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Mortons Neuroma Treatment

Overview

MortonNeuromas are generally benign or non-cancerous growths of nerve tissue, developing in various parts of the body. Morton?s Neuromas are confined to the nerves of the foot, most commonly, between the third and fourth toes. The condition involves a thickening of the tissue around one of the digital nerves leading to the toes and does not qualify as an actual tumor. The affliction causes a sharp, burning pain, usually in the region of the ball of the foot. A patient?s toes may also sting, burn or exhibit numbness. Often, the symptoms have been likened to ?walking on a marble.?

Causes

The pain of Morton's neuroma occurs when the nerve connecting the toe bones (metatarsal bones) becomes irritated or compressed. The exact cause of the irritation is unknown, but it may be the metatarsal bones pressing against the nerve when the gap between the bones is narrow. This causes the nerve and surrounding tissue to thicken. Some experts believe that a number of other foot problems, including flat feet, high foot arches, bunions and hammer toes, may also play a role in Morton's neuroma.

Symptoms

Patients will feel pain that worsens with walking, particularly when walking in shoes with thin soles or high heels. Also, anything that squeezes the metatarsal heads together may aggravate symptoms, such as narrow shoes. A patient may feel the need to remove the shoe and rub the foot to soothe the pain.

Diagnosis

In some cases your doctor will be able to feel the Morton's as a swelling in the middle of your foot. However they may also suggest an X-ray or a blood test - this is normally to rule our other causes of the pain such as arthritis. The most accurate way to diagnose Morton?s itself is with magnetic resonance imaging (MRI) or ultrasound.

Non Surgical Treatment

Anti-inflammatory drugs may be recommended to dull the pain and lessen swelling. Neuropathic pain medications such as the antionvulsants and / or antidepressants may be tried as well. Many are able to recover from this issue at home by icing the area, resting the feet, and by avoiding wearing narrow or tight shoes. If these remedies do not work to alleviate symptoms, the doctor may give special devices to separate the toes and avoid the squeezing of the nerve. Steroid injections may reduce pain and swelling. Surgery may be required if these do not help.intermetatarsal 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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Podiatrists Prefer Shoe Lifts For Leg Length Difference

There are actually two different types of leg length discrepancies, congenital and acquired. Congenital indicates that you are born with it. One leg is structurally shorter than the other. Through developmental stages of aging, the human brain senses the gait pattern and identifies some variance. The body usually adapts by tilting one shoulder over to the "short" side. A difference of less than a quarter inch isn't really excessive, demand Shoe Lifts to compensate and ordinarily won't have a serious effect over a lifetime.

Shoe Lift

Leg length inequality goes typically undiagnosed on a daily basis, yet this issue is very easily corrected, and can reduce numerous cases of back discomfort.

Treatment for leg length inequality typically involves Shoe Lifts. These are typically cost-effective, often costing less than twenty dollars, compared to a custom orthotic of $200 plus. 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.

Chronic back pain is easily the most widespread health problem afflicting men and women today. Over 80 million people experience back pain at some point in their life. It is a problem which costs businesses vast amounts of money every year as a result of lost time and production. Innovative and more effective treatment solutions are always sought after in the hope of decreasing the economic influence this condition causes.

Shoe Lift

Men and women from all corners of the world suffer the pain of foot ache as a result of leg length discrepancy. In these situations Shoe Lifts are usually of worthwhile. The lifts are capable of reducing any pain in the feet. Shoe Lifts are recommended by numerous qualified orthopaedic doctors.

To be able to support the body in a well-balanced manner, the feet have got a very important role to play. Irrespective of that, it is often the most neglected area of the body. Some people have flat-feet which means there is unequal force placed on the feet. This will cause other areas of the body such as knees, ankles and backs to be impacted too. Shoe Lifts make sure that appropriate posture and balance are restored.

Diagnosing Calcaneal Spur

Calcaneal Spur

Overview

A heel spur is a pointed bony outgrowth of the bone of the heel (the calcaneus bone). They are attributed to chronic local inflammation at the insertion of soft tissue tendons or fascia in the area. Heel spurs can be located at the back of the heel or under the heel, beneath the sole of the foot. Heel spurs at the back of the heel are frequently associated with inflammation of the Achilles tendon (tendinitis) and cause tenderness and pain at the back of the heel made worse while pushing off the ball of the foot.

Causes

Some causes of heel spurs include abnormal or lopsided walking, which places excessive stress on the heel bone, ligaments and nerves Running, jogging or jumping, especially on hard surfaces. Poorly fitted or badly worn shoes, especially those lacking appropriate arch support, excess weight and obesity.

Posterior Calcaneal Spur

Symptoms

Most bone spurs cause no signs or symptoms. You might not realize you have bone spurs until an X-ray for another condition reveals the growths. In some cases, though, bone spurs can cause pain and loss of motion in your joints.

Diagnosis

Sharp pain localized to the heel may be all a doctor needs to understand in order to diagnose the presence of heel spurs. However, you may also be sent to a radiologist for X-rays to confirm the presence of heel spurs.

Non Surgical Treatment

By reducing excessive motion and controlling and supporting the foot during physical activities an orthotic can help to limit how far the plantar fascia is pulled or torn away from the heel. A Heel Spur pad can be offered- which is a pad designed to take pressure off the spur. If the problem persists, consult your foot doctor.

Surgical Treatment

Heel spur surgery should only be considered after less invasive treatment methods have been explored and ruled insufficient. The traditional surgical approach to treating heel spurs requires a scalpel cut to the bottom of the food which allows the surgeon to access the bone spur. Endoscopic plantar fasciotomies (EPF) involve one or two small incisions in the foot which allow the surgeon to access and operate on the bone spur endoscopically. Taking a surgical approach to heel spur treatment is a topic to explore with a foot and ankle specialist.
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Diagnosing Inferior Calcaneal Spur

Heel Spur

Overview

A heel spur is a pointed bony outgrowth of the bone of the heel (the calcaneus bone). Heel spurs under the sole of the foot (plantar area) are associated with plantar fasciitis. Heel spurs and plantar fasciitis can occur alone or be related to underlying diseases. Heel spurs and plantar fasciitis are treated by measures that decrease the associated inflammation and avoid reinjury.

Causes

Though this syndrome is most common in individuals 40 years or older, it can occur at any age. The following factors increase the likelihood of heel spur development. An uneven gait which applies too much pressure to certain areas of the foot. Being overweight. Wearing worn shoes or ill-fitting footwear. Job conditions that require long periods spent standing or lifting heavy objects. The normal aging process which results in a decrease in ligament elasticity.

Heel Spur

Symptoms

Pain and discomfort associated with heel spurs does not occur from the spur itself. The bone growth itself has no feeling. However, as you move, this growth digs into sensitive nerves and tissue along the heel of the foot, resulting in severe pain. Pain can also be generated when pushing off with the toes while walking. Swelling along the heel is also common.

Diagnosis

A thorough history and physical exam 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

Perform some exercises. Exercises that strengthen and lengthen your plantar fascia can also be very helpful for heel spurs. Try some of the following activities. Calf stretch. Place your hands on a wall. Extend 1 foot (0.3 m) behind you with your knee straight and place the other foot in front of you with the knee bent. Push your hips toward the wall and hold the stretch for 10 seconds. You should feel a pull in your calf muscles. Repeat the stretch 20 times for each foot. Plantar fascia stretch, Perform this exercise in the morning before you've done any standing or walking. Cross your injured foot over the knee of your other leg. Grasp your toes and gently pull them toward you. If you can't reach your toes, then wrap a towel around them and pull on the towel. Hold the stretch for 10 seconds and repeat 20 times for each foot.

Surgical Treatment

Surgery, which is a more radical treatment, can be a permanent correction to remove the spur itself. If your doctor believes that surgery is indicated, he will recommend an operation - but only after establishing that less drastic methods of treatment are not successful.
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Bursitis Foot Pain Signs And Symptoms

Overview

A bursa is a fluid-containing sac that is present at many areas of pressure on the body. Its job is to protect these areas of pressure by being a shock absorber. A bursitis is an abnormal inflammation of the bursa sac caused by abnormal excessive pressure, stress and/ or strain over the area it is protecting. On the heel bone, there are two bursa sacs: one on the bottom and the other on the back. Specifically on the bottom of the heel, it is known as an Inferior (bottom) Calcaneal (heel) Bursa. On the back of the heel, it is called the Retro (back) Calcaneal Bursa. When either of these bursas become abnormally stressed, strained, or swollen, the result is bursitis of the heel. It is this bursitis that is the reason for pain in the heel upon arising (Poststatic Dyskinesia) in the morning or after resting for a while. You can either develop these bursitises with or without the presence of heel spur (explanation to follow). As stated before, Morton?s Toe can cause this by causing over pronation in the foot.

Causes

Improper foot wear, tight shoes or shoes that do not fit properly can cause extra pressure and friction on the back of the heel. Overtime, this pressure causes irritation of the bursae that protects the Achilles tendon causing one or both to swell and become inflamed. Athletes who overtrain or runners that increase their distance to quickly are at greater risk of experiencing Achilles bursitis. With over use, the Achilles bursae and tendon can become irritated and inflamed leading to thickening of the bursae lining and wearing of the tendon. Fluid builds in the bursa when it becomes irritated causing swelling of the Achilles bursa and pain at the back of the heel.

Symptoms

Common signs and symptoms associated with infracalcaneal bursitis include redness under the heel. Pain and swelling under the heel. Pain or ache in the middle part of the underside of the heel. Heel pain or discomfort that increases with prolonged weight-bearing activities.

Diagnosis

When a patient has pain in a joint, a careful physical examination is needed to determine what type of movement is affected and if there is any swelling present. Bursitis will not show up on x-rays, although sometimes there are also calcium deposits in the joint that can be seen. Inserting a thin needle into the affected bursa and removing (aspirating) some of the synovial fluid for examination can confirm the diagnosis. In most cases, the fluid will not be clear. It can be tested for the presence of microorganisms, which would indicate an infection, and crystals, which could indicate gout. In instances where the diagnosis is difficult, a local anesthetic (a drug that numbs the area) is injected into the painful spot. If the discomfort stops temporarily, then bursitis is probably the correct diagnosis.

Non Surgical Treatment

With anterior and posterior Achilles tendon bursitis, applying warm or cool compresses to the area and using nonsteroidal anti-inflammatory drugs (NSAIDs) can temporarily relieve the pain and inflammation, as can injections of a corticosteroid/anesthetic mixture into the inflamed bursa. The doctor is careful not to inject the mixture into the tendon. After this treatment, the person should rest. When these treatments are not effective, part of the heel bone may need to be surgically removed.

Surgical Treatment

Surgery to remove the damaged bursa may be performed in extreme cases. If the bursitis is caused by an infection, then additional treatment is needed. Septic bursitis is caused by the presence of a pus-forming organism, usually staphylococcus aureus. This is confirmed by examining a sample of the fluid in the bursa and requires treatment with antibiotics taken by mouth, injected into a muscle or into a vein (intravenously). The bursa will also need to be drained by needle two or three times over the first week of treatment. When a patient has such a serious infection, there may be underlying causes. There could be undiscovered diabetes, or an inefficient immune system caused by human immunodeficiency virus infection (HIV).

Prevention

To prevent bursitis of the heel in the first place, always keep proper form during exercise. In addition, don?t jump into exercises that are too intense without building up to them. Strengthen and flex your ankle.
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Hammer Toe Repair Surgery

Hammer ToeOverview

A hammertoes occurs when the middle of the toe points upwards abnormally. This most often occurs in the second toe, and is often the result of a big toe bunion pushing on the second toe. A painful callous often forms on top of the first joint in the toe. Treatment of a hammer toe may consist of simple padding of the callous on top of the toe, as well as buying appropriate footwear. The best shoes for patients with a hammer toe will have a wide toebox, no pressure on the end of the toe, and will not press on a bunion (which may cause worsening of the hammer toe).

Causes

People who have a high-arched feet have an increased chance of hammer toes occurring. Also, patients with bunion deformities notice the second toe elevating and becoming hammered to make room for the big toe that is moving toward it. Some patients damage the ligament that holds the toe in place at the bottom of the joint that connects the toe and foot. When this ligament (plantar plate) is disrupted or torn, the toe floats upward at this joint. Hammer toes also occur in women wearing ill-fitting shoes or high heels, and children wearing shoes they have outgrown.

Hammer ToeSymptoms

A hammertoe may be present but not always painful unless irritated by shoes. One may have enlarged toe joints with some thickened skin and no redness or swelling. However, if shoes create pressure on the joint, the pain will usually range from pinching and squeezing to sharp and burning. In long standing conditions, the dislocated joints can cause the pain of arthritis.

Diagnosis

Although hammertoes are readily apparent, to arrive at a diagnosis the foot and ankle surgeon will obtain a thorough history of your symptoms and examine your foot. During the physical examination, the doctor may attempt to reproduce your symptoms by manipulating your foot and will study the contractures of the toes. In addition, the foot and ankle surgeon may take x-rays to determine the degree of the deformities and assess any changes that may have occurred.

Non Surgical Treatment

If the affected toe is still flexible, you may be able to treat it by taping or splinting the toe to hold it straight. Your family doctor can show you how to do this. You Hammer toe may also try corrective footwear, corn pads and other devices to reduce pain. You may need to do certain exercises to keep your toe joints flexible. For example, you may need to move and stretch your toe gently with your hands. You can also exercise by picking things up with your toes. Small or soft objects, such as marbles or towels, work best. If your hammer toe becomes painful, you may need to apply an ice pack several times a day. This can help relieve the soreness and swelling. Nonsteroidal anti-inflammatory medicines (also called NSAIDs), such as ibuprofen (two brand names: Advil, Motrin) or naproxen (one brand name: Aleve), may be helpful. If your pain and swelling are severe, your doctor may need to give you a steroid injection in the toe joint.

Surgical Treatment

If conservative treatments fail and your symptoms persist, the doctor may recommend a surgical option to straighten the toe. The procedures used vary greatly, depending upon the reasons for the hammertoe. There are a number of different operations to correct hammertoes, the most common ones involve Soft tissue corrections such as tendon transfers, tendon lengthening, and joint capsule repairs. Digital arthroplasty involves removal of bone from the bent joint to allow the toe to straighten. The temporary use of pins or K-wires may be necessary to keep the toe straight during the healing period. Joint implants are sometimes used to allow for a better range of motion in the toe following surgery. Digital arthrodesis involves the removal of bone from the bent joint and fusing the toe in a straight position. If the corn is due to a bone spur, the most common procedure used is an exostectomy, in which surgically removing it or filing it down removes the bone spur. Because of the possible complications involved with any surgery, one should be sure to understand the risks that may be involved with surgery to correct hammertoes and remove bone spurs.

HammertoePrevention

To help prevent hammertoe, wear roomy, low-heeled shoes that allow plenty of width and length for the toes. The Mayo Clinic recommends wearing shoes that have at least 1/2 inch of space between the shoe and the longest toe.
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Hammer Toe Relief

Hammer ToeOverview

A Hammer toes is a toe that becomes permanently bent in the middle so that the end of the toe points downward. The portion of the toe before the joint where the bend occurs tends to arch upward. A hammer toe takes years to develop. Once the toe becomes permanently bent, corns or calluses may form. Treatment helps control symptoms in many people, but surgery is sometimes needed to straighten the toe.

Causes

The cause of hammertoes varies, but causes include genetics, arthritis and injury to the toe. Treatment for hammertoes depends on the severity and can include anti-inflammatory medication, metatarsal pads, foot exercises and better-fitting shoes. If the pain caused by a hammertoe is so severe that wearing a shoe is uncomfortable, surgery may be necessary. Typically this surgery is an outpatient procedure that doesn?t require general anesthesia, though it is an option. Recovery from surgery usually takes a few weeks, and patients are given special shoes to wear.

Hammer ToeSymptoms

The symptoms of a hammer toe include the following. Pain at the top of the bent toe upon pressure from footwear. Formation of corns on the top of the joint. Redness and swelling at the joint contracture. Restricted or painful motion of the toe joint. Pain in the ball of the foot at the base of the affected toe.

Diagnosis

Although hammertoes are readily apparent, to arrive at a diagnosis the foot and ankle surgeon will obtain a thorough history of your symptoms and examine your foot. During the physical examination, the doctor may attempt to reproduce your symptoms by manipulating your foot and will study the contractures of the toes. In addition, the foot and ankle surgeon may take x-rays to determine the degree of the deformities and assess any changes that may have occurred.

Non Surgical Treatment

There is a variety of treatment options for hammertoe. The treatment your foot and ankle surgeon selects will depend upon the severity of your hammertoe and other factors. A number of non-surgical measures can be undertaken. Padding corns and calluses. Your foot and ankle surgeon can provide or prescribe pads designed to shield corns Hammer toe from irritation. If you want to try over-the-counter pads, avoid the medicated types. Medicated pads are generally not recommended because they may contain a small amount of acid that can be harmful. Consult your surgeon about this option. Changes in shoewear. Avoid shoes with pointed toes, shoes that are too short, or shoes with high heels, conditions that can force your toe against the front of the shoe. Instead, choose comfortable shoes with a deep, roomy toe box and heels no higher than two inches. Orthotic devices. A custom orthotic device placed in your shoe may help control the muscle/tendon imbalance. Injection therapy. Corticosteroid injections are sometimes used to ease pain and inflammation caused by hammertoe. Medications. Oral nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, may be recommended to reduce pain and inflammation. Splinting/strapping. Splints or small straps may be applied by the surgeon to realign the bent toe.

Surgical Treatment

Surgery may be the treatment of choice if conservative approaches prove unsuccessful. Usually performed as an outpatient procedure, the specific surgery will depend on the type and extent of injury to the toe. Recovery my take several days or weeks and you may experience some redness, stiffness and swelling of the affected toe. Your physician will recommend taking it easy and to keep your foot elevated while you recover.
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