From Our Experts  |  March 23, 2017  |  William J. Vanarthos, MD

Put Your Best Foot Forward

We ask a lot of our feet. From standing on them all day to wearing ill-fitting shoes, it’s easy to understand why they can hurt. And, there are a lot of places for pain to originate and hide. The foot is a complex structure that includes 26 bones, 33 joints, multiple muscles, tendons and ligaments, and fat pads designed to bear our weight and absorb impact. With so many parts, plus all that we do to our feet, it’s easy to see why they can be prone to pain and discomfort. 

Foot pain can stem from various causes, such as acute trauma, repetitive stress, arthritis, infections and even improper footwear. Of course, depending on the cause, treatment options can vary from simple stretching exercises to pain-reducing medications or surgery. For acute trauma, the RICE method of Rest, Ice, Compression (with a support or brace), and Elevation is often recommended. Crutches may even be prescribed if there is pain associated with weight-bearing activities.

When foot pain begins to interfere with daily living or if desired activities cannot be performed without pain, it’s important to seeking medical attention. A delay in treatment could lead to chronic long-term issues, disability or arthritis.

For patients with chronic pain, arthritis and other degenerative joint diseases, an injection of steroids into troubled joints is an effective pain management tool for several reasons:

  • Surgery is often delayed, prevented or optimally timed.
  • The diagnostic value of an accurate injection (providing pain relief in a particular joint) can predict surgical outcome if fusion is being contemplated.
  • Many patients are able to return to their daily activities immediately and for sustained periods of time without the need for narcotics or other pain medications.
  • Satisfied patients and faithful referring physicians give testimony to the success of image-guided injections.

If a joint injection is recommended, a patient simply needs to make an appointment. There is no preparation for this minimally invasive, outpatient procedure that uses extremely small needles to penetrate the affected joints. The key is that these injections be performed by skilled radiologists who are experts in anatomy and uniquely qualified to access the soft area around the foot’s small joints. With the assistance of image guidance using fluoroscopy (low-level x-rays) or sometimes ultrasound, even the smallest joints of the foot, or those severely deformed by advanced degenerative diseases like arthritis, can be accessed and treated with outstanding results.

As with any treatment, results vary. However, most patients experience sustained pain relief within 24-48 hours of the injection and enjoy months of pain-free living thereafter. Depending on the person’s level of discomfort, their physician’s recommendations, and their insurance plan, these injections may be performed at regular intervals.

If you are experiencing foot pain, talk with your primary care doctor to see if an image guided injection at Wake Radiology could help alleviate your symptoms. We perform joint injections at multiple Wake Radiology offices throughout the Triangle. You can learn more about joint injections and our orthopedic and sports imaging services by visiting the

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