learn more about some common lower limb conditions that you may have experienced, and their causes, symptoms, and available treatments.
Heel pain (or plantar fasciitis) occurs when the band of tissue on the soles of your feet, which connects your heel to your toes (also known as the plantar fascia), becomes inflamed. This inflammation is what causes the pain that is experienced. Plantar fasciitis can be caused by having too much pressure being placed on the heel of our feet, resulting in damage to the tissue.
The most common sign of plantar fasciitis is pain in the heel. This is usually most intense when taking those first few steps in the morning, or after a prolonged period of rest, such as when getting out of a car.
Plantar fasciitis may show up in people who experience the following:
To diagnose plantar fasciitis, your doctor may suggest for an X-ray of your foot. The presence of a heel spur, a calcium deposit on the underside of the heel bone, is typically indicative of plantar fasciitis.
Your doctor may suggest various different ways of managing plantar fasciitis, most of which can be carried out conveniently at home.
Lean forward and push both your hands, with arms extended, onto the wall. Take a lunge position, with one leg in front and knees bent and feel the pull in your calf during the stretch. Hold the position for 10 seconds and relax. Repeat this exercise 20 times for each foot.
In a seated position, cross your affected leg over the other. With the affected leg’s knee bent, grasp the toes of the painful foot and slowly pull them upwards until you feel a stretch in your calf. You may also try wrapping a towel around your affected foot and pulling it towards you. Hold the stretch for 10 seconds and repeat it 20 times for each foot. You should do this exercise first thing in the morning, or after a long period of sitting or resting.
In serious cases where the pain does not go away despite home treatments, other treatments that may be recommended include cortisone injections to the foot, or even shockwave therapy.
Ankle sprains happen when the ligaments in our ankle get stretched beyond their limits and tear. This can be caused when our ankles get rolled or twisted awkwardly while walking on uneven ground, or when we fall. Ankle strains can also occur in the same manner. The difference between an ankle sprain and strain is that the former involves injury to ligaments, while the latter involves injury to muscles or tendons. Both conditions have similar symptoms.
Pain over the ankle is a telltale sign of injury. The affected ankle may also swell up and be painful to touch. Following the injury, ankle movement may be restricted and you may feel unstable when walking.
Common risk factors for ankle sprains and strains include:
Your doctor will first examine the affected area gently to check for extent of injury. They may rotate the ankle gently to ascertain the site of injury and pain. If necessary, an X-ray of the ankle may be ordered to rule out a fracture.
Following the physical examination, your doctor will grade the severity of the sprain according to the severity of ligament damage. Grade 1 ankle sprains involve mild injury while Grade 3 ankle sprains may potentially cause permanent instability. Ankle sprain grades help determine what treatment is necessary.
In milder sprains, the doctor will usually recommend Rest, Ice, Compression and Elevation (RICE) treatment at home in the first 2 – 3 days following an injury.
Generally, the time taken to recover from an ankle sprain will range from 3 weeks to 6 months. After an ankle sprain heals, physical therapy exercises may be recommended to strengthen the ankle and prevent another injury. Surgical treatment is uncommon and reserved for patients with persistent ankle instability that does not respond to conservative treatment.
Osteoarthritis is a degenerative joint disease that typically occurs in the hands, hips and knees. Osteoarthritis of the knee is usually caused by wear and tear or degeneration of the cartilage in the knee joint, and can cause knee pain once the knee loses this natural protection.
The knee may feel swollen and stiff. Pain will also be experienced with everyday physical activity, such as walking or climbing the stairs. Creaking in the knees, sometimes with sound, may also be experienced with movement. In severe cases, the pain may prevent you from going about your normal daily activities.
The risk of developing osteoarthritis of the knee is higher if you are:
Your doctor will gently feel the knee joint and check for pain. The range of motion, flexion and extension of the knee may be tested. If necessary, an X-ray will be ordered. Other tests, such as magnetic resonance imaging (MRI) or computerised tomography (CT) scans, may be also recommended to determine the condition of the knee in greater detail.
The following treatments may be prescribed for osteoarthritis of the knee: