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Many conditions can lead to chronic pain of the feet and ankles. These include:

Foot and ankle arthritis - This involves inflammation of the joints. The pain can be caused by rheumatoid arthritis (immune system dysfunction), osteoarthritis (wear-and-tear), or gouty arthritis (too much uric acid). The symptoms of arthritis include pain with movement of the feet/ankles, redness or swelling of the joint, and tenderness.

Bunions - These are enlarged bumps on the side of the big toe, which throws the bones out of alignment. This progressive foot condition can cause swelling, redness, and pain.

Extensor tendonitis - This pain occurs near the middle top of the foot, where tendons become inflamed. This is caused by calf muscle tightness and stress on the tendons.

Diabetic foot problems - These issues occur when elevated blood glucose damages the nerves that supply feeling in the feet. People with diabetic neuropathy complain of foot pain, numbness, tingling, and burning of the feet.

Flatfeet - A term used to describe a foot with a non-existent arch, flatfeet occurs quite often. People with this condition complain of heel pain or pain at the instep.

Metatarsalgia - This is the medical term that describes pain at the bottom ball of the foot when walking or standing. The pain can be dull, burning, or aching, and often is relieved with rest.

Morton’s neuroma - With this condition, there is a thickening of nerve tissue at the base of the third and fourth toes. This enlargement or thickening can cause nerve compression, which leads to pain, swelling, and permanent nerve damage.

Plantar fasciitis - This chronic foot and heel pain occurs from inflammation of the plantar fascia.

Chronic venous insufficiency (CVI) - This is a condition where blood accumulates in the lower legs and feet veins. This can cause skin color changes, redness, and pain.

Radiculopathy - Many spinal conditions can lead to nerve compression, which causes symptoms of leg and foot pain.

The treatment of foot and ankle pain depends on the cause of the discomfort. Treatment options are:

Medications - Commonly prescribed medicines include nonsteroidal anti-inflammatory drugs (NSAIDs), non-narcotic analgesics, and certain anticonvulsants. Tricyclic antidepressants are used for neuropathic pain.

Orthotics - Padded supports and other custom orthotic devices can reduce pressure on nerves and provide pain relief.

Injection therapy - The doctor can inject the foot/ankle with a long-acting corticosteroid, with or without an analgesic. Options may also include regenerative medicine injections with platelet rich plasma therapy or stem cells derived from bone marrow or amniotic fluid.

Minor surgical procedures - This could involve removal of an ingrown toenail, bunion, corn, or callus.

Epidural steroid injection (ESI) - For pain associated with radiculopathy and spine problems, the doctor can inject a steroid agent into the epidural space near the spinal cord. According to clinical studies, the success rate of ESI is 80-90%.

Facet joint injections (FJIs) - Found to be around 80% effective, the FJI procedure involves instillation of an anesthetic, with or without a steroid, into the facet joint spaces and near the spinal nerves. This helps with foot/leg pain related to radiculopathy and facet joint syndrome.

ESWT - Extracorporeal shock wave therapy is used to treat foot pain by way of quick energy waves. This treatment was found to help with tendionopathy and plantar fasciitis, with an 80% efficacy rate.