Why You Should Treat Heel Spur

Calcaneal Spur


Overview


A heel spur is a bony growth at the underside of the heel bone. The underlying cause of heel spurs is a common condition called ?Plantar Fasciitis?. This is Latin for inflammation of the plantar fascia. This tendon forms the arch of the foot, starting at the heel and running to the ball of the foot. Plantar Fasciitis is a persistent and painful condition. Interestingly, in some people a heel spur has been present for a long time, but no pain is felt for years until one day the pain suddenly appears ?out of nothing?.


Causes


Heel spurs can form as a result of repeated strain placed on foot muscles and ligaments as well as from abnormally stretching the band of tissue connecting the heel and ball of the foot. Repeated injury to the membrane that lines the heel bone can also cause problems as can repeated tight pressure on the back of the heel. The causes can range from excessive walking (especially if unaccustomed to walking), running or jumping to improperly fitted or worn-out shoes. Runners, volleyball players, and tennis players, people who do step aerobics or stair climbing for exercise, those with flat feet, pregnant women, the obese and diabetics and those who wear tight-fitting shoes with a high heel are all prone to developing spurs (and plantar fasciitis) more readily.


Inferior Calcaneal Spur


Symptoms


Symptoms of heel spur syndrome often include pain early in the morning or after rest, as you take the first few steps. It may also include severe pain after standing or walking long hours, especially on hard cement floors. Usually more pain exist while wearing a very flat soled shoe. A higher heel may actually relieve the pain as an arch is created. The pain is usually sharp, but can also be a dull ache. The pain may only be at the bottom of the heel, or may also travel along the arch of the foot.


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 some cases, heel spur pain may not be resolved through conservative treatment options. In those cases, cortisone injections may be used to reduce inflammation associated with the condition, helping to reduce discomfort. However, treatment options such as these must be discussed in detail with your physician, since more serious forms of treatment could yield negative side effects, such as atrophy of the heel's fat pad, or the rupture of the plantar fascia ligament. Although such side effects are rare, they are potential problems that could deliver added heel pain.


Surgical Treatment


Approximately 2% of people with painful heel spurs need surgery, meaning that 98 out of 100 people do well with the non-surgical treatments previously described. However, these treatments can sometimes be rather long and drawn out, and may become considerably expensive. Surgery should be considered when conservative treatment is unable to control and prevent the pain. If the pain goes away for a while, and continues to come back off and on, despite conservative treatments, surgery should be considered. If the pain really never goes away, but reaches a plateau, beyond which it does not improve despite conservative treatments, surgery should be considered. If the pain requires three or more injections of "cortisone" into the heel within a twelve month period, surgery should be considered.

tag : Heel Spur,Calcaneal Spur,Inferior Calcaneal Spur,Posterior Spur

Calcaneal Spur Symtoms

Calcaneal Spur


Overview


Heel spur is a thorn-like, bony protrusion of the heel bone, which can become inflamed through irritation, thus causing pain. A heel spur forms at the tendon attachments on the muscles of the heel bone as a result of micro-injuries to the tissue caused by overstraining. As part of the healing process for these micro-injuries, the body stores bone material in the tendon attachments as a repair mechanism. Heel spurs can develop over a very long period without causing major complaints. However, irritation of the area surrounding the ossified tendon attachment can cause inflammations. Left untreated, the inflammations can in turn lead to increased ossification and thus to permanent degradation with a risk of chronic manifestation. The normal rolling procedure that we all use when walking is then frequently no longer possible.


Causes


When a bone is subjected to pressure, rubbing, or other stress over long periods, it tries to repair itself by building extra bone. This extra bone is what is referred to as a ?spur?. Many form as part of the aging process when cartilage breaks down in the joints.


Posterior Calcaneal Spur


Symptoms


Some symptoms at the beginning of this condition include pain and swelling, and discomfort when pushing off with the toes during walking. This movement of the foot stretches the fascia that is already irritated and inflamed. If this condition is not treated, pain will be noticed in the heel when a heel spur develops in response to the stress. This is a common condition among athletes and others who run and jump a significant amount.


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


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


Most studies indicate that 95% of those afflicted with heel spurs are able to relieve their heel pain with nonsurgical treatments. If you are one of the few people whose symptoms don?t improve with other treatments, your doctor may recommend plantar fascia release surgery. Plantar fascia release involves cutting part of the plantar fascia ligament in order to release the tension and relieve the inflammation of the ligament. Sometimes the bone spur is also removed, if there is a large spur (remember that the bone spur is rarely a cause of pain. Overall, the success rate of surgical release is 70 to 90 percent in patients with heel spurs. One should always be sure to understand all the risks associated with any surgery they are considering.

tag : Heel Spur,Calcaneal Spur,Inferior Calcaneal Spur,Posterior Spur

Bursitis Of The Foot Therapy

Overview


A Bursa is a small fluid filled sac that forms in areas of extra rubbing and friction. They are usually present with a bone deformity as the bone is pressed against other structures like a tendon or against the ground as you walk. The bursa acts as a shock absorber and is a way for your body to protect you from damage. When this bursa or sac like structure becomes swollen and inflammed it is called bursitis. The bursa may be anatomical meaning normally present, or it may be adventitious meaning, only present because of a problem. Many bursa are present and do not cause pain.


Causes


Age. Bursitis is more common during middle age due to repetitive activities that put wear and tear on the body over time. Certain activities or occupations. If your job or hobby involves repetitive motion or puts pressure on bursae, you have a higher likelihood of developing bursitis. Reaching overhead, leaning elbows on arm rests, crossing your legs, laying carpet, setting tile, gardening, biking, playing baseball and ice skating are some activities that, when repeated very often, can put you at increased risk of developing bursitis. Sports in which you may get hit in the knee or fall to the knees, such as football, can also increase the risk. Some medical or health conditions. Rheumatoid arthritis, osteoarthritis, gout, thyroid disease, diabetes, alcoholism and some immunosuppressive disorders can increase the risk of bursitis. The reasons can vary, from cartilage breakdown around joints (arthritis) to crystals in the bursa that cause inflammation (gout). Wearing high heels. Posterior Achilles tendon bursitis occurs when the bursa located between the skin and the Achilles tendon (the band of tissue that attaches the calf muscle to the heel bone) becomes inflamed. High heels are often to blame for this, the stiff heel can put direct pressure on the bursa between the skin and the Achilles tendon.


Symptoms


Posterior heel pain is the chief complaint in individuals with calcaneal bursitis. Patients may report limping caused by the posterior heel pain. Some individuals may also report an obvious swelling (eg, a pump bump, a term that presumably comes from the swelling's association with high-heeled shoes or pumps). The condition may be unilateral or bilateral. Symptoms are often worse when the patient first begins an activity after rest.


Diagnosis


If heel pain has not responded to home treatment, X-rays may be ordered. These images can show deformities of the heel bone and bone spurs that have developed at the attachment of the Achilles. If there is swelling and/or pain that is slightly higher and within the Achilles tendon itself, an MRI may be ordered to determine if the tendon is simply inflamed or if there is a chronic tear on the tendon. Aspiration and lab tests. If a septic bursitis is highly suspected, a doctor may perform an aspiration, removing fluid from the bursa with a needle and syringe. In addition to relieving pressure and making the patient more comfortable, it provides a fluid sample that can be tested for infection.


Non Surgical Treatment


Rest and apply cold therapy or ice. Ice should not be applied directly to the skin as it may cause ice burns but wrap in a wet tea towel. Commercially available hot and cold packs are often more convenience than using ice. Taping the bursa with a donut shaped pad to take some of the pressure from footwear may help. A doctor may prescribe anti-inflammatory medication e.g. ibuprofen to reduce the pain and inflammation. Applying electrotherapy such as ultrasound may reduce inflammation and swelling. A steroid injection followed by 48 hours rest may be given for persistent cases. If the bursitis is particularly bad and does not respond to conservative treatment then surgery is also an option.


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.


Prevention


People can lower the risk of bursitis by gradually strengthening and stretching the muscles around the joints and taking regular breaks from repetitive motion that might irritate bursae. Prolonged time resting on the elbows or kneeling should be avoided, if it cannot be avoided, wearing cushioned elbow and knee pads can help protect the bursae. Comfortable, supportive, low-heeled shoes can help prevent bursitis in the foot.

tag : Foot Pain, Bursitis

Hammer Toe Surgery Physical Therapy

Hammer ToeOverview


A hammertoes is a term used to describe a crooked, deviated, or contracted toe. Although the condition usually stems from muscle imbalance, it is often aggravated by poor-fitting shoes or socks that cramp the toes. Over a period of years, the tendons that move the toe up and down begin to pull the toe with unequal tension, and the toe then begins to buckle or become contracted, causing an abnormal "v"-shaped bending of the little toes. Patients with this condition often experience pain, swelling, redness and stiffness in the affected toes.


Causes


Your toe contains two joints that allow it to bend at the middle and bottom. A hammertoe occurs when the middle joint becomes dislocated. Common causes of this joint dislocation include a toe injury, arthritis, a high foot arch, wearing shoes that don?t fit properly, tightened ligaments or tendons in the foot, pressure from a bunion (when your big toe points inward toward your second toe) Spinal cord or peripheral nerve damage may cause all of your toes to curl downward.


HammertoeSymptoms


The symptoms of a hammer toe are usually first noticed when a corn develops on the top of the toe and becomes painful, usually when wearing tight shoes. There may be a bursa under the corn or instead of a corn, depending on the pressure. Most of the symptoms are due to pressure from footwear on the toe. There may be a callus under the metatarsal head at the base of the toe. Initially a hammer toe is usually flexible, but when longstanding it becomes more rigid.


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.


Non Surgical Treatment


Treating hammertoe involves straightening the toe, making tendons in the toes flexible again, and preventing the problem from returning. Some hammertoes simple treatments include splinting the toe to keep it straight and to stretch the tendons of the foot. Using over-the-counter pads, cushions or straps to decrease discomfort Exercising the toes to relax the foot tendons (a session with a physical therapist may help you get started with foot exercises) Wearing shoes that fit properly and allow toes plenty of room to stretch out.


Surgical Treatment


If your toe is not bendable, your doctor may recommend surgery. The type of surgery that will be performed will depend on the severity of the condition. You should expect blood and urine studies before the procedure, as well as x-rays of your feet. Your doctor will inject either a local or regional anesthetic. If your toe has some flexibility, the doctor may be able to straighten it by simply making an incision in the toe to release or lengthen the tendon. If the toe is not flexible, your doctor will probably make the same incision to release the tendon, but he or she may also remove some pieces of the bone so that the bone can be straightened. A k-wire is placed in the toe to help hold it straight while it is healing. This is taken out after about four weeks.


HammertoePrevention


These tips may help you buy the right shoes. Buy shoes at the end of the day. Your feet are smaller in the morning and swell throughout the day. Don't assume your shoe size hasn't changed. As you age, your shoe size may change, especially the width. Measure both feet and buy for the larger foot. Ask for just the right fit. A shoe repair store can stretch shoes in tight spots.

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Hammertoes Treatment

HammertoeOverview


A hammertoes is a deformity of the second, third or fourth toes in which the main toe joint is bent upward like a claw. Initially, hammertoes are flexible and can be corrected with simple measures. Left untreated, they can become fixed and require surgery. Hammertoe results from shoes that don?t fit properly or a muscle imbalance, usually in combination with one or more other factors. Muscles work in pairs to straighten and bend the toes. If the toe is bent and held in one position long enough, the muscles tighten and can?t stretch out.


Causes


Hammer toe most frequently results from wearing poorly fitting shoes that can force the toe into a bent position, such as excessively high heels or shoes that are too short or narrow for the foot. Having the toes bent for long periods of time can cause the muscles in them to shorten, resulting in the hammer toe deformity. This is often found in conjunction with bunions or other foot problem (e.g., a bunion can force the big toe to turn inward and push the other toes). It can also be caused by muscle, nerve, or joint damage resulting from conditions such as osteoarthritis, rheumatoid arthritis, stroke, Charcot-Marie-Tooth disease, complex regional pain syndrome or diabetes. Hammer toe can also be found in Friedreich's ataxia.


HammertoeSymptoms


A toe (usually the second digit, next to the big toe) bent at the middle joint and clenched into a painful, clawlike position. As the toe points downward, the middle joint may protrude upward. A toe with an end joint that curls under itself. Painful calluses or corns. Redness or a painful corn on top of the bent joint or at the tip of the affected toe, because of persistent rubbing against shoes Pain in the toes that interferes with walking, jogging, dancing, and other normal activities, possibly leading to gait changes.


Diagnosis


The treatment options vary with the type and severity of each hammer toe, although identifying the deformity early in its development is important to avoid surgery. Your podiatric physician will examine and X-ray the affected area and recommend a treatment plan specific to your condition.


Non Surgical Treatment


Your podiatrist may recommend conservative treatment techniques for your hammertoes based on your foot structure, which will likely involve removing any thick, painful skin, padding your painful area, and recommending for you shoes that give your curled toes adequate room. Conservative care strategies for this health purpose may also involve the use of Correct Toes, our toe straightening and toe spacing device.


Surgical Treatment


Surgery is used when other types of treatment fail to relieve symptoms or for advanced cases of hammertoe. There are several types of surgeries to treat hammertoe. A small piece of bone may be removed from the joint (arthroplasty). The toe joint may be fused to straighten it (arthrodesis). Surgical hardware, such Hammer toe as a pin, may be used to hold the bones in place while they heal. Other types of surgery involve removing skin (wedging) or correcting muscles and tendons to balance the joint.


Hammer ToePrevention


The best ways to prevent a hammertoe are. Wear shoes that fit well. Shoes should be one-half inch longer than your longest toe. Shoes should be wide enough and the toe box should be high enough to give the foot room to move. Don?t wear shoes with heels over 2 inches high. If a toe starts to look like a hammertoe, buy shoes that have an extra high toe box. Wear corn pad removers or cushion pads on top of the affected toe. See your healthcare provider any time you have foot pain that does not go away quickly or is more than mild pain. Foot pain is not normal.

tag : Hammer Toes

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