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Sep272015

Diagnosing Posterior Calcaneal Spur

Heel Spur


Overview


Heel spurs are abnormal bony growths that develop at the back of or under the heel. Inflammation around a spur, more so than the spur itself, can cause significant pain. Fortunately, symptoms can be eased with non-surgical treatments for the vast majority of people.


Causes


Heel spurs under the sole of the foot (plantar area) are associated with inflammation of the plantar fascia (fasciitis), the "bowstring-like" tissue stretching underneath the sole that attaches at the heel. Plantar heel spurs cause localized tenderness and pain made worse when stepping down on the heel. Heel spurs and plantar fasciitis can occur alone or be related to underlying diseases that cause arthritis (inflammation of the joints), such as reactive arthritis (formerly called Reiter's disease), ankylosing spondylitis, and diffuse idiopathic skeletal hyperostosis. It is important to note that heel spurs may cause no symptoms at all and may be incidentally discovered during X-ray exams taken for other purposes.


Posterior Calcaneal Spur


Symptoms


Most heel spurs cause no symptoms and may go undetected for years. If they cause no pain or discomfort, they require no treatment. Occasionally, a bone spur will break off from the larger bone, becoming a ?loose body?, floating in a joint or embedding itself in the lining of the joint. This can cause pain and intermittent locking of the joint. In the case of heel spurs, sharp pain and discomfort is felt on the bottom of the foot or heel.


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


Rest your foot. Reduce the amount of weight-bearing activities you participate in. Get off of your feet and elevate them. This will allow healing to begin. Apply ice to your foot. Applications of ice packs that provide a comfortable cooling to the heel and arch (not a freezing cold) will help reduce pain, swelling, and inflammation. Apply the ice to the heel and arch (not the toes). Make sure it is comfortable, and leave on your foot for about 20 minutes, 3 times a day. If you have any medical problems such as diabetes, poor circulation, etc., discuss the use of ice with your doctor before applying the ice. Active Wrap allows you to apply comfortable cold therapy to your foot without messy ice cubes. Use while on the ?go.? Do not walk with bare feet. Always protect your heels, arches, and plantar fascia with good supportive shoes. Vionic Orthotic Flip Flops For Men and Women are designed for walking comfort with built in orthotic foot beds that help reduce foot pain from heel spurs. Use in the house or on the beach.


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.


Prevention


To prevent this condition, wearing shoes with proper arches and support is very important. Proper stretching is always a necessity, especially when there is an increase in activities or a change in running technique. It is not recommended to attempt working through the pain, as this can change a mild case of heel spurs and plantar fascitis into a long lasting and painful episode of this condition.

Admin · 9 views · 0 comments
Sep252015

What Is The Perfect Resolution For Inferior Calcaneal Spur

Calcaneal Spur


Overview


A heel spur is a calcium deposit on the underside of the heel bone, often caused by strain on foot muscles and ligaments. Heel spurs are common among athletes but also tend to develop as we age, as flexibility decreases. Heel spurs can be painful when associated with plantar fasciitis, an inflammation of the connective tissue that runs along the bottom of the foot and connects the heel bone to the ball of the foot.


If left untreated, the mild aches associated with this condition can evolve into chronic pain. And as you try to compensate for the pain, your gait may change, which could impact your knee, hip and back.


Causes


A heel spur is a bony overgrowth on the bottom of your heel bone. The heel spur is usually a result of an inflamed ligament (plantar fascia) on the bottom of the foot that attaches to the heel bone. Constant abnormal pulling of this ligament irritates the heel bone and the body lays down a bone spur as a protective mechanism. The patient usually complains of pain with the first step in the morning, some relief following activity, but returning after extended amounts of time standing or walking.


Inferior Calcaneal Spur


Symptoms


The vast majority of people who have heel spurs feel the asscociated pain during their first steps in the morning. The pain is quite intense and felt either the bottom or front of the heel bone. Typically, the sharp pain diminishes after being up for a while but continues as a dull ache. The pain characteristically returns when first standing up after sitting for long periods.


Diagnosis


Your doctor, when diagnosing and treating this condition will need an x-ray and sometimes a gait analysis to ascertain the exact cause of this condition. If you have pain in the bottom of your foot and you do not have diabetes or a vascular problem, some of the over-the-counter anti-inflammatory products such as Advil or Ibuprofin are helpful in eradicating the pain. Pain creams, such as Neuro-eze, BioFreeze & Boswella Cream can help to relieve pain and help increase circulation.


Non Surgical Treatment


Heel spurs can be solved with simple solutions that do not involve surgery. Avoiding extended periods of activity such as running, sports and walking. Applying ice directly to the heel for 5 minutes at a time. This helps soothe and reduce inflammation. Lose weight to reduce stress on your heels. A series of simple exercises. Inexpensive orthotic shoe inserts. The best way to treat heel spurs is by treating the underlying cause of the problem. This involves correcting the dynamics of your foot motion with orthotic insoles.


Surgical Treatment


Though conservative treatments for heel spurs work most of the time, there are some cases where we need to take your treatment to the next level. Luckily, with today?s technologies, you can still often avoid surgery. Some of the advanced technologies to treat a Heel Spur are Platelet Rich Plasma Therapy. Platelet Rich Plasma Therapy (also known as PRP) is one of several regenerative medicine techniques that University Foot and Ankle Institute has helped bring to foot and ankle care. This amazing in-office procedure allows the growth factors in the blood to be used to actually begin the healing process again long after your body has given up on healing the area. Heel Pain Shockwave Therapy. Shockwave therapy is a non-invasive procedure done in the office that allows for new blood to get to the region of fascia damage and help with healing. Results have been excellent with more than 70 percent of patients getting relief with only one treatment. Topaz for Heal Spurs and pain. Another minimally invasive technology technique is called Coblation Surgery using a Topaz probe. This minimally invasive procedure involves controlled heating of multiple tiny needles that are inserted through the skin and into the plantar fascia. This process, like PRP and Shockwave therapy, irritates the fascia enough to turn a chronic problem back into an acute problem, greatly increasing the chances of healing. Heel Spur Surgery. Endoscopic Plantar Fasciotomy is one surgical procedure that we consider to release the tight fascia. University Foot and Ankle Institute has perfected an endoscopic (camera guided) approach for fascia release to allow rapid healing and limited downtime with minimal pain.

Admin · 11 views · 0 comments
Aug232015

Debilitating Bursitis Of The Feet

Overview


A bursa is a fluid-filled sac. There are hundreds of deep and superficial bursae throughout the human body. They are typically located near major joints. Bursae are situated between bone and soft tissues like tendons, ligaments, muscles, and skin. They serve as a cushioning pad to absorb shock. The fluid within the sac is secreted to assist with friction-free movement as the soft tissues move across a bony area.


Causes


Occasionally the bursal sac can become inflamed and painful. Pain to the region is worse typically with initial weight bearing activity such as rising from bed in the morning. Swelling and warmth to the region are common. Clinical examination shows pain to palpation at the retrocalcaneus at a level just before the Achilles tendon. Increase pressure and friction of the Achilles tendon across the retrocalcaneal region is the cause of this bursitis. A high arch, tight Achilles tendon or bone spur appear to be some of the main causes of this problem. With a high arch the back portion of the calcaneus abnormally projects into the Achilles tendon region.


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


The doctor will discuss your symptoms and visually assess the bones and soft tissue in your foot. If a soft tissue injury is suspected, an MRI will likely be done to view where and how much the damage is in your ankle. An x-ray may be recommended to rule out a bone spur or other foreign body as the cause of your ankle pain. As the subcutaneous bursa is close to the surface of the skin, it is more susceptible to septic, or infectious, bursitis caused by a cut or scrape at the back of the heel. Septic bursitis required antibiotics to get rid of the infection. Your doctor will be able to determine whether there is an infection or not by drawing a small sample of the bursa fluid with a needle.


Non Surgical Treatment


All types of bursitis often can be successfully managed non-surgically, and possible treatments include use of ice packs or compressive dressings, activity modification that may reduce stress or irritation, administration of nonsteroidal anti-inflammatory drugs (NSAIDs) or antibiotics, corticosteroid injections (knee and elbow), stretching exercises, and/or change of footwear (heel). Surgery may be required in patients whose symptoms remain following these treatments and in certain situations when infection is involved.


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


Because many soft tissue conditions are caused by overuse, the best treatment is prevention. It is important to avoid or modify the activities that cause problems. Underlying conditions such as leg length differences, improper position or poor technique in sports or work must be corrected. Be aware of potential overuse or injury in your daily activities and change your lifestyle to prevent problems. Otherwise, problems may persist or occur repeatedly. Following are some ways you can avoid future problems. Wear walking or jogging shoes that provide good support. High-top shoes provide support for people with ankle problems. Wear comfortable shoes that fit properly. Wear heel cups or other shoe inserts as recommended by your doctor. Exercise on level, graded surfaces.

Admin · 19 views · 0 comments
Aug192015

Hammer Toe Surgery Foot Problems

HammertoeOverview


Hammer toes is a type of crooked toe that involve unnatural contracture, or bending, of your toes. In most cases, a hammertoe is characterized by a toe malposition in which the end of your affected toe points down and the first joint of your same toe-your proximal interphalangeal joint-points up. This crooked toe syndrome usually leads to rubbing within your shoe and pain. A hammertoe resembles an upside-down letter v when viewed from the side. This crooked toe syndrome most commonly affects your second to fifth toes, though it may also affect your big toe. This health problem is more commonly experienced by women than men.


Causes


Wearing ill-fitting shoes is probably the main cause of hammer toe. As the toe bends, tendons add to the problem by contracting in such a way that the bending is reinforced to the point of becoming permanent. In some cases, tendons that are abnormal to begin with may start the bending process.


HammertoeSymptoms


The most obvious symptom of hammertoe is the bent, hammer-like or claw-like appearance of one or more of your toes. Typically, the proximal joint of a toe will be bending upward and the distal joint will be bending downward. In some cases, both joints may bend downward, causing the toes to curl under the foot. In the variation of mallet toe, only the distal joint bends downward. Other symptoms may include Pain and stiffness during movement of the toe, Painful corns on the tops of the toe or toes from rubbing against the top of the shoe's toe box, Painful calluses on the bottoms of the toe or toes, Pain on the bottom of the ball of the foot, Redness and swelling at the joints. If you have any of these symptoms, especially the hammer shape, pain or stiffness in a toe or toes, you should consider consulting your physician. Even if you're not significantly bothered by some of these symptoms, the severity of a hammertoe can become worse over time and should be treated as soon as possible. Up to a point hammertoes can be treated without surgery and should be taken care of before they pass that point. After that, surgery may be the only solution.


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 hammertoes 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


Conservative treatment is the first choice, often starting with a change of shoes to ones that have soft, larger toe spaces. Toe exercises may be prescribed to stretch and strengthen the toe muscles. Over-the-counter straps, cushions or non-medicated corn pads may be recommended to help relieve your symptoms.


Surgical Treatment


As previously mentioned it?s best to catch this problem early; hammer toe taping is relatively harmless and simple. Long term complications can cause foot deformities and even difficulty walking. It?s always best to stiff shoes and high heel, especially if you?re working on hammer toe recovery. Pick comfortable shoes with plenty of toe space. Prevention is the best cure here as this injury is nearly always self inflicted.


Hammer ToePrevention


You can avoid many foot, heel and ankle problems with shoes that fit properly. Here's what to look for when buying shoes. Adequate toe room. Avoid shoes with pointed toes. Low heels. Avoiding high heels will help you avoid back problems. Adjustability. Laced shoes are roomier and adjustable.

Admin · 425 views · 0 comments
Jun252015

Hammer Toe Inducing Knee Pain

Hammer ToeOverview


Hammertoes are quite common and may range from mild to severe. A Hammer toe is a contracture, or bending, of one or more toes, usually due to an imbalance between the muscles or tendons on the top and bottom of the toes. Over time, the affected toes lose flexibility, becoming rigid and fixed in a contracted position. The abnormal bend positions the knuckle of the toe upward, causing it to push against the top of the shoe leading to additional problems. The condition Hammer toe usually becomes progressively worse if not treated.


Causes


Hammer toe is commonly caused by wearing shoes that are too narrow, tight or short on a regular basis. By doing so, your toe joints are forced into odd position. Over time, the tendons and muscles in your toe become shorter and cause it to bend. You can suffer a hammer toe if you have diabetes and the disease is worsening. If this occurs, you should contact your doctor right away. Arthritis can also cause hammer toes. Because your toe muscles get out of balance when you suffer from this joint disorder, tendons and joints of your toes are going to experience a lot of pressure.


HammertoeSymptoms


The most obvious sign of hammertoes are bent toes, other symptoms may include pain and stiffness during movement of the toe. Painful corns on the tops of the toe or toes from rubbing against the top of the shoe's toe box. Painful calluses on the bottoms of the toe or toes. Pain on the bottom of the ball of the foot. Redness and swelling at the joints.


Diagnosis


Hammer toes may be easily detected through observation. The malformation of the person's toes begin as mild distortions, yet may worsen over time - especially if the factors causing the hammer toes are not eased or removed. If the condition is paid attention to early enough, the person's toes may not be permanently damaged and may be treated without having to receive surgical intervention. If the person's toes remain untreated for too long, however the muscles within the toes might stiffen even more and will require invasive procedures to correct the deformity.


Non Surgical Treatment


To keep your hammertoes more comfortable, start by replacing your tight, narrow, pointy shoes with those that have plenty of room in the toes. Skip the high heels in favor of low-heeled shoes to take the pressure off your toes. You should have at least one-half inch between your longest toe and the tip of your shoe. If you don't want to go out and buy new shoes, see if your local shoe repair shop can stretch your shoes to make the toe area more accommodating to your hammertoe.


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.

Admin · 105 views · 0 comments

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