Most conditions in the feet and ankles are noticed and addressed due to the pain of inflammation - but what does that mean? Not every condition will appear visually swollen and larger, but your podiatrist may still be talking to you about inflammation.
Inflammation is a reaction that your body has to injury whether it be a traumatic injury or damage to a particular body structure from repetitive small injuries (we call this microtrauma). Medically and scientifically speaking, inflammation involves chemical mediators in the body that travel with the blood to an affected area and stimulate healing in some fashion. Inflammation is necessary for healing - that's right! It is broken up into two phases, acute and chronic. Each of these has different chemical mediators and there is a different process at play for each. In acute inflammation, your body is removing damaged tissue from an area, where chronic is when scar tissue and collagen is deposited to heal that area. When either of these 'phases' gets stuck in a loop, conditions such as tendinitis, capsulitis or fasciitis require ANTI-inflammatories to halt the process.
Typically, if an injury or condition begins and your body successfully runs through the course of inflammation and healing, you would not need an anti-inflammatory. What is important to take into consideration is that with foot and ankle conditions particularly, using the affected body part while healing is being attempted can interfere with appropriate healing. In this day, its is nearly never that someone with a foot or ankle condition will literally sit at home until they are healed which is why you may find anti-inflammatories recommended frequently at a podiatry office.
Going back to why swelling and inflammation are different is because inflammation can still be present after swelling is gone or reduced. When a condition first starts, the chemical mediators of acute inflammation cause an influx of blood flow to an area to help heal the area. Swelling reduces over time, but as the body transitions into chronic inflammation, there is much less visible swelling or fluid to the area. How do we know then that there is inflammation still present? Because of pain.
Some of the factors in the body that are in inflammation are those which cause pain. So, unless there has been damage to a surrounding nerve, in most cases pain in the foot or ankle means that there is inflammation present.