Acupuncture for Foot and Ankle Pain
Our feet support our body weight and need to be strong to cushion the repeated stress of striking the ground as we walk or run; they also need to be flexible to allow us to walk or run over uneven ground. There are many possible causes of foot pain such as a single injury, repetitive trauma, arthritis or wearing inappropriate footwear. Furthermore, most of us spend most of our lives these days walking on completely flat floors with our feet effectively bound in thick or hard soled shoes. This is not what our feet evolved to do, and is the source of many of the problems which afflict our feet and ankles.
A common type of foot pain is plantar fasciitis, in which there is pain on or near the heel, usually made worse by walking or running, and often affecting runners and athletes. It involves inflammation of the thick band of tissue that runs from the heel to the front of the foot, supporting the arch. Achilles tendinopathy (formerly called Achilles tendonitis) involves degenerated tissue in the tendon which connects the calf muscles to the heel, and is also a common problem among runners and other athletes. Overloading the calf muscles or the Achilles tendon may also lead to heel spur, a small bony projection on the heel.
Foot and Ankle Pain and TCM
Pain in TCM arises when our Qi is not free flowing; for some reason it is stuck or stagnant. In the case of foot or ankle pain, the obstruction is in one or more of the meridians which flow down the leg into the foot, so treatment will involve freeing up that flow of Qi, which will usually involve acupuncture treatment on the foot, perhaps combined with invigorating massage and the use of topical herbal applications. The patient can also do some simple daily exercises at home to help to restore flexibility and encourage the free flow of Qi to their feet, thus speeding up and maintaining the effects of treatment when away from the clinic.
It is also important to understand more deeply why the Qi is getting stuck at the foot though, and there are several possible causes of this.
i) A single traumatic injury to the area having temporarily damaged the meridians and blocked the flow of Qi. This is the most straightforward case and unless the injury is particularly severe a few treatments will usually be enough to substantially reduce the pain if not eradicate it completely.
ii) Repeated small stresses on the foot or ankle may have eventually weakened them, causing a local deficiency of Qi which in turn leads to the Qi failing to flow freely. Treatment here will need to not only restore the smooth flow but gradually strengthen the area concerned by encouraging the local nourishing circulation of Qi and Blood. This is often the case with, for example, chronic Achilles problems.
iii) Whilst the pain is felt in the foot, there may also be blockage of the meridians further up the leg; in this case treatment will also need to be focused in this area to ensure the foot has an adequate supply of flowing Qi.
iv) Sometimes the Qi is blocked due to what in TCM is called a pathogenic factor obstructing the flow. For example exposure to a wet environment, as for example in walking in the rain without proper footwear, may cause a Damp pathogen to lodge in the foot, typically leading to swelling, pain and a heavy feeling (Damp pathogens also have a tendency to sink down the body, so the feet are particularly prone to their presence). In this case as well as moving the Qi, the practitioner will seek to expel the pathogen, using acupuncture, topical and/or oral herbal medicine, and perhaps moxibustion.
v) Foot and ankle problems, especially if in both feet, may also point to underlying disharmony of our body’s Qi; for example, perhaps it has a general tendency to not flow freely, and the foot pain is only the most obvious manifestation of this. The TCM practitioner’s careful questioning at the initial consultation gives them a clear picture of any such disharmony, and in this case local treatment of the foot will be supplemented by treatment to rebalance your Qi overall, using acupuncture and perhaps herbal therapy.
Is Acupuncture Helpful in the treatment of Foot and Ankle Pain?
A US army study 1 has confirmed acupuncture as an effective treatment for plantar fasciitis. Another American study 2 of 67 cases of foot pain which had been unresponsive to conventional treatments found that almost half the patients had complete pain relief from acupuncture, and another third had better than 75% relief.
1 Perez-Millan R & Foster L. (2001) Low-Frequency Electroacupuncture In The Management Of Refractory Plantar Fasciitis: A Case Series. Medical Acupuncture 13(1)
2 Erickson R & Edwards B (1996) Medically Unresponsive Foot Pain Treated Successfully with Acupuncture Acupuncture in Medicine 14(2)