Amber Felsher

Foot Problems Explained

Addressing Mortons Neuroma

Overview

Morton neuromaMorton's neuroma is an enlarged nerve that usually occurs in the third interspace, which is between the third and fourth toes. To understand Morton's neuroma further, it may be helpful to look at the anatomy of the foot. Problems often develop in the third interspace because part of the lateral plantar nerve combines with part of the medial plantar nerve here. When the two nerves combine, they are typically larger in diameter than those going to the other toes. Also, the nerve lies in subcutaneous tissue, just above the fat pad of the foot, close to an artery and vein. Above the nerve is a structure called the deep transverse metatarsal ligament. This ligament is very strong, holds the metatarsal bones together, and creates the ceiling of the nerve compartment. With each step, the ground pushes up on the enlarged nerve and the deep transverse metatarsal ligament pushes down. This causes compression in a confined space.

Causes

Morton's neuroma may be the result of irritation, pressure or injury. In some cases its cause is unknown. In the majority of cases only one nerve is affected. Having both feet affected is extremely rare. A high percentage of patients with Morton's neuroma are women who wear high-heeled or narrow shoes. Patients with Morton's neuroma may need to change their footwear, take painkillers or steroid injections, while others may require surgery to either remove the affected nerve or release the pressure on it.

Symptoms

Neuroma patients occasionally complain of a ?pins and needles? sensation that spreads through their feet, or of a feeling akin to hitting their ?funny bone.? The sensation may be described as similar to an electric shock. Some patients also say that these symptoms, as well as those listed above, will come and go, depending on what they are wearing on their feet, the activity they are doing, or on other external factors.

Diagnosis

During the examination, your physician will feel for a palpable mass or a "click" between the bones. He or she will put pressure on the spaces between the toe bones to try to replicate the pain and look for calluses or evidence of stress fractures in the bones that might be the cause of the pain. Range of motion tests will rule out arthritis or joint inflammations. X-rays may be required to rule out a stress fracture or arthritis of the joints that join the toes to the foot.

Non Surgical Treatment

Orthotics and corticosteroid injections are widely used conservative treatments for Morton?s neuroma. In addition to traditional orthotic arch supports, a small foam or fabric pad may be positioned under the space between the two affected metatarsals, immediately behind the bone ends. This pad helps to splay the metatarsal bones and create more space for the nerve so as to relieve pressure and irritation. It may however also elicit mild uncomfortable sensations of its own, such as the feeling of having an awkward object under one's foot. Corticosteroid injections can relieve inflammation in some patients and help to end the symptoms. For some patients, however, the inflammation and pain recur after some weeks or months, and corticosteroids can only be used a limited number of times because they cause progressive degeneration of ligamentous and tendinous tissues.interdigital neuroma

Surgical Treatment

The ultimate success of a Morton?s neuroma treated surgically can be variable. In cases where the underlying problem is only an irritated nerve (a true Morton?s neuroma), then surgery will probably be curative (although it may take a few months for the foot to fully heal). But in many cases, forefoot pain is more complex. There may be an irritated nerve or two causing pain, but the real problem is often excessive loading of the lesser metatarsals. The generic term for this condition is metatarsalgia. When considering surgery, identifying and addressing these problems may lead to a better end result.

Prevention

While Morton?s Neuroma has been an ongoing topic of clinical investigation, the condition is in some cases difficult to either treat or prevent. Experimental efforts involving the injection of muscle or bone with chemicals such as alcohol, as well as suturing, and covering affected areas with silicone caps have been attempted, with varying success.
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Are Shoe Lifts The Answer To Leg Length Discrepancy

There are actually two different types of leg length discrepancies, congenital and acquired. Congenital means you are born with it. One leg is structurally shorter in comparison to the other. Through developmental periods of aging, the human brain senses the walking pattern and identifies some variance. The entire body typically adapts by tilting one shoulder over to the "short" side. A difference of under a quarter inch is not very abnormal, demand Shoe Lifts to compensate and ordinarily doesn't have a serious effect over a lifetime.

Leg Length Discrepancy Shoe Lifts

Leg length inequality goes largely undiagnosed on a daily basis, however this condition is very easily fixed, and can eliminate many cases of lower back pain.

Treatment for leg length inequality commonly involves Shoe Lifts . They are very reasonably priced, usually priced at below twenty dollars, compared to a custom orthotic of $200 or higher. Differences over a quarter inch can take their toll on the spine and should probably be compensated for with a heel lift. In some cases, the shortage can be so extreme that it requires a full lift to both the heel and sole of the shoe.

Back ache is the most widespread ailment afflicting people today. Over 80 million people have problems with back pain at some stage in their life. It's a problem which costs businesses vast amounts of money every year due to lost time and production. Fresh and improved treatment solutions are always sought after in the hope of minimizing the economical impact this condition causes.

Shoe Lifts

Men and women from all corners of the world suffer the pain of foot ache as a result of leg length discrepancy. In these types of situations Shoe Lifts are usually of very beneficial. The lifts are capable of easing any pain in the feet. Shoe Lifts are recommended by many specialist orthopaedic practitioners".

So as to support the human body in a balanced manner, the feet have got a crucial function to play. Inspite of that, it can be the most overlooked zone in the body. Many people have flat-feet meaning there is unequal force exerted on the feet. This causes other areas of the body including knees, ankles and backs to be impacted too. Shoe Lifts ensure that suitable posture and balance are restored.

What Are The Major Causes Of Calcaneal Spur

Heel Spur

Overview

A heel spur is a hook of bone that can form on the heel bone of the foot. Heel spurs are associated with plantar fasciitis. Heel spurs can cause extreme pain in the rearfoot. The pain is most intense while standing or walking. What Causes Heel Spurs? Heel spurs develop as an abnormal growth in the heel bone due to calcium deposits that form when the plantar fascia stretches and pulls away from the heel. The plantar fascia is a ligament located at the bottom of your foot. This stretching of the plantar fascia is usually the result of flat feet or unusually high arches.

Causes

Heel spurs are exacerbated by an movements that stretch, twist or impact the plantar ligaments. Running, jumping, standing or walking on hard surfaces with unsupportive shoes, walking barefoot in sand are all activities that can activate heel spurs and plantar fasciitis. Obesity is another factor that increases stress to the plantar ligaments.

Calcaneal Spur

Symptoms

Heel spur and plantar fasciitis pain usually begins in the bottom of the heel, and frequently radiates into the arch. At times, however, the pain may be felt only in the arch. The pain is most intense when first standing, after any period of rest. Most people with this problem experience their greatest pain in the morning, with the first few steps after sleeping. After several minutes of walking, the pain usually becomes less intense and may disappear completely, only to return later with prolonged walking or standing. If a nerve is irritated due to the swollen plantar fascia, this pain may radiate into the ankle. In the early stages of Heel Spurs and Plantar Fasciitis, the pain will usually subside quickly with getting off of the foot and resting. As the disease progresses, it may take longer periods of time for the pain to subside.

Diagnosis

A thorough medical history and physical exam by a physician is always necessary for the proper diagnosis of heel spurs and other foot conditions. X rays of the heel area are helpful, as excess bone production will be visible.

Non Surgical Treatment

In case of heel spurs rest is most important. Active sports, running, long walks etc should be avoided to start with. If you?re in a job that requires a lot of standing, take a few days off work. Rest (or reduced activity) is essential to allow the inflammation from becoming aggrevated. Furthermore, you can use ice packs (placed on the heel for 5-10 minutes) to ?cool down? the inflamed area. You may take anti-inflammatory medication or apply a topical inflammatory (i.e. a cream) to help reduce inflammation. In addition, there are some simple exercises that should be done daily to help relieve heel spur pain.

Surgical Treatment

Surgery involves releasing a part of the plantar fascia from its insertion in the heel bone, as well as removing the spur. Many times during the procedure, pinched nerves (neuromas), adding to the pain, are found and removed. Often, an inflamed sac of fluid call an accessory or adventitious bursa is found under the heel spur, and it is removed as well. Postoperative recovery is usually a slipper cast and minimal weight bearing for a period of 3-4 weeks. On some occasions, a removable short-leg walking boot is used or a below knee cast applied.

What Is The Ideal Remedy For Calcaneal Spur

Posterior Calcaneal Spur

Overview

A bone spur (osteophyte) is a bony growth that forms along the edge of normal bone in response to wear and tear, most frequently in the joints. A heel spur is a bone spur of the heel bone, which causes heel pain by rubbing on the achilles tendon or other soft tissues.

Causes

There exists a membrane that covers most of the bone along the heel. When this membrane gets torn repeatedly due to straining of the muscles in the foot, the calcium deposits that lead to heel spurs are more likely to occur.

Heel Spur

Symptoms

Heel spurs often cause no symptoms. But heel spurs can be associated with intermittent or chronic pain, especially while walking, jogging, or running, if inflammation develops at the point of the spur formation. In general, the cause of the pain is not the heel spur itself but the soft-tissue injury associated with it. Many people describe the pain of heel spurs and plantar fasciitis as a knife or pin sticking into the bottom of their feet when they first stand up in the morning, a pain that later turns into a dull ache. They often complain that the sharp pain returns after they stand up after sitting for a prolonged period of time.

Diagnosis

A Diagnosis of Heel Spur Syndrome is a very common reason for having heel pain. Heel pain may be due to other types of conditions such as tendonitis, Haglund's Deformity, Stress Fracture, Tarsal Tunnel Syndrome, or low back problems. A more common condition in children is Sever's Disease. The diagnosis is usually made with a combination of x-ray examination and symptoms.

Non Surgical Treatment

Many treatment options exist, and good results are often observed. Generally, a calcaneal spur develops when proper care is not given to the foot and heels. It is often seen as a repetitive stress injury, and thus lifestyle modification is typically the basic course of management strategies. To alleviate heel spur pain, a person should begin doing foot and calf workouts. Strong muscles in the calves and lower legs will help take the stress off the bone and thus help cure or prevent heel spurs. Icing the area is an effective way to get immediate pain relief.

Surgical Treatment

When chronic heel pain fails to respond to conservative treatment, surgical treatment may be necessary. Heel surgery can provide pain relief and restore mobility. The type of procedure used is based on examination and usually consists of releasing the excessive tightness of the plantar fascia, called a plantar fascia release. The procedure may also include removal of heel spurs.

Indications Of Bursitis Of The Feet

Overview

In your heel, there is a sac filled with fluid known as a bursa. It is located under your Achilles tendon at the back of your heel bone. Many of your large joints have a bursa around them. They provide cushioning and lubrication for the tendons, muscles and bone. Bursitis of the heel occurs when the bursa in your ankle becomes swollen.

Causes

Normally, only one bursa is in the heel, between the Achilles tendon and the heel bone (calcaneus). This bursa may become inflamed, swollen, and painful, resulting in anterior Achilles tendon bursitis. Abnormal pressure and foot dysfunction can cause a protective bursa to form between the Achilles tendon and the skin. This bursa may also become inflamed, swollen, and painful, resulting in posterior Achilles tendon bursitis.

Symptoms

Symptoms of Achilles bursitis are often mistaken for Achilles tendinitis because of the location of the pain at the back of the heel. When you suffer from Achilles bursitis you will experience some or all of the following symptoms which are most noticeable when you begin activity after resting. High heels can add pressure on the retrocalcaneal bursa, subcutaneous calcaneal bursa, and Achilles tendon.

Diagnosis

Careful examination by your physician or physiotherapist can determine if the inflammation is from the Achilles tendon or from the retrocalcaneal bursa. Tenderness due to insertional Achilles tendinitis is normally located slightly more distal where the tendon inserts into the back of the heel, whereas tenderness caused by the retrocalcaneal bursa is normally palpable at the sides of the distal Achilles tendon. Diagnosis can be confirmed with an ultrasound investigation, MRI or CT scan.

Non Surgical Treatment

Medications may be used to reduce the inflammation and pain of retrocalcaneal bursitis. Nonsteroidal anti-inflammatory drugs such as ibuprofen, naproxen and ketoprofen can be purchased without a prescription and used to treat mild to moderate pain. These drugs are often used in combination with a physical therapy program or other retrocalcaneal bursitis treatments.

Surgical Treatment

Surgery is rarely need to treat most of these conditions. A patient with a soft tissue rheumatic syndrome may need surgery, however, if problems persist and other treatment methods do not help symptoms.
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Hammer Toe Pain

Hammer ToeOverview

A hammertoes is a contracture of the toes as a result of a muscle imbalance between the tendons on the top and the tendons on the bottom of the toe. They can be flexible or rigid in nature. When they are rigid, it is not possible to straighten the toe out by manipulating it. Frequently, they develop corns on the top of the toe as a result of rubbing on the shoe. They may also hammertoe cause a bothersome callous on the ball of the foot. This occurs as a result of the toe pressing downward on the bone behind the toe. This area then becomes prominent and the pressure of the bone against the ground causes a callous to form.

Causes

Many disorders can affect the joints in the toes, causing pain and preventing the foot from functioning as it should. A mallet toe occurs when the joint at the end of the toe cannot straighten. Excessive rubbing of the mallet toe against the top of the shoe can lead to pain and the development of a corn. The tip of the toe is often turned down against the shoe causing pressure and discomfort. Arthritis can also lead to many forefoot deformities including mallet toes. Mallet toes can cause extreme discomfort, and can be aggravated if restrictive or improperly fitting footwear is worn for a prolonged period of time.

Hammer ToeSymptoms

The middle joint of the toe is bent. The end part of the toe bends down into a claw-like deformity. At first, you may be able to move and straighten the toe. Over time, you will no longer be able to move the toe. It will be painful. A corn often forms on the top of the toe. A callus is found on the sole of the foot. Walking or wearing shoes can be painful.

Diagnosis

Most health care professionals can diagnose hammertoe simply by examining your toes and feet. X-rays of the feet are not needed to diagnose hammertoe, but they may be useful to look for signs of some types of arthritis (such as rheumatoid arthritis) or other disorders that can cause hammertoe. If the deformed toe is very painful, your doctor may recommend that you have a fluid sample withdrawn from the joint with a needle so the fluid can be checked for signs of infection or gout (arthritis from crystal deposits).

Non Surgical Treatment

Podiatric Care may include using anti-inflammatory oral medications or an injection of medication and local anesthetic to reduce this swelling. When you go to your doctor, x-rays are usually required to evaluate the structure of your foot, check for fractures and determine the cause. The podiatrist may see you to take care of any corns that develop due to the bone deformities. They may advise you on different shoewear or prescribe a custom made orthotic to try and control the foot structure. Padding techniques may be used to straighten the toe if the deformity is flexible, or pads may be used to lessen the pressure on the area of the corn or ulcer. Your podiatric physician may also recommend a surgical procedure to actually fix the structural problem of your foot.

Surgical Treatment

Surgery involves removing a small section of bone from the affected joint through a procedure called arthroplasty. Arthrodesis may also be performed to treat hammertoes, which involves fusing together one of the joints in the toe in order to keep it straight. This procedure requires the use of a metal pin to hold the toe in position while it heals.
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The Treatment And Cause Of Overpronation Of The Foot

Overview

If you've been running long enough, you've most likely had to deal with various aches and pains in your feet, knees, hips or lower back. Plantar fasciitis, achilles tendinitis, IT-band syndrome, meniscus tears, runner's knee, bursitis of the hip or knee, patellofermoral pain syndrome, chondromalacia patella, lower back pain and piriformis syndrome are only some of many conditions an athlete may develop during the course of his or her running career.Pronation

Causes

For those not familiar with the term pronation, you might be familiar with terms related to shoes and pronation such as ?motion control?, ?stability,? and ?neutral cushioned.? The terms motion control and stability are typically associated with the word ?over-pronation? or a foot that is supposedly pronating too much and needs correction. According to the running shoe industry, ?over-pronation? is a biomechanical affliction evident when the foot and or ankle rolls inward past the vertical line created by your leg when standing.

Symptoms

Symptoms can manifest in many different ways. The associated conditions depend on the individual lifestyle of each patient. Here is a list of some of the conditions associated with Over Pronation. Hallux Abducto Valgus (bunions). Hallux Rigidus (stiff 1st toe). Arch Pain. Heel Pain (plantar fascitis). Metatarsalgia (ball of the foot pain). Ankle sprains. Shin Splints. Achilles Tendonitis. Osteochondrosis. Knee Pain. Corns & Calluses. Flat Feet. Hammer Toes.

Diagnosis

Do the wet foot test. Get your feet wet and walk along a paved surface or sand and look at the footprints you leave. If you have neutral feet you will see a print of the heel with a thin strip connecting to your forefoot, but if you're overpronating your foot print will look a bit like a giant blob with toes.Overpronation

Non Surgical Treatment

Orthotics are medical devices used to provide support to correct a physical abnormality. They can provide arch support when needed to remedy over-pronation, and in this particular cases the orthoses used are usually convenient shoe inserts. These can be taken in and out of shoes, and will be carefully tailored by your podiatrist to the specifics of your foot. It can take some weeks before the effects of the inserts can become truly noticeable, and in many cases your podiatrist will want to review your orthotics within a few weeks to make fine adjustments based on how well they have worked to reduce your pain.

Prevention

With every step we take, we place at least half of our body weight on each foot (as we walk faster, or run, we can exert more than twice our body weight on each foot). As this amount of weight is applied to each foot there is a significant shock passed on to our body. Custom-made orthotics will absorb some of this shock, helping to protect our feet, ankles, knees, hips, and lower back.