Pain Management


Pain management

Note: For any foot condition, please consult your physician before taking any medication for pain management.

Ankle pain

Recurring or persistent (chronic) pain on the outer side of the ankle often develops after an injury, such as a sprained ankle.

The American Orthopaedic Foot and Ankle Society identifies both conservative and surgical treatment methods to alleviate this pain.

Conservative treatments include:

  • Anti-inflammatory medications, such as aspirin or ibuprofen to reduce swelling.

  • Physical therapy, including tilt-board exercises directed at strengthening the muscles, restoring range of motion, and increasing the perception of joint position.

  • An ankle brace or other support.

  • An injection of a steroid medication.

  • In the case of a fracture, immobilization to allow the bone to heal.

Almost half of all people who sprain their ankle once will experience additional ankle sprains and/or chronic pain. You can help prevent chronic pain from developing by following these simple steps:

  • Follow your doctor's instructions carefully and complete the prescribed physical rehabilitation program.

  • Do not return to activity until cleared by your physician.

  • When you do return to sports, use an ankle brace rather than taping the ankle. Bracing is more effective than taping in preventing ankle sprains.

  • If you wear hi-top shoes, be sure to lace them properly and completely.

Arch pain

Plantar fasciitis is an inflammation of a thick, fibrous ligament in the arch of the foot. The plantar fascia (arch of the foot) attaches into the heel bone and fans out toward the ball of the foot, attaching into the base of the toes. If this ligament is stretched excessively it will become inflamed and begin to cause pain.

The main emphasis for treatment of arch pain is to reduce the forces that are causing the plantar fascia to stretch excessively. This includes calf muscle stretching, over the counter arch supports, and orthotics. Oral anti-inflammatory medications may be useful in controlling the pain.

Additionally, cortisone injections may be recommended for the treatment of plantar fasciitis.


Arthritis in the foot and ankle can be treated in many ways, including:

  • Physical therapy and exercise.

  • Orthotics or specially prescribed shoes.

  • Foot soaks/paraffin baths.

  • Ice packs.

  • Massages.

  • Over-the-counter anti-inflammatory medications, such as aspirin, ibuprofen, or acetaminophen products.

  • Prescription nonsteroidal anti-inflammatory medications.

  • Vitamins B6, B12, and folic acid.

Pain Management 2

Ball of the foot pain

Calluses are the most common source of pain on the ball of the foot. Treatment consists of periodic trimming or shaving the callus, padding the shoes to remove the pressure, using shoe orthotics, or, in severe cases, surgery.

Pain in the ball of the foot not associated with calluses can be a result of inflammation of a tendon in the toe, arthritis, inflammation of the joint, or a neuroma. Stiffness in the big toe and big toe joint (Hallux Limitus andHallux Rigidus) and sesamoiditis, an inflammation of two small bones under the big toe joint, are also conditions that lead to pain in the ball of the foot.

While treatments vary based on the condition and individual case, techniques for reducing pain in the ball of the foot include:

  • Physical therapy and exercise.

  • Over-the-counter or prescription pain and/or anti-inflammatory medications.

  • Orthotics or specially prescribed corrective shoes.

  • Cortisone injections.

  • Proper shoe wear.


Most bunions can be treated without surgery by wearing protective pads to cushion the painful area, and by wearing properly-fitted shoes.

Bunion surgery, known as a bunionectomy, realigns the bone, ligaments, tendons, and nerves so the big toe can be brought back to its correct position. Many bunion surgeries are performed on a same-day, outpatient basis. However, a long recovery is common and may include persistent swelling and stiffness.

Heel pain

Plantar fasciitis is commonly traced to an inflammation of the ligament that stretches across the bottom of the foot. The condition can usually be treated effectively with conservative measures, such as use of anti-inflammatory medications, ice packs, stretching exercises, orthotic devices, and physical therapy.


Foot pain in the ball of the foot, the area between the arch and toes, is generally referred to as metatarsalgia. The pain centers on one or more of the five bones (metatarsals) in this mid-portion of the foot.

A simple change of shoes may solve the problem. In more severe cases, podiatrists may prescribe a custom orthotic device to make sure the foot structures are in their proper position.



See the Foot Doctor!


Tenex Health TX™

  • Tenex Health TX™

    Plantar fasciitis or achilles tendonitis, an inflammation, irritation and swelling of the tendon, comes from an injury or doing the things you love or need to do—over and over again. Repetitive motions, no matter how ordinary, can cause small micro tears that occur each time you use your tendon. When the micro tears do not heal properly, tendinosis (tendon degeneration) can occur.

    Percutaneous tenotomy or percutaneous fasciotomy, using ultrasonic energy powered by the Tenex Health TX™ System, is a safe and quick procedure specially designed for those who are suffering from painful conditions associated with chronic tendon damage. The procedure treats tendinosis or fasciitis in the ankle and foot.

    Tenex Health TX is based on advanced technology developed in collaboration with the world renowned Mayo Clinic.


    Tenex Health TX™ benefits:

    If you have tried physical therapy, cortisone injections, medication, or just taking time to ice, stretch and rest and are still in pain, talk to us. We now have a solution that does not involve general or open surgery, may give you quick pain reduction and should have you back to enjoying the things you love in a few weeks to a few months.

    Patient benefits may include:
    ∙ Quick pain relief
    ∙ Rapid return to normal activities
    ∙ Local anesthetic used instead of general anesthesia
    ∙ No sutures, no stitches (requires only a small, adhesive bandage)
    ∙ 20­minute, minimally invasive procedure (not open surgery)
    ∙ Coverage by most insurances

  • How does Tenex Health TX™ work?

    Precisely targets your damaged tissue. Your doctor uses ultrasound imaging, just like the kind used to see babies in the womb, to visualize and identify the specific location of the damaged tendon tissue.

    Gently removes damaged tissue. Once the source of your tendon pain is identified, your doctor numbs the area with a local anesthetic, allowing you to stay awake the entire time. Many people say after the numbing process—which feels like a bee sting—they felt only a slight pressure during the procedure (if they felt anything at all). Your doctor then uses gentle ultrasonic energy designed to safely breakdown and remove the damaged tissue. The ultrasonic energy is applied with the TX MicroTip, which requires only a microincision to reach the damaged tissue. Because the incision is so small and the ultrasonic energy precisely treats only the damaged tendon tissue, the surrounding healthy tissue is left unharmed.

    Requires no stitches. When the procedure is completed, your doctor applies a small adhesive bandage; no stitches are required. Because you are awake during the procedure (no general anesthesia), many people are able to drive home after the procedure.

    Can offer nearly instant pain relief with a rapid recovery. Recovery is rapid with many people being back to normal activity within 6 weeks or less. Because the surrounding healthy tissue is not disturbed, and no stitches or general anesthesia is required, there is minimal downtime and less discomfort compared to open surgery. The speed of your recovery depends on the location of your tendinitis and your individual results may vary.


    What areas of the body does our practice treat with Tenex Health TX™?

    Our practice treats the ankle and foot with Tenex Health TX.

  • VIDEO: Learn more about Tenex Health TX™

    As a percutaneous tenotomy or percutaneous fasciotomy procedure, Tenex Health TX is typically covered by Medicare­approved and private health insurers. It is always recommended that patients consult the treating physician and individual health plan. For more information, visit

    MKT112. Rev. C

  • LAPIPLASTY® Procedure Patient Education Video from Treace Medical Concepts on Vimeo.

Patient Portal

We are pleased to provide patients with secure, 24/7 access to their health records through the Pancholi Foot and Ankle Patient Portal. Patients can safely and easily:

  • Request prescription refills
  • Update insurance/demographic information
  • Review financial statements/make secure payments
  • View lab and test results
  • Access relevant health education materials

Patient Portal Login

Read more






Book your appointment online now!

Read more
Pancholi Foot and Ankle
3295 Forest Inn Road, Suite 4
Palmerton, PA 18071
Phone: 610-255-7383
Fax: 610-824-7229
Office Hours

Get in touch