Posterior Calcaneal Spur Treatment

posted on 26 Sep 2015 14:13 by prettygrump4607
Inferior Calcaneal Spur

Overview

A calcaneal spur (or heel spur) is a small osteophyte (bone spur) located on the calcaneus (heel bone). Calcaneal spurs are typically detected by a radiological examination (X-ray). When a foot bone is exposed to constant stress, calcium deposits build up on the bottom of the heel bone. Generally, this has no effect on a person's daily life. However, repeated damage can cause these deposits to pile up on each other,causing a spur-shaped deformity, called a calcaneal (or heel) spur. Obese people, flatfooted people, and women who constantly wear high-heeled shoes are most susceptible to heel spurs. An inferior calcaneal spur is located on the inferior aspect of the calcaneus and is typically a response to plantar fasciitis over a period, but may also be associated with ankylosing spondylitis (typically in children). A posterior calcaneal spur develops on the back of the heel at the insertion of the Achilles tendon. An inferior calcaneal spur consists of a calcification of the calcaneus, which lies superior to the plantar fascia at the insertion of the plantar fascia. A posterior calcaneal spur is often large and palpable through the skin and may need to be removed as part of the treatment of insertional Achilles tendonitis. These are also generally visible to the naked eye.

Causes

Bone spurs can occur all over the body including the spine, shoulders, hands, hips and feet. The feet are a common place to find them. A heel spur happens when the body tries to mend itself. Building extra bone is one way your body tries to correct a weakness. Wearing shoes that are too tight in the heel can cause bone spurs. More women than men get heel spurs because of the kinds of shoes they wear. Athletes who stress their feet and legs routinely are also prone to heel spurs. Being overweight can also indirectly cause heel spurs by over-exerting the plantar fascia. Some heel spurs are caused by the aging process, in which the cartilage covering the ends of bones wears away. This process can lead to pain, swelling and spur formation. Stress-related problems with the plantar fascia frequently lead to heel spurs.

Heel Spur

Symptoms

An individual with the lower legs turning inward, a condition called genu valgus or "knock knees," can have a tendency toward excessive pronation. This can lead to a fallen arch and problems with the plantar fascia and heel spurs. Women tend to suffer from this condition more than men. Heel spurs can also result from an abnormally high arch. Other factors leading to heel spurs include a sudden increase in daily activities, an increase in weight, or a thinner cushion on the bottom of the heel due to old age. A significant increase in training intensity or duration may cause inflammation of the plantar fascia. High-heeled shoes, improperly fitted shoes, and shoes that are too flexible in the middle of the arch or bend before the toe joints will cause problems with the plantar fascia and possibly lead to heel spurs.

Diagnosis

Most patients who are suffering with heel spurs can see them with an X-ray scan. They are normally hooked and extend into the heel. Some people who have heel spur may not even have noticeable symptoms, although could still be able to see a spur in an X-ray scan.

Non Surgical Treatment

Exercise. If you think your pain is exercise-related, change your exercise routine, environment, or foot-ware, and emphasize movements and/or body parts that do not cause pain. Mind/Body. Occasionally foot pain can be related to stress. The body may respond with generalized tension that contributes to pain in many areas, including the feet. Hypnosis and guided imagery are worth exploring if an anatomical problem is not apparent. Supplements. Natural anti-inflammatories can be just as effective as ibuprofen or other over-the-counter pain relievers with fewer side effects. Try one of the following. Ginger (Zingiber officinale) standardized to 5-6% gingerols and 6% shogoals, take one to two 500 mg tablets three to four times daily. Turmeric (Curcuma longa) standardized to 95% curcuminoids, take 400-600 mg three times daily. Also, be sure that you're wearing well-fitting shoes, the proper shoes for each activity, and that you buy new foot-ware as soon as you notice signs of wear. You can also take the pressure off your heel with a donut-shaped heel cushion or a heel-raising pad placed in your shoe. Acupuncture can also relieve the pain, as can for some sufferers, magnetic shoe inserts, although the evidence behind their effectiveness is not conclusive. Osteopathic or chiropractic manipulation can help with soft tissue pain in and around the feet.

Surgical Treatment

Surgery is used a very small percentage of the time. It is usually considered after trying non-surgical treatments for at least a year. Plantar fascia release surgery is use to relax the plantar fascia. This surgery is commonly paired with tarsal tunnel release surgery. Surgery is successful for the majority of people.

Bursitis Foot Pads

posted on 23 Aug 2015 06:53 by prettygrump4607
Overview

Do you experience pain at the back of your heel? Is the back of your heel red and swollen? And you were told that it might Achilles Tendonitis? But so far treatment for Achilles Tendonitis does not seem to be working? You might be suffering instead from Retrocalcaneal Bursitis.

Causes

Bursitis occurs when the synovial lining becomes thickened and produces excessive fluid, leading to localized swelling and pain. It most commonly affects the subacromial, olecranon, trochanteric, prepatellar, and infrapatellar bursae. Symptoms of bursitis may include localized tenderness, pain, edema, erythema, or reduced movement. Pain is aggravated by movement of the specific joint, tendon, or both.

Symptoms

Pain at the back of the heel at the attachment site of the Achilles tendon when running. Pain on palpation of the back of the heel or bottom of heel. Pain when standing on tiptoes. Swelling and redness at the back and bottom of the heel.

Diagnosis

Your doctor will check for bursitis by asking questions about your past health and recent activities and by examining the area. If your symptoms are severe or get worse even after treatment, you may need other tests. Your doctor may drain fluid from the bursa through a needle (aspiration) and test it for infection. Or you may need X-rays, an MRI, or an ultrasound.

Non Surgical Treatment

Home treatment is often enough to reduce pain and let the bursa heal. Your doctor may suggest physical therapy to strengthen the muscles around your joints. Rest the affected area. Avoid any activity or direct pressure that may cause pain. Apply ice or cold packs as soon as you notice pain in your muscles or near a joint. Apply ice 10 to 15 minutes at a time, as often as twice an hour, for 3 days (72 hours). You can try heat, or alternating heat and ice, after the first 72 hours. Use pain relievers. Use nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen or naproxen, to reduce pain and inflammation. NSAIDs come in pills and also in a cream that you rub over the sore area. Acetaminophen (such as Tylenol) can also help with pain. Don't rely on medicine to relieve pain so that you can keep overusing the joint. Do range-of-motion exercises each day. If your bursitis is in or near a joint, gently move the joint through its full range of motion, even during the time that you are resting the joint area. This will prevent stiffness. As the pain goes away, add other exercises to strengthen the muscles around your joint. Avoid tobacco smoke.Smoking delays wound and tissue healing. If you have severe bursitis, your doctor may use a needle to remove extra fluid from the bursa. You might wear a pressure bandage on the area. Your doctor may also give you a shot of medicine to reduce swelling. Some people need surgery to drain or remove the bursa. Sometimes the fluid in the bursa can get infected. If this happens, you may need antibiotics. Bursitis is likely to improve in a few days or weeks if you rest and treat the affected area. But it may return if you don't stretch and strengthen the muscles around the joint and change the way you do some activities.

Prevention

You can help to prevent heel pain and bursitis by maintaining a healthy weight, by warming up before participating in sports and by wearing shoes that support the arch of the foot and cushion the heel. If you are prone to plantar fasciitis, exercises that stretch the Achilles tendon (heel cord) and plantar fascia may help to prevent the area from being injured again. You also can massage the soles of your feet with ice after stressful athletic activities. Sometimes, the only interventions needed are a brief period of rest and new walking or running shoes.

Hammer Toe Surgery Procedures

posted on 05 Jul 2015 12:58 by prettygrump4607
HammertoeOverview

Hammer toes is a Z-shaped deformity caused by dorsal subluxation at the metatarsophalangeal joint. Diagnosis is clinical. Treatment is modification of footwear and/or orthotics. The usual cause is misalignment of the joint surfaces due to a genetic predisposition toward aberrant foot biomechanics and tendon contractures. RA and neurologic disorders such as Charcot-Marie-Tooth Hammer toe disease are other causes.

Causes

Flat feet can result in hammertoes, this is due to poor mechanics off the foot. High arched feet can also result in buckling toes. A major cause is in hereditary, all the toe conditions mentioned could be acquired due in hereditary factors. Bunions are a major cause of hammertoes. Claw toes are usually the result of a shoe that is too short. For many people, the second toe is actually longer than the great toe, and if shoes are sized to fit the great toe, the second (and maybe even the third toe) will have to bend to fit into the shoe. Shoes that are pointed make matters even worse. Combine pointed shoes with high heels, the foot is under similar pressure as if it was constantly being pushed downhill into a wall. Rheumatoid arthritis can also lead to bunions, which in turn can lead to hammer toes.

Hammer ToeSymptoms

If you have any of these symptoms, do not assume it is due to hammer toe. Talk to your doctor about symptoms such as a toe that curls down, corns on the top of a toe, calluses on the sole of the foot or bottom of the toe, pain in the middle joint of a toe, discomfort on the top of a toe, difficulty finding any shoes that fit comfortably, cramping in a toe, and sometimes also the foot and leg, difficult or painful motion of a toe joint, pain in the ball of the foot or at the base of a 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

Treating hammertoe involves straightening the toe, making tendons in the toes flexible again, and preventing the problem from returning. Some simple treatments include Soaking your feet every day in warm water, then stretching your toes and ankles by pointing your toes. Using over-the-counter pads, cushions or straps to decrease discomfort. Splinting the toe to keep it straight and to stretch the tendons of the foot. Exercising the toes to relax the foot tendons (a session with a physical therapist may help you get started with foot exercises). One simple exercise is to place a small towel on the floor and then pick it up using only your toes. You also can grasp at carpet with your toes or curl your toes up and down repeatedly. Wearing shoes that fit properly and give toes plenty of room to stretch out.

Surgical Treatment

If this fails or if treatment is not sought until the toes are permanently misaligned, then surgery may be required. Surgery may involve either cutting the tendon or fusing the joint. Congenital conditions should be treated in early childhood with manipulations and splinting.

HammertoePrevention

The best first step you can take is to evaluate your shoe choices. Ditch any shoes that aren?t serving your feet well. Shoes that crowd the front of your foot, especially around your toes, aggravate the existing condition and can also cause the condition to develop. If you suspect the development of hammertoe, you may also try using protective pads to prevent irritation and the development of corns. Custom orthotics to correct muscle imbalances in your feet may also help prevent hammertoe.