Foot and ankle pain is extremely common.

It is one of the biggest misunderstandings in modern medicine to believe that doctors treat pain. Doctors do not treat pain. Doctors treat diseases and injuries, and different diseases causing pain in the foot and ankle are treated by different doctors  

For this reason, foot pain does not automatically require referral to an orthopaedic surgeon.

With this blog, I hope to arm you with the information to help understand who should tackle foot pain, and why  

Some foot pain may come from medical causes. There are at least 10 different types of doctors and allied medical staff who look after conditions that cause foot pain, including, but not limited to:

• orthopaedic surgeon – where there is a structural, physical or mechanical problem with the foot

• rheumatologist – where inflammatory, metabolic or immune disease attacks the musculoskeletal system (along with other targets)

• neurologist – central, spinal or peripheral nerve disease causing pain in the legs and feet

• neurosurgeon – similar to the neurologist, but structural nerve problem such as lumbar disc disease

• vascular surgeon – foot pain from low blood flow to the feet or leg pain from blocked veins or varicose veins

• general surgeon – nail problems of the feet

• dermatologist – skin problems of the feet

• podiatrist / chiropodist – skin and nail problems of the feet, treatment of foot problems with orthotic or shoe modifications

• internal medicine doctors (most commonly cardiologists or nephrologists)  - heart or kidney problems can lead to swollen ankles, which cause ankle pain because the swelling leads to stretching of the soft tissues around the ankle.

However, most foot pain comes from lifestyle problems, such as:

• deconditioning (weakness) of the feet

• sudden increase in activity (such as going on vacation and walking much more than usual, or a new exercise programme)

• returing to normal activities after illness or period of rest

• wearing of bad shoes, and

• tightness of Achilles tendons.

There is no medical test for lifestyle-related foot and ankle pain, because lifestyle problems are not medical diseases. At best, medical tests will all be normal. At worst, medical tests sometimes show asymptomatic findings not related to the pain, causing confusion.  

Doctors cannot cure lifestyle-related foot pain, because doctors cannot give patients stronger or more flexible feet. 

We are all responsible for our own strength and flexibility. The best exercise for strengthening is standing calf raises, as shown here(clickable link). You do not need to go to a gym. It can be done at home. The important thing is to do this on a step, in order to stretch the Achilles Tendon. 

Unfortunately, there is no single doctor to treat all causes of ankle or foot pain. Such a doctor doesn't exist. 

A good general practitioner or family doctor can help make the best choice for initial treatment or referral to the correct specialty. 

Orthopaedic foot & ankle surgeons can help investigate for structural causes of foot & ankle pain, however we cannot take over the role of the general practitioner if investigations show that there is no structural problem present.