Medical therapies for foot and ankle problems
“Early diagnosis and intervention for musculoskeletal problems is essential for a successful outcome and is important to prevent longer term disability.”
Many musculoskeletal problems can be effectively treated by medical treatments, without the need for surgery. London Foot and Ankle Centre specialises in treating a wide range of foot and ankle complaints, often finding solutions for people with complex problems and for patients whose previous treatments may have failed.
We have a multi-disciplinary team, including experienced podiatrists and Professor Cathy Speed, consultant in rheumatology, sport and exercise medicine. This means we are able to find the right approach for each individual patient, selecting minimally invasive and non-surgical approaches where possible.
How are medical therapies used at LFAC?
“There is no overnight cure and no injury will have one single treatment. The most effective approach involves a package of treatment tailored to the patient’s unique needs.”
Medical therapies for foot and ankle problems can be very effective for many people, from athletes to elderly people with arthritis alike. Customised treatment programmes are tailored to the needs and preferences of the patient and aim to returning the patient to pain free function.
Making a detailed and accurate diagnosis
It is vital to begin with a complete and accurate diagnosis. To achieve this, we use a wide range of diagnostic tools and in particular diffeent imaging techniques:
- MRI (Magnetic Resonance Imaging)
- CT (Computed tomography)
- Diagnostic Ultrasound
- Isotope Bone Scanning
- Bone density assessment
Further specialist tests may also be undertaken including blood tests, isokinetic strength testing and biomechanical assessment.
How are medical therapies used?
Professor Speed has an expertise in managing a wide range of musculoskeletal problems in all areas of the body, including foot and ankle complaints. She is internationally recognised and holds a range of high profile role with national sports organisations. This enables Professor Speed to bring the advanced technology and expertise used in elite professional sport to all patients. Therefore some of the therapies used by Professor Speed may not be widely available elsewhere. Her core practice principle is taking a holistic, thorough approach, starting with a detailed diagnosis, then applying a comprehensive treatment plan.
What medical therapies are used?
Treatment approach will include a combination of these medical therapies:
- Medications and natural therapies
- Injection therapies
- Extracorporeal shockwave therapy
- Nutrition including dietetic prescription
- Exercise prescription
Medications and Natural Therapies
Medications and natural therapies are used to promote healing, reduce inflammation, and to control pain. These may be oral tablets or topical (applied directly to the affected area). This is an area of significant new developments and improvements in the treatments - including natural remedies - available. It is essential to quickly establish effective pain control. Only once pain management is established can key issues such as gait or function be properly addressed.
Professor Speed performs targeted ultrasound guided injections injections under ultrasound guidance Different injections work in different ways. The principle aim is to redice pain, control inflammation and to allow healing and repair to take place. Professor Speed uses a wide variety of different injections based upon individual need.
Steroids injections are used sparingly and there are often other options. Professor Speed regularly uses viscosupplement injections, based on hyaluronic acid, a natural component of the fluid which lubricates joints. Homeopathic injections are used to promote healing and reduce pain. PRP and ACP injections are based on injecting your own blood into the affected area because it contains growth factors promoting healing in tendons, ligaments and muscles. The full range of injections used is:
- Dry needling and acupuncture
- Anaesthetic injections
- Homeopathic injections
- Platelet Rich Plasma (PRP) and Autologous Conditioned Plasma (ACP)
- Infiltrations to reduce scar tissue
- Corticosteroid injections
- Viscosupplement injections
Extracorporeal shockwave therapy
Electrical waves have been applied to the treatment of pain for many years, working on the basis that they can disrupt the transmission of pain signals from nerve endings and stimulate tissue healing. More recently, the most advanced approach called extracorporeal shockwave therapy has developed a strong evidence base for its effectiveness. At LFAC we have recently invested in a dedicated, advanced Swiss Dolar Clast machine to deliver shockwave therapy.
Find out more about how shockwave therapy works and medical evidence for its effectiveness.
Nutrition and exercise prescription
Nutrition and exercise are critical parts of treatment and rehabilitation strategies. Patients are given individual exercise prescriptions, tailored to their own needs, with supervision and support. All people with musculoskeletal complaints may benefit form supported therapeutic exercie regimes and nutritional advice.