Q: I am a 60-year-old woman who has had worsening pain along the inside part of my right ankle for the last six months. I have also noticed that my arch is flatter on my right foot than my left. I do not remember any injury. The more I walk, the more painful it becomes. I have tried ibuprofen that provides minor relief, as well as a variety of shoe types, but I am still experiencing tremendous discomfort. This foot problem is limiting my lifestyle and exercise. What is my next step?
A: The posterior tibial tendon is a very important structure that runs along the inside part of the ankle to the bottom of the foot. This tendon supports the arch of the foot.
In many patients, as they get older, this tendon can begin to tear, producing pain and eventually flattening of the arch. Initially, this condition can be treated with anti-inflammatory medications, arch supports, and supportive shoes. In patients where conservative treatment fails, surgery is the next step.
If this condition is caught before the deformity is rigid, then tendon transfers to replace the posterior tibial tendon may be effective. In more extreme cases, realigning or fusing the bones may be necessary. I recommend you see an orthopedic surgeon or foot specialist to establish the correct diagnosis and best treatment.