'Non-specific foot pain'

NewsBot · Mar 4, 2015

Members do not see these Ads. Sign Up.
Ischemic compression and joint mobilisation for the treatment of nonspecific myofascial foot pain: findings from two quasi-experimental before-and-after studies.
Hains G, Boucher PB, Lamy AM
J Can Chiropr Assoc. 2015 Mar;59(1):72-83.

OBJECTIVE:
The aim of this study was to evaluate the efficacy of myofascial therapy involving ischemic compression on trigger points in combination with mobilization therapy on patients with chronic nonspecific foot pain.
STUDY DESIGN:
Two quasi-experimental before-and-after studies involving two different baseline states.
METHOD:
Foot pain patients at a private clinic were divided into two separate cohorts: A, custom orthotic users; and B, non-users. In Study A, 31 users received 15 experimental treatments consisting of ischemic compressions on trigger points and mobilization of articulations through the foot immediately after study enrollment. In study B, ten non-users were prescribed a soft prefabricated insole and were monitored for five weeks before subsequently receiving 15 experimental treatments after the initial five-week delay.
OUTCOME MEASURES:
The Foot Function Index (FFI) and patients' perceived improvement score (PIS) on a scale from 0% to 100%.
RESULTS:
The Study A group (n=31) maintained a significant reduction in the FFI at all three follow-up evaluations. Mean improvement from baseline in FFI was 47%, 49% and 56% at 0, 1 and 6 months, respectively, post-treatment. Mean PIS was 58%, 57%, and 58%, again at 0, 1 and 6 months post-treatment. For the Study B group, mean improvement in FFI was only 19% after the monitoring period, and 64% after the experimental treatment period. Mean PIS was 31% after monitoring, and 78% after experimental treatment. In repeated measures analyses, experimental treatment was associated with a significant main effect in both of these before-and after studies (all P values<0.01).
CONCLUSION:
Combined treatment involving ischemic compression and joint mobilization for chronic foot pain is associated with significant improvements in functional and self-perceived improvement immediately and at up to six-months post-treatment. Further validation of this treatment approach within a randomized controlled trial is needed.
Click to expand...

Nonspecific foot pain
In the absence of the above-mentioned specific causes
of chronic foot pain, we suggest that a diagnosis of nonspecific
foot pain is applicable. For nonspecific foot pain,
we have utilized a treatment approach that appears to be
promising from an anecdotal perspective, but has not yet
been formally validated to date.
The proposed treatment assumes that nonspecific
foot pain has, at least in part, a myofascial component
which may be present either exclusively or in addition
to the aforementioned specific causes of foot pain. Our
use of ischemic compression and joint mobilization is
therefore based on the theoretical rationale that myofascial
trigger points (TrPs) may be located within muscles,
ligaments, tendons, fascia, and articular capsules of the
painful foot.23,24 Previous studies (further detailed in the
Discussion section) have shown that other manual myofascial
therapy techniques such as friction massage, mobilization,
and Graston Instrument Mobilization Technique
have helped alleviate many foot problems
Click to expand...

Griff · Mar 4, 2015

Not sure I'm on board with a diagnosis of 'non-specific foot pain'...

Feels very much like a step backwards

Ian Drakard · Mar 4, 2015

Agree. I thought a diagnosis was meant to give some indication of location and pathology. Makes metatarsalgia and shin splints look positively insightful.

Craig Payne · Mar 4, 2015

Yes and no.
We had this case a few days ago: Autoimmune Foot Pain - "non-specific" would be an appropriate diagnosis at this stage.

I did write this elsewhere a while ago:

‘Foot Strain’ (‘Non-specific foot pain’)
The term, ‘Foot Strain’ is a non-specific term that is used to describe a vague ache or pain in the foot that is due to repeated stress on the tissues of the foot beyond their what they can take over a longer period of time. There may also be a type compensatory chronic pain cycle involved and maybe involvement of trigger points or myofascial pain. It appears to be more common in those who are more active, are heavier or are on their feet all day. It is not uncommon for it to occur during the later stages of a pregnancy.

Usually a 'foot strain' is described initially as a ‘muscular ache’ in foot and maybe the leg that gets progressively worse over time. There may be some specific points of tenderness that may be noted, suggesting that myofascial trigger points are involved. The foot is usually excessively pronated and a compensatory forefoot supinatus is often present.

Sometimes a specific pathology may be identified, leading to concern if the actual diagnosis of ‘foot strain’ is appropriate or not. It is rarely mentioned in the literature, but most clinicians will see it, or something similar, commonly; however, they do not necessarily use the term 'foot strain'. The term was probbaly more common historically. The term 'Non-specific foot pain' is probably more appropriate. The diagnosis is also one of excluding other potential causes of the symptoms

Differential diagnosis:
This could be the early stages of another condition and not enough of the 'pattern' is established to reach a specific diagnosis.
Fibromyalgia | Plantar fasciitis | Posterior tibial tendon dysfunction | Enthesitis | Inflammatory arthritis

Treatment is usually directed at the specific symptoms if they can be identified.
Correction of foot biomechanics is probably important.
Ischaemic compression of trigger points is often useful.
Mobilisation and manipulation is often helpful.
Click to expand...

NewsBot The Admin that posts the news.

Griff Moderator

Ian Drakard Active Member

Craig Payne Moderator

Define 'non healing wound' please.

Subject-specific responses to footwear during running

Foot and Ankle Related Sex-Specific Analysis Within High-Impact Journals

Why are there no football boots designed specifically for women?

Non Specific Calcification in Big Toe

Prefab v Prefab with extra design feature trial on specific symptom cohort

Subject Specific Optimisation of the Stiffness of Footwear Material

Share This Page