Sciatic nerve pain can persist for years, affecting mobility and overall quality of life. Wendy, a patient at Well Heeled Podiatry, had been battling with sciatic nerve pain in her right leg for an astounding 16 years.
After seeking various treatments, including physiotherapy and custom orthotics, Wendy continued to experience discomfort that limited her daily activities. In this case study, we explore deeper into Wendy’s journey toward relief, uncovering the importance of a holistic, personalised approach to both her sciatic pain and foot health.
Wendy’s Long-Standing Battle with Sciatica
For 16 years, Wendy struggled with sciatic nerve pain, which radiated down her right leg. Over the years, she had seen physiotherapists for rehabilitation, which provided some relief, but her condition never fully resolved. The pain affected her ability to walk and enjoy physical activities, especially walking long distances, which she loved to do.
About a year ago, Wendy began experiencing additional foot pain. Initially, her healthcare providers attributed the pain to referred pain from her sciatic nerve. Wendy visited a podiatrist who made her custom foot orthotics, which helped somewhat, but the relief was not complete. Wendy continued to feel the aggravation, and she knew she needed to investigate the issue further.
Initial Assessment and Findings: Identifying the Root Cause
When Wendy came to Well Heeled Podiatry, she was hoping to uncover a solution that would give her lasting relief. During the initial assessment, we took a detailed look at her posture, walking patterns, and specific pain points.
While it was clear that Wendy had sciatic nerve pain in her leg, we found that her foot pain seemed to be localized, particularly under the third metatarsal of her right foot. This raised questions as to whether the pain was truly referred from her sciatic nerve or if there was another issue at play.
To dig deeper, we recommended an MRI, and the results revealed a key finding: Wendy had a tear in her plantar plate. The plantar plate is an extension of the plantar fascia, running under the ball of the foot. It plays a crucial role in stabilising the toes and providing support during walking and other movements. A tear in this area can cause significant discomfort, which Wendy had been experiencing but had previously attributed to her sciatic nerve.
A New Approach: Education and Custom Orthotics
Upon reviewing the MRI results and understanding the full scope of Wendy’s condition, we noticed that she had been using a toe separator between her third and fourth toes to alleviate some of the pain. However, this separation was inadvertently causing additional strain on her plantar plate, worsening the issue.
We educated Wendy on the importance of stopping the use of the toe separator to prevent further damage to the plantar plate, even though it had offered temporary relief. Wendy had become quite reliant on this tool, so we took a gradual approach to stop its use, ensuring she didn’t feel overwhelmed by the change.
Next, we designed a new set of custom foot orthotics tailored specifically to offload the pressure under Wendy’s foot and address her plantar plate injury. During the biomechanical assessment for the new orthotics, we also discovered a leg length discrepancy—Wendy’s legs were about 0.8 centimetres different in length, which likely contributed to an uneven load on her feet.
Shockwave Therapy and Footwear Adjustments
To further enhance her recovery, we incorporated shockwave therapy into Wendy’s treatment plan. Over the course of five sessions, we applied shockwave therapy to the painful spot on Wendy’s foot, aiming to reduce inflammation and accelerate the healing process.
Shockwave therapy is an effective treatment for soft tissue injuries and has shown significant success in treating conditions like Wendy’s plantar plate tear. We recommended a new pair of shoes with a stiffer forefoot sole.
This type of footwear helps Wendy roll over the ball of her foot more effectively, reducing strain and pressure on the injured area. Along with this, we provided specific exercises to strengthen the smaller muscles in her feet and legs, helping her body adapt to the new orthotics and ensure a more stable and supportive gait.
The Unexpected Outcome: Relief from Sciatica
While the focus of Wendy’s treatment was primarily on resolving her foot pain, something remarkable happened. Correcting the leg length discrepancy and evenly loading pressure on both feet resulted in complete relief from her sciatic nerve pain—pain that she had been living with for 16 years.
By addressing the biomechanical issues in her feet, we were able to restore balance to her body’s alignment, ultimately relieving the strain on her lower back and leg muscles. Wendy was overjoyed with the results. Not only did her foot pain resolve, allowing her to walk longer distances without discomfort, but her sciatic pain—something she had never imagined could be completely alleviated—was gone. Wendy was finally able to enjoy the activities she loved without the constant discomfort that had held her back for so long.
Key Takeaways from Wendy’s Case
- Holistic Treatment is Key: Wendy’s case highlights the importance of looking at the body as a whole. While her foot pain was a significant issue, addressing the underlying biomechanical imbalances, such as the leg length discrepancy, also played a crucial role in resolving her sciatic pain.
- Custom Orthotics and Shockwave Therapy: Custom foot orthotics can provide significant relief for localized foot pain, especially when designed with the specific injury in mind. In combination with shockwave therapy, this approach can be highly effective in accelerating recovery and promoting healing.
- Importance of Proper Footwear: Footwear with the correct support, including a stiffer forefoot sole, is essential in ensuring proper foot function and reducing strain on the affected areas. This can also help prevent further injury and enhance recovery.
- Patience and Education: Educating patients about their condition and taking a gradual, step-by-step approach to changing habits—like stopping the use of a toe separator—can help them feel more confident in their treatment plan and allow for better outcomes.
Conclusion
Wendy’s journey underscores the importance of a personalised, comprehensive treatment plan. By addressing the full scope of her condition—focusing not only on the foot pain but also on the alignment issues contributing to her sciatic nerve pain—we were able to help Wendy find lasting relief. Her case serves as a powerful reminder that everything is connected, and sometimes, the solution to one problem can resolve several others.
At Well Heeled Podiatry, we are committed to providing holistic care tailored to the unique needs of each patient. Wendy’s success story is just one example of how we approach foot health and overall well-being with expertise, compassion, and a commitment to long-term solutions.
Frequently Asked Questions About Sciatic Nerve Pain and Podiatry Care
What Is Sciatica, And How Does It Affect Foot Health?
Sciatica is pain that radiates along the sciatic nerve, which extends from the lower back down through the hips and legs. It often causes discomfort in the lower back, legs, and feet. Sciatic pain can result in numbness, tingling, or weakness in the affected leg, and in some cases, it can impact foot health by causing difficulties with walking and standing comfortably. It’s important to address sciatic pain promptly to prevent it from affecting your daily life, including your foot health.
How Can A Podiatrist Help With Sciatic Nerve Pain?
A podiatrist can play a crucial role in treating sciatic nerve pain, especially when it affects the feet. They assess your foot alignment, posture, and gait to identify any imbalances that may be contributing to nerve discomfort. Podiatrists can also provide treatments like custom orthotics to correct alignment and reduce pressure on the sciatic nerve. Additionally, they may recommend exercises, stretches, and lifestyle changes to complement the treatment and improve overall well-being.
What Are Custom Orthotics, And How Can They Help With Sciatica?
Custom orthotics are specialised insoles designed to provide personalised support for your feet. They can help alleviate pressure on the sciatic nerve by improving foot alignment and posture. By supporting the arch and correcting misalignments, custom orthotics can reduce the strain on your legs and lower back, providing significant relief from sciatica-related pain. A podiatrist can assess your feet and recommend the right orthotics for your specific needs.
Can I Treat Sciatic Nerve Pain At Home, Or Do I Need Professional Help?
While some basic measures, such as stretching, applying heat or cold, and using over-the-counter pain relievers, can help manage sciatic pain at home, it’s important to seek professional help if the pain persists. A podiatrist can evaluate the underlying causes of your pain and offer more targeted solutions, such as orthotics, foot care advice, and exercises. Professional care ensures that you address the root cause of the problem and avoid potential long-term issues.
When Should I See A Podiatrist For Sciatic Nerve Pain?
If you experience persistent or worsening pain, numbness, or weakness in your legs or feet due to sciatica, it’s a good idea to see a podiatrist. Early intervention can help prevent the condition from progressing and affecting your quality of life. If your pain is interfering with your ability to walk, stand, or perform daily activities, seeking professional help is essential to finding a comprehensive and effective treatment plan tailored to your needs.
